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Article: Right atrial volumes and strains in healthy adults: is the Frank-Starling mechanism working?-detailed analysis from the three-dimensional speckle-tracking echocardiographic MAGYAR-Healthy Study.

Nemes, Attila / Kormányos, Árpád

Quantitative imaging in medicine and surgery

2022 Volume 13, Issue 2, Page(s) 825–834

Abstract: Background: With larger blood volume flowing into a cardiac chamber, by stretching muscle fibers, increased contraction force could be detected. This phenomenon is called Frank-Starling mechanism, allowing the output of a cardiac chamber to be ... ...

Abstract	Background: With larger blood volume flowing into a cardiac chamber, by stretching muscle fibers, increased contraction force could be detected. This phenomenon is called Frank-Starling mechanism, allowing the output of a cardiac chamber to be synchronized without external regulation. The purpose of the present study was to investigate the Frank-Starling mechanism in the right atrium (RA) represented by its volumes, volume-based functional properties and strains respecting the cardiac cycle in healthy adults by three-dimensional (3D) speckle-tracking echocardiography (3DSTE). Methods: The present single center retrospective cohort study comprised 179 healthy adult volunteers (mean age: 33.2±12.0 years, 92 males), in whom complete two-dimensional Doppler echocardiography with 3DSTE was performed. Subjects were divided into 3 groups according to the mean value of maximum RA volume (V Results: All RA volumes respecting the cardiac cycle of all subjects and calculated separately for females and males and their indexed equivalents increased with V Conclusions: Increasing RA volumes do not cause significant increase in RA contractility represented by strains, but reduction in strains in longitudinal and circumferential directions could be detected in end-diastolic booster pump function. In contrast to the left atrium, obvious signs of Frank-Starling mechanism could not be detected in case of the RA.
Language	English
Publishing date	2022-12-08
Publishing country	China
Document type	Journal Article
ZDB-ID	2653586-5
ISSN	2223-4306 ; 2223-4292
ISSN (online)	2223-4306
ISSN	2223-4292
DOI	10.21037/qims-22-307
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Article: The mitral annulus in transposition of the great arteries late after Senning- and Mustard-procedures (Insights from the CSONGRAD Registry and MAGYAR-Path Study).

Nemes, Attila / Kormányos, Árpád

Cardiovascular diagnosis and therapy

2022 Volume 12, Issue 5, Page(s) 646–654

Abstract: Background: Dextro-transposition of the great arteries (dTGA) is a rare condition comprising 5-7% of all congenital heart diseases (CHD). Until 1990s, atrial switch operations were the method of choice for the treatment of dTGA. The aim of our present ... ...

Abstract	Background: Dextro-transposition of the great arteries (dTGA) is a rare condition comprising 5-7% of all congenital heart diseases (CHD). Until 1990s, atrial switch operations were the method of choice for the treatment of dTGA. The aim of our present study was to evaluate the abnormalities of the mitral annulus (MA) by three-dimensional speckle-tracking echocardiography (3DSTE). Potential differences in MA dimensions and functional properties late after Senning- and Mustard-procedures were analyzed as well. Methods: This retrospective cohort study comprised 19 dTGA patients late after atrial switch operation, from which 7 subjects were not involved due to inferior image quality. The remaining dTGA patient group comprised 12 subjects (age: 30.7±8.6 years, 7 males). For comparisons, 32 age- and gender-matched healthy controls were evaluated (age: 34.4±12.3 years, 18 males). Results: End-systolic and end-diastolic MA diameter (MAD), area and perimeter proved to be increased, while MA functional parameters [MA fractional area change (MAFAC) and fractional shortening (MAFS)] were reduced in all dTGA patients as compared to matched controls regardless of the atrial switch procedure used. However, MA morphological parameters were tendentiously lower, while MA functional parameters were tendentiously favorable in case of Senning-procedure compared to Mustard-procedure. Conclusions: dTGA is accompanied by MA dilation and its functional impairment late after Senning- and Mustard-procedures.
Language	English
Publishing date	2022-10-28
Publishing country	China
Document type	Journal Article
ZDB-ID	2685043-6
ISSN	2223-3660 ; 2223-3652
ISSN (online)	2223-3660
ISSN	2223-3652
DOI	10.21037/cdt-22-208
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Article ; Online: Echocardiographic evaluation of the left ventricular global myocardial work

Nemes, Attila / Kormányos, Árpád

Orvosi hetilap

2022 Volume 163, Issue 13, Page(s) 495–499

Abstract: Összefoglaló. A bal kamra funkciójának megítélésére számos echokardiográfiás paraméter alkalmas. Bár a bal kamrai ejekciós frakció és a globális longitudinális strain széleskörűen alkalmazott paraméterek, használatuk során limitáló tényezők változatlanul ...

Title translation	A bal kamrai globális myocardialis munka echokardiográfiás vizsgálata.
Abstract	Összefoglaló. A bal kamra funkciójának megítélésére számos echokardiográfiás paraméter alkalmas. Bár a bal kamrai ejekciós frakció és a globális longitudinális strain széleskörűen alkalmazott paraméterek, használatuk során limitáló tényezők változatlanul fennállnak. A globális myocardialis munka noninvazív meghatározása ma már elérhető klinikai lehetőség, mely kombinálja a speckle-tracking echokardiográfiás strainanalízist a brachialis artériában mandzsettával systoléban mért vérnyomásértékkel. Az így számítható paraméterek töltéstől független lehetőséget nyújtanak a bal kamra funkciójának jellemzésére. A jelen összefoglaló mű célja ennek az új módszernek a rövid bemutatása a korai eredmények ismertetése mellett, irodalmi adatok alapján. Orv Hetil. 2022; 163(13): 495-499. Summary. Several echocardiographic parameters are suitable for the evaluation of left ventricular function. Although left ventricular ejection fraction and global longitudinal strain are widely used parameters, limitations are still persisting. Non-invasive estimation of global myocardial work has become a new clinical opportunity, which combines speckle-tracking echocardiography-derived strain analysis with systolic blood pressure measured by brachial cuff. Calculated parameters make a load-independent choice for featuring left ventricular function. The present review aimed a short demonstration of this methodology together with early results based on literature. Orv Hetil. 2022; 163(13): 495-499.
MeSH term(s)	Echocardiography/methods ; Humans ; Stroke Volume ; Ventricular Function, Left/physiology
Language	Hungarian
Publishing date	2022-03-27
Publishing country	Hungary
Document type	Journal Article ; Review
ZDB-ID	123879-6
ISSN	1788-6120 ; 0030-6002
ISSN (online)	1788-6120
ISSN	0030-6002
DOI	10.1556/650.2022.32400
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Article: Prevalence of left ventricular 'rigid body rotation', the near absence of left ventricular twist (insights from the MAGYAR studies).

Nemes, Attila / Kormányos, Árpád

Reviews in cardiovascular medicine

2022 Volume 23, Issue 1, Page(s) 5

Abstract: Left ventricular (LV) twist is defined as the wringing motion of the LV around its long-axis during systole generated by rotation of the LV apex in a counterclockwise direction, as viewed from the apex, while the LV base moves in a clockwise direction. ... ...

Abstract	Left ventricular (LV) twist is defined as the wringing motion of the LV around its long-axis during systole generated by rotation of the LV apex in a counterclockwise direction, as viewed from the apex, while the LV base moves in a clockwise direction. In several cases, the LV apex and base move in the same direction during ejection demonstrating a special condition called as LV 'rigid body rotation'. The present review aimed to summarize our knowledge about this rare but not fully understood entity demonstrating its theoretic pathophysiologic background, clinical significance, associated diseases, and reversibility based on available literature.
MeSH term(s)	Echocardiography, Three-Dimensional ; Heart Ventricles/diagnostic imaging ; Humans ; Prevalence ; Ventricular Function, Left
Language	English
Publishing date	2022-01-29
Publishing country	Singapore
Document type	Journal Article ; Review
ZDB-ID	2108910-3
ISSN	1530-6550
ISSN	1530-6550
DOI	10.31083/j.rcm2301005
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Article: Complex Relationship of Left Ventricular Rotational Mechanics and Deformation Represented by Strain Parameters in Healthy Adults-Detailed Analysis from the Three-Dimensional Speckle-Tracking Echocardiographic MAGYAR-Healthy Study.

Nemes, Attila / Kormányos, Árpád / Ambrus, Nóra / Lengyel, Csaba

Journal of clinical medicine

2023 Volume 12, Issue 23

Abstract: Introduction: Left ventricular (LV) strains are measures of deformation that reflect LV function quantifying the rate of LV contraction, providing information in three directions in space: radial (RS), longitudinal (LS) and circumferential directions ( ... ...

Abstract	Introduction: Left ventricular (LV) strains are measures of deformation that reflect LV function quantifying the rate of LV contraction, providing information in three directions in space: radial (RS), longitudinal (LS) and circumferential directions (CS). The LV moves around its longitudinal axis in a special movement called LV rotational mechanics. The present study aimed to assess associations between three-dimensional speckle-tracking echocardiography (3DSTE)-derived LV rotational mechanics and LV strains in healthy adult subjects. Methods: The present study consisted of 174 healthy adults (mean age: 32.8 ± 12.2 years, 79 males). Complete two-dimensional Doppler echocardiography and 3DSTE were performed in all subjects. Results: While LV-gRS and LV-gLS did not show associations with increased basal LV rotation, the lowest LV-gCS was seen in the presence of the highest LV basal rotation. An increase in basal LV rotation and consequential LV twist were not associated with apical LV rotation. While LV-gLS was not associated with the increase in apical LV rotation, LV-gRS and LV-gCS showed a trend towards increasing values. An increase in LV-gRS was associated with an increasing trend towards apical LV rotation, LV twist and LV-gCS and the preservation of basal LV rotation. LV-gLS also increased but only up to a certain value. An increase in LV-gCS was associated with a tendency towards a decrease in basal LV rotation and a tendency towards an increase in LV-gRS and LV-gLS. The highest LV-gCS was associated with the highest apical LV rotation and LV twist. The highest apical LV rotation, LV twist and LV-gCS were seen in the presence of the highest LV-gLS, while basal LV rotation and LV-gRS were not associated with increasing LV-gLS. Conclusions: Basal LV rotation has been shown to have an inverse relationship with LV-gCS, but without being related to LV-gRS and LV-gLS, while apical LV rotation is associated with LV strains in all directions, but to a different extent, suggesting a complex relationship between LV rotational mechanics and LV strains in healthy adults.
Language	English
Publishing date	2023-11-29
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm12237389
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Article ; Online: Prognostic role of three-dimensional speckle-tracking echocardiography-derived left ventricular global longitudinal strain in cardiac amyloidosis: Insights from the MAGYAR-Path Study.

Földeák, Dóra / Kormányos, Árpád / Nemes, Attila

Journal of clinical ultrasound : JCU

2023 Volume 51, Issue 6, Page(s) 952–959

Abstract: Introduction: Systemic amyloidosis is an uncommon disorder in which amyloid fibrils deposit extracellularly. Three-dimensional speckle-tracking echocardiography (3DSTE) is a novel method able to assess left ventricular (LV) global longitudinal strain ( ... ...

Abstract	Introduction: Systemic amyloidosis is an uncommon disorder in which amyloid fibrils deposit extracellularly. Three-dimensional speckle-tracking echocardiography (3DSTE) is a novel method able to assess left ventricular (LV) global longitudinal strain (GLS). Our aim was to evaluate the prognostic impact of 3DSTE-derived LV-GLS in patients with cardiac amyloidosis (CA). Materials and methods: A total of 35 patients suffering from light-chain (AL) CA or transthyretin (TTR) CA were selected, but 7 patients had to be excluded due to insufficient image quality or were lost for follow-up. With AL-CA 23 cases, while for TTR-CA 5 patients were diagnosed. Complete two-dimensional Doppler and 3DSTE were performed in all subjects. Results: The median follow-up was 201 days (ranging from 36 to 632 days) during which cardiovascular event was detected in 17 CA patients, including 8 cardiac deaths. Six patients were diagnosed with acute heart failure, two patients needed invasive interventions (percutaneous coronary intervention with stent-implantation, implantable cardioverter defibrillator implantation) and in one patient new higher grade atrioventricular block was registered. Using ROC analysis, 3DSTE-derived LV-GLS ≥11.8% (absolute value) was found to be a significant predictor for cardiovascular event-free survival (sensitivity 65%, specificity 64%, area under the curve 0.71, p = .05). Lower LV ejection fraction was confirmed in patients with LV-GLS <11.8% as compared to cases with LV-GLS ≥11.8%. In case of a cardiovascular event, LV-GLS was lower as compared to that of subjects with no events. Multivariable regression analysis confirmed that LV-GLS and LV end-diastolic diameter were independent predictors of cardiovascular survival. Conclusion: 3DSTE-derived LV-GLS is an independent predictor for future cardiovascular events in CA patients.
MeSH term(s)	Humans ; Prognosis ; Global Longitudinal Strain ; Echocardiography/methods ; Amyloidosis/complications ; Amyloidosis/diagnostic imaging ; Ventricular Function, Left ; Immunoglobulin Light-chain Amyloidosis ; Ventricular Dysfunction, Left/diagnostic imaging
Language	English
Publishing date	2023-02-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	189393-2
ISSN	1097-0096 ; 0091-2751
ISSN (online)	1097-0096
ISSN	0091-2751
DOI	10.1002/jcu.23445
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Article ; Online: Similarities and Differences between Three-Dimensional Speckle-Tracking Echocardiography-Derived Left and Right Atrial Volumes and Volume-Based Functional Properties in the Same Healthy Adults-A Detailed Analysis from the MAGYAR-Healthy Study.

Nemes, Attila / Kormányos, Árpád / Ambrus, Nóra / Lengyel, Csaba

Medicina (Kaunas, Lithuania)

2023 Volume 59, Issue 12

Abstract: Background and ... ...

Abstract	Background and Objectives
MeSH term(s)	Adult ; Male ; Humans ; Young Adult ; Echocardiography, Three-Dimensional/methods ; Heart Atria/diagnostic imaging ; Echocardiography/methods ; Atrial Function ; Atrial Appendage
Language	English
Publishing date	2023-11-21
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2188113-3
ISSN	1648-9144 ; 1010-660X
ISSN (online)	1648-9144
ISSN	1010-660X
DOI	10.3390/medicina59122051
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Article ; Online: Autonomic function and specific right atrial functions - Is there a relationship? Correlations from the three-dimensional speckle-tracking echocardiographic MAGYAR-Healthy Study.

Nemes, Attila / Kormányos, Árpád / Orosz, Andrea / Ambrus, Nóra / Várkonyi, Tamás T / Lengyel, Csaba

Journal of clinical ultrasound : JCU

2024

Abstract: Introduction: Similarly to the ventricles, the atria are under sympathetic/parasympathetic neural regulation. Accordingly, correlations were investigated between Ewing's standard cardiovascular reflex tests (SCRTs) and three-dimensional speckle-tracking ...

Abstract	Introduction: Similarly to the ventricles, the atria are under sympathetic/parasympathetic neural regulation. Accordingly, correlations were investigated between Ewing's standard cardiovascular reflex tests (SCRTs) and three-dimensional speckle-tracking echocardiography (3DSTE)-derived right atrial (RA) volumes and strains in healthy subjects. Materials and methods: The study comprised 45 healthy adults, but 5 subjects were excluded due to inferior image quality for 3DSTE-derived RA assessments. The remaining 40 individuals being in sinus rhythm had a mean age of 35.1 ± 3.5 years (20 men). Two-dimensional, Doppler, 3DSTE and SCRTs were performed in all cases. Results: RA maximum volume and total and passive RA stroke volumes correlated with the Valsalva ratio. Active RA stroke volume and emptying fraction showed correlations with 30/15 ratio. Peak global and mean segmental RA circumferential (CS) and longitudinal strains (LS) showed correlation with the Valsalva ratio. At atrial contraction, global RA-LS and mean segmental RA-CS showed correlations with the Valsalva ratio. Moreover, mean segmental RA-CS correlated with 30/15 ratio and mean segmental RA radial strain showed correlations with systolic blood pressure in response to standing. Autonomic neuropathy score correlated with peak global RA-LS. Conclusions: Autonomic function parameters have significant associations with specific RA functions in healthy adults, making the latter possible indicators of autonomic dysregulation.
Language	English
Publishing date	2024-04-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	189393-2
ISSN	1097-0096 ; 0091-2751
ISSN (online)	1097-0096
ISSN	0091-2751
DOI	10.1002/jcu.23672
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Article: Myocardial, Valvular, and Vascular Structural and Functional Properties in Acromegaly.

Nemes, Attila / Kormányos, Árpád / Ambrus, Nóra / Lengyel, Csaba / Valkusz, Zsuzsanna

Journal of clinical medicine

2023 Volume 12, Issue 21

Abstract: Acromegaly is an uncommon systematic endocrine disease caused by the hypersecretion of human growth hormone and, consequently, of insulin-like growth factor-1 during adulthood. Acromegaly could cause a typical cardiomyopathy characterized by left ... ...

Abstract	Acromegaly is an uncommon systematic endocrine disease caused by the hypersecretion of human growth hormone and, consequently, of insulin-like growth factor-1 during adulthood. Acromegaly could cause a typical cardiomyopathy characterized by left ventricular hypertrophy associated with diastolic dysfunction, which later could progress to systolic dysfunction. Moreover, some valvular and vascular abnormalities are also associated with acromegaly. This present review aims to summarize available information regarding acromegaly-associated abnormalities in myocardial, valvular, and vascular structural and functional properties and their relationship to disease activity and treatment options.
Language	English
Publishing date	2023-10-30
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm12216857
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Article: Left ventricular deformation in patients with lymphedema before and after the use of medical compression stockings-detailed analysis from the three-dimensional speckle-tracking echocardiographic MAGYAR-Path Study.

Nemes, Attila / Kormányos, Árpád / Ambrus, Nóra / Szolnoky, Győző / Kemény, Lajos

Quantitative imaging in medicine and surgery

2023 Volume 13, Issue 10, Page(s) 6590–6597

Abstract: Background: Lymphedema (LE) is a chronic condition, which refers to tissue swelling due to excess interstitial fluid accumulation or impaired lymphatic conduit. Theoretically, lymphedema-related fluid retention could affect left ventricular (LV) ... ...

Abstract	Background: Lymphedema (LE) is a chronic condition, which refers to tissue swelling due to excess interstitial fluid accumulation or impaired lymphatic conduit. Theoretically, lymphedema-related fluid retention could affect left ventricular (LV) mechanics, which could be detailed by recent three-dimensional speckle-tracking echocardiography. Therefore, it was purposed to examine LV strains in LE patients before and one hour after the use of medical compression stockings and to compare findings to those of matched normal subjects. Methods: The study comprised 26 cases with lymphedema, however, 4 cases had to be excluded due to inferior quality of images. Their results were compared to 27 age- and gender-matched healthy controls. Results: Global LV circumferential and area strains and mean segmental LV circumferential strain were increased in lymphedema patients before the use of medical compression stockings as compared to controls. One hour after the use of medical compression stockings, no global and mean segmental LV strain showed significant impairment or improvement, but tendentious reduction was seen in LV circumferential strain. With LV segmental analysis, midventricular LV radial, circumferential and area strains proved to be significantly increased, while basal LV longitudinal strain and midventricular LV three-dimensional strain were decreased as compared to controls. No changes in regional LV strains could be detected after one-hour medical compression stockings use as compared to data collected at rest. Conclusions: Increased global LV circumferential strain is seen in lymphedema. With using medical compression stockings, LV deformation parameters change towards the normal range emphasizing their importance on cardiac function.
Language	English
Publishing date	2023-09-11
Publishing country	China
Document type	Journal Article
ZDB-ID	2653586-5
ISSN	2223-4306 ; 2223-4292
ISSN (online)	2223-4306
ISSN	2223-4292
DOI	10.21037/qims-23-243
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