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Advances in Multimodality Approach to Echocardiographic Imaging: Deformation Indexes, 3D-Evaluations, and Future Perspectives

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A special issue of Applied Sciences (ISSN 2076-3417). This special issue belongs to the section "Applied Physics General".

Deadline for manuscript submissions: closed (31 December 2021) | Viewed by 18382

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Prof. Dr. Pietro Scicchitano

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Cardiology Department, Perinei Hospital, Bari, Italy
Interests: noninvasive assessment; heart failure; arrhythmias; preventive cardiology; cardiovascular pharmacology; cardio-oncology
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Marco Matteo Ciccone

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Department of Cardiology, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
Interests: cardiovascular imaging; peripheral artery and venous diseases; preventive cardiology; clinical trials; vascular ultrasound; heart failure
Special Issues, Collections and Topics in MDPI journals

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Dear Colleagues,

Revolutionary approaches are emerging within the evaluation of cardiovascular systems. From the ancient M-mode ultrasound visualization of cardiac chambers, advances in technology have provided physicians with new tools that enable the objective evaluation of cardiac and vascular systems. The main aims were to firstly overcome the inter-observer variability and, secondly, to ameliorate the intra-observer variability, which would allow for a detailed visualization of cardiac and vascular tissues. This is fundamental for assuring the most objective evaluation of patients and the exact measurement of cardiac and vascular parameters.

Echocardiography is facing revolutionary advances in techniques. Multimodality approaches have been created and approved for daily evaluation of all types of patients and controls.

The three-dimensional approach within imaging systems for cardiovascular system evaluation is emerging as a reliable tool able to overcome the reproducibility concerns of previous methods.

Deformation indexes provided detailed evaluations of subtle alterations in cardiac chambers function and early detection of the signs for pre-clinical alterations in cardiac performances.

The application of 3D imaging software to echocardiography has revolutionized the evaluation of images, although some technical disadvantages persist. Computed tomography and magnetic resonance have acquired 3D capability and become some of the most prominent of the available cardiovascular imaging techniques.

Finally, vascular ultrasound is emerging as a new field in which 3D techniques are presenting advantages over their alternatives. The definition of peripheral plaques and the representation of the vessels in a three-dimensional fashion will certainly improve the diagnostic skills of physicians.

The aim of this Special Issue is to provide a full, comprehensive, and exhaustive overview of the application of the different echocardiographic techniques in cardiovascular imaging, the state of art, indications regarding their use in daily laboratory practices, and the future developments of such techniques.

Dr. Pietro Scicchitano
Prof. Marco Matteo Ciccone
Guest Editors

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Keywords

three-dimensional imaging
cardiovascular imaging
echocardiography
peripheral vascular ultrasound
preventive cardiology
accuracy

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Published Papers (6 papers)

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Editorial

Jump to: Research, Review

3 pages, 188 KiB

Open AccessEditorial

Next-Generation Approaches to Echocardiography: Clinical Perspectives

by Pietro Scicchitano and Marco Matteo Ciccone

Appl. Sci. 2023, 13(1), 227; https://doi.org/10.3390/app13010227 - 24 Dec 2022

Viewed by 1131

Abstract

The application of imaging to cardiovascular diseases fosters the diagnosis, clinical management, and risk stratification of patients, thus leading to the early detection of cardiac and vascular diseases [...] Full article

(This article belongs to the Special Issue Advances in Multimodality Approach to Echocardiographic Imaging: Deformation Indexes, 3D-Evaluations, and Future Perspectives)

Research

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14 pages, 2042 KiB

Open AccessFeature PaperArticle

Influence of Heart Rate on Left and Right Ventricular Longitudinal Strain in Patients with Chronic Heart Failure

by Vito Di Terlizzi, Roberta Barone, Vincenzo Manuppelli, Michele Correale, Grazia Casavecchia, Giovanni Goffredo, Pierluigi Pellegrino, Alessandra Puteo, Riccardo Ieva, Matteo Di Biase, Natale Daniele Brunetti and Massimo Iacoviello

Appl. Sci. 2022, 12(2), 556; https://doi.org/10.3390/app12020556 - 6 Jan 2022

Cited by 6 | Viewed by 1744

Abstract

Over the past years, a number of studies have demonstrated the relevance of strain assessed by two-dimensional speckle tracking echocardiography (STE) in evaluating ventricular function. The aim of this study was to analyze changes in left (LV) and right ventricular (RV) longitudinal strain associated with variations of heart rate (HR) in participants with and without chronic heart failure (CHF). We enrolled 45 patients, 38 of these diagnosed with CHF and carrying an implantable cardioverter defibrillator, and seven patients with pacemakers and without CHF. The frequency of atrial stimulation was increased to 90 beats/min and an echocardiogram was performed at each increase of 10 beats/min. Global LV and RV longitudinal strain (LVGLS and RVGLS, respectively) and RV free wall longitudinal strain (RVfwLS) were calculated at each HR. When analyzed as continuous variables, significant reductions in LVGLS were detected at higher HRs, whereas improvements in both RVGLS and RVfwLS were observed. Patients with a worsening of LVGLS (76% overall) were more likely to present lower baseline LV function. Only a few patients (18% for RVGLS and 16% for RVfwLS) exhibited HR-related deteriorations of RV strain measures, which was associated with lower levels of baseline RV function and higher pulmonary systolic pressures. Finally, 21 (47%) and 25 (56%) participants responded with improvements in RVGLS and RVfwLS, respectively. Our findings revealed heterogeneous RV and LV responses to increases in HR. These findings might ultimately be used to optimize cardiac functionality in patients diagnosed with CHF. Full article

(This article belongs to the Special Issue Advances in Multimodality Approach to Echocardiographic Imaging: Deformation Indexes, 3D-Evaluations, and Future Perspectives)

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11 pages, 542 KiB

Open AccessArticle

Vascular and Cardiac Prognostic Determinants in Patients with Gynecological Cancers: A Six-Year Follow-up Study

by Pietro Scicchitano, Marco Tucci, Gabriella Ricci, Michele Gesualdo, Santa Carbonara, Giuseppe Totaro, Annagrazia Cecere, Rosa Carbonara, Francesca Cortese, Vera Loizzi, Gennaro Cormio, Ettore Cicinelli and Marco Matteo Ciccone

Appl. Sci. 2021, 11(13), 6091; https://doi.org/10.3390/app11136091 - 30 Jun 2021

Cited by 1 | Viewed by 1852

Abstract

Background: The aim of this study was to assess the role of cardiac and vascular parameters as all-cause mortality determinants in patients suffering from gynecological cancers. Methods: This was an observational, prospective, non-randomized, and non-controlled study. Forty-seven consecutive patients (mean age: 58 ± 13 years) were enrolled after cancer staging. All patients underwent evaluation of vascular (common carotid intima-media thickness (mean C-IMT), flow-mediated dilation of the brachial artery (FMD), and antero-posterior diameter of the infrarenal abdominal aorta (APAO)) and cardiac function and morphology before cancer-related interventions. A 6-year follow-up was carried out to assess the overall survival of the whole population. Results: Twenty patients (42%) died by the time of the 6-year follow-up. The brachial artery FMD values were higher in the survivors than the non-survivors (9.71 ± 3.53% vs. 6.13 ± 2.62%, p < 0.001), as well as the LVEF (60.8 ± 3.0% vs. 57.8 ± 4.4%, p = 0.009). There were no differences in the mean C-IMT, APAO, and other echocardiographic parameters. ROC curve analysis identified a baseline LVEF < 57% and FMD value < 5.8% as the best cut-offs. Kaplan–Meier evaluation showed that the LVEF, tricuspid annular plane systolic excursion, and FMD were the best predictors of all-cause mortality, although only the LVEF and FMD were confirmed in multivariate Cox regression analysis. Conclusions: The LVEF and brachial artery FMD are independent prognostic determinants in patients with gynecological cancers. Full article

(This article belongs to the Special Issue Advances in Multimodality Approach to Echocardiographic Imaging: Deformation Indexes, 3D-Evaluations, and Future Perspectives)

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11 pages, 1169 KiB

Open AccessArticle

Right Ventricular Global and Regional Remodeling in American-Style Football Athletes: A Longitudinal 3D Echocardiographic Study

by Amir Hodzic, Gabriel Bernardino, Damien Legallois, Patrick Gendron, Hélène Langet, Mathieu De Craene, Miguel A. González Ballester, Paul Milliez, Hervé Normand, Bart Bijnens, Eric Saloux and Francois Tournoux

Appl. Sci. 2021, 11(8), 3357; https://doi.org/10.3390/app11083357 - 8 Apr 2021

Cited by 3 | Viewed by 2166

Abstract

Few data exist concerning the right ventricular (RV) physiological adaptation in American-style football (ASF) athletes. We aimed to analyze the RV global and regional responses among ASF-trained athletes. Fifty-nine (20 linemen and 39 non-linemen) ASF athletes were studied before and after inter-seasonal training. During this period, which lasted 7 months, all athletes were exposed to combined dynamic and static exercises. Cardiac longitudinal changes were examined using three-dimensional transthoracic echocardiography. A computational method based on geodesic distances was applied to volumetrically parcellate the RV into apical, outlet, and inlet regions. RV global and regional end-diastolic volumes increased significantly and similarly in linemen and non-linemen after training, with predominant changes in the apex and outlet regions. RV global and regional ejection fractions were preserved. Morphological changes were uniformly distributed among the four cardiac chambers, and it was independent of the field position. Assessment of RV end-diastolic global, inlet and apical volumes showed low intra-observer (3.3%, 4.1%, and 5.3%, respectively) and inter-observer (7%, 12.2%, and 9%, respectively) variability, whereas the outlet regional volumetric assessment was less reproducible. To conclude, ASF inter-seasonal training was associated with a proportionate biventricular enlargement, regardless of the field position. Regional RV analysis allowed us to quantify the amount of exercise-induced remodeling that was larger in the apical and outlet regions. Full article

(This article belongs to the Special Issue Advances in Multimodality Approach to Echocardiographic Imaging: Deformation Indexes, 3D-Evaluations, and Future Perspectives)

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Review

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17 pages, 40477 KiB

Open AccessReview

Multi-Modality Cardiovascular Imaging Assessment in Fabry Disease

by Ashwin Roy, Mohamed Mansour, David Oxborough, Tarekegn Geberhiwot and Richard Steeds

Appl. Sci. 2022, 12(3), 1605; https://doi.org/10.3390/app12031605 - 2 Feb 2022

Cited by 1 | Viewed by 2950

Abstract

Fabry disease (FD) is a rare X-linked lysosomal storage disorder manifesting as progressive multi-organ accumulation of sphingolipids due to deficiency in the enzyme α-Galactosidase A. Sphingolipid accumulation can take place in all cardiac cell types which manifests as left ventricular hypertrophy, microvascular ischaemia, conduction abnormalities, arrhythmia, heart failure, and valvular disease. The use of advanced cardiovascular imaging techniques have enabled clinicians to stage and prognosticate the disease and guide therapy. Transthoracic echocardiography (TTE) and cardiac magnetic resonance imaging (CMR) in conjunction are the hallmark imaging modalities to allow for this assessment. Traditionally, the assessment of cardiac involvement in FD was based on the assessment of maximal wall thickness (MWT) and the development of left ventricular hypertrophy (LVH). It is now understood that sphingolipid accumulation takes place before the development of LVH. Advances in techniques within TTE and CMR, particularly that of strain assessment and T1/T2 mapping, have meant that Fabry cardiomyopathy (FCM) can be diagnosed earlier in the disease process. This potentially provides a window for initiation of enzyme replacement therapy (ERT) at a stage where it is likely to have the most beneficial effect in reducing the high mortality associated with FCM. This review outlines the advances in multimodality imaging in staging and prognosticating FCM, as well as the applications of cardiac imaging in assessing symptoms and complications of FCM. Full article

(This article belongs to the Special Issue Advances in Multimodality Approach to Echocardiographic Imaging: Deformation Indexes, 3D-Evaluations, and Future Perspectives)

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36 pages, 14428 KiB

Open AccessFeature PaperReview

Echocardiography in the Diagnosis and Management of Tricuspid Atresia

by P. Syamasundar Rao

Appl. Sci. 2021, 11(20), 9472; https://doi.org/10.3390/app11209472 - 12 Oct 2021

Cited by 4 | Viewed by 7564

Abstract

This review focuses on the utility of echocardiographic studies in the diagnosis of tricuspid atresia (TA) and in its management. Tricuspid atresia is a cyanotic congenital heart defect (CHD) accounting for nearly 1.5% of all CHDs. It is generally classified according to the morphology of the atretic tricuspid valve and associated heart defects. Following the description of the anatomic features of TA, echocardiographic features characteristic for TA were illustrated. Subsequent to a review of palliative and corrective procedures to treat TA, echocardiographic evaluation at each stage of Fontan was detailed. The role of echocardiography in the assessment of cardiac defects responsible for interstage mortality was also addressed. It was concluded that echo-Doppler studies are useful in the diagnosis and management of TA. Full article

(This article belongs to the Special Issue Advances in Multimodality Approach to Echocardiographic Imaging: Deformation Indexes, 3D-Evaluations, and Future Perspectives)

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