Ventricular Dysfunction, Left/physiopathology

ABCIC

Case Report

Ramp-Test Echocardiography in Patients with Long-Term Continuous-Flow Ventricular Assist Device: Case Report and Systematic Review

Marco Stephan Lofrano-Alves et al. Carolina Santana dos Reis Santos Ana Carolina Miguel Pedro Henrique Basto Miranda … Marlon Almeida Guedes Silvia Moreira Ayub-Ferreira

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Original Article

Software for Post-Processing Analysis of Strain Curves: The D-Station

Rafael Duarte de Sousa et al. Carlos Danilo Miranda Regis Ittalo dos Santos Silva Paulo Szewierenko … Renato de Aguiar Hortegal Henry Abensur

Abstract

Background

The use of speckle-tracking echocardiography for evaluation of cardiac function has great applicability in different scenarios. The broad use of this method requires tools that allow the extraction of relevant data from strain curves and inclusion of these data in traditionally used parameters.

Objectives

The present study aimed to present and validate a free software, called D-station, for analysis of strain curves.

Methods

From raw data files, the D-Station determines the phases of the cardiac cycle, and simultaneously exhibits the strain and strain rate curves of different cardiac chambers. Validation of the software was done by global longitudinal strain (GLS), and the analyses were performed: 1) graphical comparison of EchoPAC and D-Station paired measurements in relation to equality line; 2) by coefficient of correlation of these measurements; 3) test of hypothesis (p > 0.05); and 4) Bland-Altman analysis.

Results

The Spearman’s rho correlation coefficient indicated a strong correlation between the measurements. Results of the test of hypothesis showed a p-value = 0.6798 >> 0.05, thus also indicating an equivalence between the softwares. The Bland-Altman analysis revealed a bias ≤ 1% and dispersion ≤ 2% between the measurements. The tests showed that, for GLS values lower than 10%, there was a trend for higher percentage difference between the values, although the absolute values remained low.

Conclusion

The D-Station software was validated as an additional tool to the EchoPAC, which uses the raw data from the strain and strain rate curves exported from a proprietary software. (Arq Bras Cardiol. 2020; 114(3):496-506)

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Original Article

Prognostic Value of a New Marker of Ventricular Repolarization in Cirrhotic Patients

Angelo Antunes Salgado et al. Paulo Roberto Benchimol Barbosa Alinne Gimenez Ferreira Camila Aparecida de Souza Segrégio Reis Carlos Terra

Abstract

Background:

There is still debate about the relationship between changes in ventricular repolarization on the surface electrocardiogram and cirrhosis severity.

Objective:

To study the relationship between variables related to ventricular repolarization and the clinical severity of the cirrhotic disease.

Methods:

We selected 79 individuals with hepatic cirrhosis, classified according to the Child-Pugh-Turcotte criteria (Child A, B, and C). We measured the QT and corrected QT (QTc) intervals, and the interval between the peak and the end of the T wave (TpTe), and we identified their minimum, maximum, and mean values in the 12-lead electrocardiogram. We also calculated the dispersion of the QT (DQT) and QTc (DQTc) intervals.

Results:

In 12 months of clinical follow-up, nine subjects underwent hepatic transplantation (Child A: 0 [0%]; Child B: 6 [23.1%]; Child C: 3 [18.8%]; p = 0.04) and 12 died (Child A: 3 [12.0%]; Child B: 4 [15.4%]; Child C: 5 [31.3%]; p = 0.002). No significant differences were observed between the cirrhotic groups related to the minimum, maximum, and mean values for the QT, QTc, TpTe, DQT, and DQTc intervals. A minimum TpTe interval ≤ 50 ms was a predictor for the composite endpoints of death or liver transplantation with a sensitivity of 90% and a specificity of 57% (p = 0.005). In the Cox multivariate analysis, the Child groups and a minimum TpTe of ≤ 50 ms were independent predictors of the composite endpoints.

Conclusion:

The intervals QT, QTc, DQT, DQTc, and TpTe have similar distributions between different severity stages in cirrhotic disease. The TpTe interval proved to be a prognostic marker in subjects with cirrhosis, regardless of disease severity (NCT01433848).

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Ramp-Test Echocardiography in Patients with Long-Term Continuous-Flow Ventricular Assist Device: Case Report and Systematic Review

Software for Post-Processing Analysis of Strain Curves: The D-Station

Abstract

Background

Objectives

Methods

Results

Conclusion

Prognostic Value of a New Marker of Ventricular Repolarization in Cirrhotic Patients

Abstract

Background:

Objective:

Methods:

Results:

Conclusion:

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