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Sanderson Cauduro

Publications and source records attributed to Sanderson Cauduro.

4 recordsLinked to original sources

Usefulness of two-dimensional speckle strain for evaluation of left ventricular diastolic deformation in patients with coronary artery disease.

We investigated the influence of > or =70% luminal coronary artery stenosis on regional diastolic deformation at rest using 2-dimensional strain echocardiography. We prospectively imaged patients during/within 24 hours of coronary angiography. Longitudinal systolic (SRs), early (SRe), and late diastolic strain rates, systolic, early, and late diastolic strain and times to isovolumic relaxation and peak SRe were measured in the 3 major vascular territories. Regions subtended by > or =70% coronary stenosis were labeled ischemic. Ischemic regions were compared with the same region in patients without significant coronary stenosis. Of 61 enrolled patients (38 men), 39 had > or =70% coronary stenosis (1 vessel in 14, 2 vessels in 15, 3 vessels in 10), and 15 had normal coronary arteries. There were no significant differences between the normal and ischemic groups with regard to age (59 +/- 13 vs 64 +/- 10 years, p = 0.20), clinical variables (dyslipidemia, smoking, diabetes), systolic (130 +/- 26 vs 139 +/- 31 mm Hg, p = 0.38) or diastolic (72 +/- 13 vs 72 +/- 11 mm Hg, p = 0.81) blood pressure and ejection fraction (58 +/- 12% vs 56 +/- 11%, p = 0.66). SRs and SRe were significantly decreased in ischemic compared with normal regions in all vascular distributions. SRs and SRe together (values below cutoff) or SRe alone were the most specific (93%) and SRe or SRs below cutoff the most sensitive (93%) parameters for detecting ischemic regions. In conclusion, analysis of regional deformation by 2-dimensional strain echocardiography enables detection of significantly diseased coronary arteries at rest. Altered diastolic deformation at rest identifies regions subtended by > or =70% coronary stenosis with high specificity.

Coronary Artery Disease↗

Two-dimensional acoustic pattern derived strain parameters closely correlate with one-dimensional tissue Doppler derived strain measurements.

BACKGROUND: Two-dimensional strain echocardiography (2D-SE) calculates tissue velocities via frame-to-frame tracking of unique acoustic markers within the image and provides strain parameters in two dimensions. Novel 2D-SE software allows semi-automated strain measurements and increased averaging capabilities optimizing signal-noise ratio. AIM: We tested whether 2D-SE and the currently used and well-validated tissue Doppler derived strain echocardiography (TD-SE) yield similar information in the clinical setting. METHODS AND RESULTS: We performed 2D-SE and TD-SE on 17 patients with amyloid cardiomyopathy and 10 age-matched healthy volunteers. Single walls from standard apical views (2- and 4-chamber) were acquired at high frame rates ( approximately 200fps). Offline analysis was performed by observers blinded to clinical data using the EchoPAC program with custom 2D-SE software. Longitudinal strain rate and strain from the basal, mid and apical segments of the septal and lateral walls were determined by each method (TD-SE and 2D-SE). Ejection fraction was >0.55 in healthy volunteers and ranged from 0.30 to 0.80 in cardiomyopathy group. A total of 54 walls (162 segments) were examined. Acceptable quality strain data was available in 92% and 85% segments by 2D-SE and TD-SE, respectively. Two-dimensional strain echocardiography values correlated closely with TD-SE values (r=0.94 and 0.96 for strain rate and strain, respectively). CONCLUSIONS: Deformation analysis by 2D-SE is feasible in a clinical setting and 2D-SE values correlate closely with TD-SE measurements over a wide range of global systolic function. Two-dimensional strain echocardiography may help to facilitate the routine clinical implementation of deformation analysis.

Acoustics↗

Relation of tissue displacement and strain to invasively determined right ventricular stroke volume.

The role of echocardiography in the clinical assessment of right ventricular (RV) systolic function remains limited. Limited data exist on the potential use of newer techniques for RV function assessment. Conventional echocardiography and tissue Doppler echocardiography (TDE) were performed during right-sided cardiac catheterization in 46 patients. Thermodilution or the Fick-derived RV stroke volume indexed (RVSVI) indexed to body surface area was used as the reference standard. Univariate and multivariate regression analyses were used to test correlations between RVSVI and various echocardiographic and TDE-derived parameters. In a subset of 12 subjects, changes in echocardiographic and TDE variables to reduced afterload from intravenous epoprostenol were measured. TDE-derived RV tissue displacement and systolic strain best predicted the RVSVI (r = 0.63, p = 0.001; r = 0.48, p = 0.002, respectively). The prediction improved after adjustment for tricuspid regurgitation jet vena contracta width (r = 0.74, p < 0.0001; r = 0.60, p < 0.001, respectively). Assuming a RVSVI of > or =30 ml/m(2) as normal, a RV displacement cutoff of 15 mm yielded a sensitivity of 100% and a specificity of 41% for RV dysfunction, and an RV systolic strain cutoff of 20% yielded a sensitivity of 91% and a specificity of 63%. The percentage change of RV systolic displacement correlated well with the percentage change of RVSVI after epoprostenol infusion (r = 0.75, p < 0.001). In conclusion, TDE-derived RV displacement and strain closely correlate with RVSVI and appropriately track load-related changes in RV function. These new parameters may help provide the noninvasive, quantitative assessment of RV function.

Cardiac Catheterization↗

Analysis of the interaction between segmental relaxation patterns and global diastolic function by strain echocardiography.

BACKGROUND: Strain echocardiography can depict segmental mechanical activity with high temporal and spatial accuracy, and may allow assessment of segmental relaxation not possible with conventional echocardiography. METHODS: Conventional and strain echocardiography were performed in healthy volunteers (young [group 1] and old [group 2]) and patients with normal 2-dimensional and stress echocardiography, with either normal global diastolic function (group 3a) or grade I or II global diastolic dysfunction (DD) (group 3b). Standard echocardiography criteria were used to define global DD. Early to late diastolic strain rate ratio less than 1.1 was defined as altered segmental relaxation. RESULTS: All participants had normal wall motion and ejection fraction. Participants of group 1 had normal segmental and global diastolic function. Participants of groups 2 and 3a demonstrated a wide range of altered segmental relaxation in the absence of global DD. All patients of group 3b had 12 or more segments with altered relaxation and global DD. Age and hypertension were associated with a larger number of altered segments, a lower mean early to late diastolic strain rate ratio, and global DD. CONCLUSIONS: A wide range of altered segmental relaxation can exist in the absence of global DD. Age and hypertension are associated with altered segmental relaxation and global DD. Assessment of segmental relaxation may be beneficial in the elderly and patients with hypertension.

Adult↗