Speckle tracking echocardiography for evaluation of myocardial functions before and after mitral valvuloplasty in dogs

Figures

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  Figure 1. Representative echocardiogram images before, 1 month, and 3 months after mitral valvuloplasty (MVP) in dog patients. Two-dimensional echocardiography at the long-axis LV inflow view demonstrating the thickening of the mitral valve, enlarged left ventricle and left atrium chambers with mitral valve regurgitation (A) and elevated mitral inflow velocity (B) before MVP. Following mitral MVP, there was significant restoration in cardiac functional parameters, characterized by reduced left ventricular and atrium lumen size (C,E) and reduced early mitral inflow velocities (D,F). LA, left atrium; LV, left ventricle.

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  Figure 2. Longitudinal strains of the left and right ventricles before, at 1 month, and at 3 months After MVP using two-dimensional speckle tracking echocardiography. A central line demonstrated the downward peak strain was captured.

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  Figure 3. Global circumferential strain (GCS) and global radial strain (GRS) before, at 1 month, and at 3 months after mitral valvuloplasty (MVP) using 2D-STE.

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  Figure 4. Left ventricular (LV) twist before, at 1 month, and at 3 months after MVP. Blue curve: LV twist, yellow curve: apex rotation, pink curve: base rotation.

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  Figure 5. Twist, LV GLS, RVFW GLS Analysis via 2D-STE. (A) Twist: no significant changes were noted between preoperative and 1-month postoperative assessments, but a notable increase was observed at 3 months postoperatively compared to preoperative (p = 0.039). (B) LV-GLS: there was a significant decrease at 1 month (p = 0.0078) and 3 months (p = 0.0156) post-surgery compared to preoperative. (C) RVFW-GLS: no significant changes were observed at 1 month and 3 months post-surgery compared to preoperative. (D) GCS: there was a significant decrease at 1 month (p = 0.0078) and 3 months (p = 0.0078) post-surgery compared to preoperative. (E) GRS: there was a significant decrease at 1 month (p = 0.0078) and 3 months (p = 0.0078) post-surgery compared to preoperative. Data are presented as medians with interquartile ranges. An asterisk (*) indicates significance in the comparison between preoperative and postoperative values (*indicates p < 0.05, **indicates p < 0.01).

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  Figure 6. Twist, LV GLS, RVFW GLS analysis via 2D-STE in ACVIM Stage D cases. (A) Twist: no significant differences were noted at 1 month (p = 0.3125) and 3 months (p = 0.0625) post-surgery compared to preoperative values. (B) LV GLS: no significant differences were observed at 1 month (p = 0.1250) and 3 months (p = 0.1250) post-surgery compared to preoperative values. (C) RVFW GLS: no significant differences were observed at 1 month (p = 0.3750) and 3 months (p = 0.2500) post-surgery compared to preoperative values.

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  Figure 7. Linear regression analysis between indices of contractility (FS), congestion (E velocity), diastolic function (E/e′), left ventricular sphericity index (LVSI), left ventricular internal diameter in diastole (LVIDd), left ventricular internal diameter in diastole normalized (LVIDDN), and twist, FS, E velocity, and E/e′ lateral did not exhibit a significant regression with twist. In contrast, LVIDd, LVIDDN, and LVSI showed a significant impact on twist.

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  Figure 8. The collective data demonstrated a mild significant effect of LVIDDN on twist. However, the effect of LVIDDN on twist was notably stronger when considering only the preoperative data. Additionally, the degree of cardiac twisting was positively influenced by the regurgitation velocity preoperatively.

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  Figure 9. Linear regression analysis between global circumferential strain (GCS) and global radial strain (GRS) and twist, LVIDd, and LVIDDN. There was a significant effect of GCS on LVIDd and LVIDDN. Similarly, GRS exhibited a significant effect on LVIDd and LVIDDN. However, there was no significant effect of GCS or GRS on twist.

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  Figure 10. Linear regression analysis between 2D-STE parameters obtained from LV and RVFW-GLS. LV-GLS had a mild significant effect on RVFW-GLS. On the other hand, there was no significant effect of RVFW-GLS on twist, GCS and GRS.