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Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
Left ventricular deformation in chronic schizophrenia-a detailed analysis from the three-dimensional speckle-tracking
Attila Nemes1, Renáta Halcsik1, Árpád Kormányos1
1Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary.
Insights
Patients with chronic schizophrenia show reduced left ventricular (LV) function and midventricular strains, indicating subclinical cardiac damage. This highlights the need for cardiovascular monitoring in schizophrenia management.
Area of Science:
- Cardiology
- Psychiatry
- Medical Imaging
Background:
- Schizophrenia (SCH) is a severe mental disorder linked to reduced life expectancy, primarily due to cardiometabolic issues.
- Left ventricular (LV) mechanics in chronic SCH (CS-SCH) are not fully understood.
- Three-dimensional speckle-tracking echocardiography (3DSTE) offers detailed LV analysis.
Purpose of the Study:
- To evaluate LV deformation in CS-SCH patients using 3DSTE.
- To compare LV function and mechanics between CS-SCH patients and healthy controls.
Main Methods:
- A case-control study included 23 CS-SCH patients and 59 matched healthy controls.
- All participants underwent 2D Doppler echocardiography with 3DSTE analysis.
- LV volumes, ejection fraction (EF), and segmental strains were analyzed.
Main Results:
- CS-SCH patients exhibited increased LV volumes and reduced LV ejection fraction (EF) compared to controls.
- Global and mean segmental LV strains were significantly reduced in CS-SCH patients.
- Midventricular LV strains were reduced, while basal and apical strains showed no difference.
Conclusions:
- 3DSTE revealed subclinical cardiac damage in CS-SCH patients, characterized by reduced LV-EF and midventricular strains.
- These findings underscore the importance of cardiovascular assessment and management in CS-SCH.
- Early detection of cardiac abnormalities can improve long-term outcomes for schizophrenia patients.
Background:
Schizophrenia (SCH) is a severe mental disorder and one of the top 20 causes of disability, associated with a reduction in life expectancy of more than 15 years. Excess mortality rates in SCH are mainly due to complex vascular and cardiometabolic causes. However, the exact nature of the detailed structural and functional alterations in myocardial mechanics, particularly regarding left ventricular (LV) function, remains insufficiently characterized in the chronic stage of SCH (CS-SCH). The novel three-dimensional (3D) speckle-tracking echocardiography (3DSTE) enables detailed volumetric and strain analysis of the LV from a single acquired 3D echocardiographic dataset. The present study aimed to evaluate LV deformation using 3DSTE in patients with CS-SCH and to compare their data to age-, gender- and body mass index (BMI)-matched healthy controls.
Methods:
In a cross-sectional case-control design, after the initial screening of 74 CS-SCH outpatients, due to non-compliance and suboptimal image quality, 23 patients (mean age: 45.9±9.3 years, 13 males, BMI: 30.4±5.1 kg/m2) were included in the final analysis and compared to 59 healthy individuals matched for age, gender and BMI (mean age: 46.7±9.4 years, 33 men, BMI: 30.1±4.5 kg/m2). All patients and controls underwent routine two-dimensional Doppler echocardiography extended with detailed 3DSTE analysis.
Results:
Increased LV volumes were associated with reduced LV ejection fraction (EF) in patients with CS-SCH as compared to controls. All global and mean segmental LV strains were reduced in CS-SCH patients. From regional LV strains, only midventricular LV strains were reduced, whereas basal and apical LV strains did not differ between the two groups.
Conclusions:
Detailed 3DSTE-derived LV deformation analysis revealed significant abnormalities, including reduced LV-EF and reduced midventricular LV strains, indicating subclinical cardiac damage in the chronic stage of CS-SCH. These findings confirm the importance of cardiovascular assessment and management in this severe mental condition.
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