PubMed Health⌕ Search

Biomedical subjects

Pascale Raud-Raynier

Publications and source records attributed to Pascale Raud-Raynier.

3 recordsLinked to original sources

Echocardiographic right ventricular strain analysis in chronic heart failure.

OBJECTIVE: We sought to compare the additive value of right ventricular (RV) function assessed by longitudinal systolic strain (epsilon% - ROI: 9.2 at 10.8 mm) with cardiopulmonary exercise testing (CPET) or brain natriuretic peptide (BNP) in patients with heart failure (HF). METHOD: We studied 19-patients (age = 56 +/- 8 years) in New York Heart Association HF class III-IV, who underwent standard and tissue Doppler echocardiography, CPET and BNP measurements on the same day. RV function was assessed by systolic strain (epsilon, %, ROI: 9.2-10.8 mm) in the mid-segment. Clinical outcomes were examined at 6 months. RESULTS: epsilon (-19.9+/-6.8%) was correlated with BNP (R = 0.52, P = 0.02), slope VE/VCO(2) (R = -0.65, P = 0.003), peak VO(2) (R = 0.46, P = 0.04) and the maximal workload (Watts) developed during CPET (R = 0.54, P=0.02). During follow-up, 1-patient died, 1-underwent heart transplantation, and 4 were re-hospitalized for worsening HF. Patients with major adverse cardiac events (MACE) had a significantly higher mean BNP concentration (852.8 ng/mL +/- 1114.3 vs. 201.4+ /- 293.8, P = 0.03), higher VE/VCO(2) (41.3 +/- 3.6 vs. 35.0 +/- 4.8 P < 0.001) and lower epsilon (-13.9 +/- 4.9 vs. -22.2+ /- 5.8, P < 0.001) than patients who remained MACE-free. By multivariate analysis, ST was the only predictor of MACE. CONCLUSION: In HF-patients presenting, RV-function assessed by systolic epsilon was reliable, easily measurable and a stronger prognosticator than CPET or BNP.

Chronic Disease↗

Tissue Doppler echocardiographic quantification. Comparison to coronary angiography results in Acute Coronary Syndrome patients.

BACKGROUND: Multiples indices have been described using tissue Doppler imaging (DTI) capabilities. The aim of this study was to assess the capability of one or several regional DTI parameters in separating control from ischemic myocardium. METHODS: Twenty-eight patients with acute myocardial infarction were imaged within 24-hour following an emergent coronary angioplasty. Seventeen controls without any coronary artery or myocardial disease were also explored. Global and regional left ventricular functions were assessed. High frame rate color DTI cineloop recordings were made in apical 4 and 2-chamber for subsequent analysis. Peak velocity during isovolumic contraction time (IVC), ejection time, isovolumic relaxation (IVR) and filling time were measured at the mitral annulus and the basal, mid and apical segments of each of the walls studied as well as peak systolic displacement and peak of strain. RESULTS: DTI-analysis enabled us to discriminate between the 3 populations (controls, inferior and anterior AMI). Even in non-ischemic segments, velocities and displacements were reduced in the 2 AMI populations. Peak systolic displacement was the best parameter to discriminate controls from AMI groups (wall by wall, p was systematically < 0.01). The combination IVC + and IVR< 1 discriminated ischemic from non-ischemic segments with 82% sensitivity and 85% specificity. CONCLUSION: DTI-analysis appears to be valuable in ischemic heart disease assessment. Its clinical impact remains to be established. However this simple index might really help in intensive care unit routine practice.

Acute Disease↗

Quantitative regional analysis of left atrial function by Doppler tissue imaging-derived parameters discriminates patients with posterior and anterior myocardial infarction.

BACKGROUND: Doppler tissue imaging can now be used for the assessment of left atrial (LA) function. LA function was evaluated by this technique in a group of patients hospitalized for acute myocardial infarction and in a control population. METHODS: Patients were all prospectively imaged with a scanner. To study the LA, a region of interest was located in the proximal part of the lateral and septal LA walls. Doppler tissue imaging, tissue tracking, strain, and delays were recorded. RESULTS: In all, 12 patients with posterior (age 54 +/- 9 years) and 13 with anterior (age 64 +/- 16 years) acute myocardial infarction, along with 16 control patients (age 54 +/- 9 years), were analyzed. Early diastolic septal velocity was found to be the best parameter for discriminating among the 3 groups. Peak strain was also relevant and did not correlate with left ventricular function. CONCLUSIONS: LA is accessible to Doppler tissue imaging analysis. Strain can quantify LA function relatively independently of left ventricular function, and may provide new insights on LA function.

Aged↗