Search Results (229)

Background: Acromegaly, typically caused by growth hormone (GH)-secreting pituitary adenomas, leads to chronic GH and insulin-like growth factor-1 overproduction, resulting in significant cardiovascular complications, including left ventricular (LV) hypertrophy, myocardial fibrosis, diastolic/systolic LV dysfunction, and frequent valvular disease. Although aortic root dilation has been documented, the morphology and function of the aortic valve annulus (AVA) and its relationship with LV performance remain unexplored. Methods: The present study comprised a total of 31 patients with acromegaly, from which eight subjects were excluded due to inferior image quality. The remaining group of acromegalics consisted of 23 cases (mean age: 54.3 ± 14.5 years, 6 males). Their results were compared to 31 age- and gender-matched healthy subjects (mean age: 50.0 ± 7.4 years, 9 males). Cardiac assessment involved routine two-dimensional Doppler echocardiography and three-dimensional speckle-tracking echocardiography (3DSTE) to quantify basal regional and global longitudinal strains. Detailed planimetric measurements of AVA dimensions and its spatial displacement, called AVA plane systolic excursion (AAPSE), were also obtained. Results: Among 12 patients with inactive acromegaly, 7 patients (58%) showed larger end-systolic AVA area (AVA-A), while 5 patients (42%) had larger end-diastolic AVA-A. Among the 11 patients with active acromegaly, 3 patients (27%) had larger end-systolic AVA-A and 5 patients (45%) had larger end-diastolic AVA-A, while in 3 patients (27%) end-systolic and end-diastolic AVA-A proved to be equal. All end-systolic and end-diastolic AVA dimensions were tendentiously greater in acromegaly, with more pronounced values seen in the presence of an active disease. AAPSE was reduced both in all acromegaly patients and in those with active disease compared to controls. From LV strains, basal and global LV longitudinal strain (LS) and basal LV circumferential strain (CS) were similar when comparing acromegaly patients and those with active and inactive disorder to controls. However, basal and global LV-LS tended to be reduced, while basal LV-CS tended to be increased. Significantly increased global LV-CS were present in active acromegaly patients compared to inactive acromegaly patients and controls Conclusions: Significant aortic valve annular dilation is present in acromegaly, which is associated with its reduced spatial systolic displacement. Full article

Background and Objectives: This study aimed to investigate changes in the descending thoracic aorta (DTA) values in athletes while performing a bench press exercise, and to evaluate their relationship with vitamin levels and nutritional values. Materials and Methods: The study used speckle tracking to assess changes in DTA parameters in athletes before and after bench press exercise, compared to non-athlete controls. Measurements included rotational and radial velocities, circumferential strain and strain rate, and displacement. Results: The study included 60 non-athlete controls and 178 athletes performing bench press exercises. In a 10-year follow-up of 30 weightlifters, aortic speckle tracking values were age-matched with controls. No significant baseline differences were observed between groups. However, following exercise, all measurements demonstrated increases: DTA rotational velocity (55.44 ± 16.15 vs. 88.98 ± 10.31°/s), radial velocity (1.02 ± 0.36 vs. 1.56 ± 0.42 cm/s), circumferential strain (−8.52 ± 0.31 vs. −12.55 ± 1.13), strain rate (−1.55 ± 0.72 vs. −2.28 ± 0.56 s⁻¹), rotational displacement (6.22 ± 0.36 vs. 14.91 ± 0.85°), and radial displacement (0.89 ± 0.31 vs. 1.19 ± 0.65 mm), with all p-values < 0.05. Rotational displacement correlated with maximal repetition (88.56 ± 12.59 Kg) and vitamin levels. Conclusions: This study hypothesizes that bench press exercise is linked to increased DTA velocities, strain, strain rate, and displacement. Full article

Background and Objectives: The aim of this study is to evaluate the changes in speckle tracking velocity vector analysis (VVI) values within the descending thoracic aorta (DTA) in patients with cardiogenic shock (CS) who are on mechanical ventilation (MV), under varying levels of positive end-expiratory pressure (PEEP). Materials and Methods: Transthoracic echocardiography (TTE) was performed during incremental increases in positive end-expiratory pressure (PEEP) from 0 to 15 cmH₂O over 15 to 30 min. The effects of increased PEEP on velocities, displacement, strain (S), and strain rate (SR) were evaluated. DTA speckle tracking values were analyzed to determine their association with patient mortality. A control group of healthy individuals was used to establish normal DTA variables. Results: Sixty-two mechanically ventilated patients were included in this study. The mean age was 62.48 ± 11.22 years. The highest values for various parameters were obtained with 5 cmH₂O PEEP. The values obtained for DTA using speckle tracking at increasing PEEP levels (ZEEP, PEEP 5, PEEP 10, and PEEP 15 cm H₂O) were as follows: DTA rotational velocity [55.18 ± 14.60, 107.39 ± 19.33, 60.05 ± 0.28, and 42.11 ± 0.34°/s], DTA radial velocity [0.80 ± 0.09, 2.21 ± 0.27, 0.99 ± 0.16, 0.56 ± 0.17 cm/s], DTA rotational displacement [5.68 ± 0.40, 15.71 ± 0.13, 5.98 ± 0.35, 6.64 ± 3.45°], circumferential strain for DTA [−8.55 ± 0.92, −11.86 ± 0.07, −9.88 ± 0.25, −8.76 ± 0.6%], and DTA circumferential SR [−0.87 ± 0.1, −1.91 ± 0.03, −1.21 ± 0.12, −0.97 ± 0.05/s]; all p-values < 0.05. Logistic binary regression found left ventricular strain and DTA rotational displacement on 5 cmH₂O PEEP level were associated with death. Conclusions: Changes in PEEP levels affect the speckle tracking measurements of the DTA. Speckle tracking can be used to assess the thoracic aorta, and certain parameters, such as rotational displacement, may relate to the prognosis of cardiogenic shock. Full article

Left ventricular (LV) hypertrabeculation is increasingly recognized as a phenotype that may reflect physiological adaptation, particularly in athletes exposed to chronic overload, although its functional relevance remains uncertain. This study evaluated the prevalence of excessive trabeculation and its physiological correlation with LV remodeling. We conducted a single-center, cross-sectional study involving 320 Olympic-level athletes without cardiovascular disease. All underwent cardiac magnetic resonance (CMR). Hypertrabeculation was defined by the Petersen criteria. Athletes meeting these criteria were classified as hypertrabeculated and compared with non-hypertrabeculated matched for age, sex, and sport category. LV morphology, function, strain parameters, and hemodynamic forces (HDFs) were analyzed. Hypertrabeculation was identified in 9% of the cohort. No significant differences were observed between groups for training exposure (p = 0.262), body surface area (p = 0.762), LV volumes (end-diastolic volume indexed p = 0.397 end-systolic volume indexed p = 0.118), ejection fraction (p = 0.101), mass (p = 0.919), sphericity index (p = 0.419), myocardial wall thickness (p = 0.394), tissue characterization (T1 mapping p = 0.366, T2 mapping p = 0.833), global longitudinal strain (GLS p = 0.898), global circumferential strain (GCS p = 0.219), or HDFs. All values were within the normal range. In our cohort, LV hypertrabeculation, evaluated by CMR, was relatively common but not associated with structural or functional abnormalities, supporting its interpretation as a benign variant in asymptomatic athletes with normal cardiac function. Full article

Background/Objectives: Although global longitudinal strain (GLS) appears more sensitive than the ejection fraction in uncovering subtle left ventricular (LV) dysfunction, evidence of impaired LV mechanics in children/adolescents with obesity, independent of comorbidities, remains limited. The aim of the present study was to provide new information on clinical and echocardiographic correlates associated with LV mechanics in normotensive children/adolescents with obesity and without comorbidities. Methods: The Pub-Med, Ovid MEDLINE, Ovid EMBASE, and Cochrane databases were searched to identify eligible studies from inception up to 31 March 2025. Studies reporting data on LV mechanics (i.e., GLS, global circumferential strain [GCS]) in children/adolescents with obesity were included. Meta-regression analyses between GLS, GCS, and several clinical, laboratory, and echocardiographic parameters were performed using a random-effect model. Results: Twenty-seven studies including 1398 normotensive children/adolescents with obesity (mean age 12.6 ± 1.8 years) were considered. There was a significant inverse relationship between GLS and body mass index (BMI) (coefficient = −0.33 ± 0.11, p = 0.003) and fat mass (coefficient = −0.19 ± 0.07, p = 0.005); this was not the case for GCS. Notably, both GLS and GCS were unrelated to several clinical/laboratory variables such as blood pressure, metabolic parameters, LV mass, and LV diastolic function indices. Conclusions: Our findings suggest that increasing BMI and fat mass are the only key factors associated with reduced longitudinal myocardial deformation in pediatric obesity. GLS, unlike GCS, can be regarded as an early marker of subclinical organ damage in this setting and should be assessed to optimize cardiovascular prevention strategies in children/adolescents with obesity regardless of hypertension or comorbidities. Full article

Background: Left ventricular (LV) non-compaction (NC) is a rare ventricular phenotype characterized by a thin compacted epicardial layer and an extensive non-compacted endocardial layer with prominent LV trabeculations and deep intertrabecular recesses. According to the recent literature, no information is available regarding the abnormalities of the aortic valve annulus (AVA) in LVNC. Therefore, the aim of the present study was to perform a detailed analysis of the AVA by three-dimensional speckle-tracking echocardiography (3DSTE) in LVNC patients and to compare the findings with matched healthy controls. Methods: The present study comprised 21 isolated LVNC patients, from which 9 cases were excluded due to inferior image quality. The remaining group consisted of 12 patients with isolated LVNC (mean age: 54.6 ± 13.6 years, 7 males). Jenni’s echocardiography criteria served as a definition of LVNC. The 12 patients’ results were compared to 38 healthy age- and gender-matched controls (mean age: 48.2 ± 8.0 years, 19 males). Subgroups of patients having a greater end-diastolic versus end-systolic AVA area were also compared. Results: Most of AVA dimensions did not differ significantly between LVNC patients and controls; however, most LVNC patients showed a larger end-diastolic AVA area (9 out of 12, 75%), which was a significantly larger ratio as seen in matched controls (11 out of 38, 29%, p < 0.05). Aortic valve annular plane systolic excursion (AAPSE) proved to be significantly reduced in all LVNC patients (1.12 ± 0.24 cm vs. 0.78 ± 0.28 cm, p < 0.05) and in LVNC subjects with a greater end-diastolic AVA area (1.11 ± 0.21 cm vs. 0.72 ± 0.21 cm, p < 0.05). Basal LV radial (RS) and longitudinal (LS) strains were reduced in healthy adults with a greater end-diastolic AVA area as compared to cases with a greater end-systolic AVA area. In LVNC, not only basal LV-RS and LV-LS, but also LV circumferential strain (CS) proved to be reduced regardless of whether the AVA was greater in end-diastole or in end-systole. Conclusions: In patients with isolated LVNC, the AVA is not dilated; however, the presence of a greater end-diastolic AVA area is observed more frequently than in healthy controls. AAPSE and basal LV-RS, LV-LS and LV-CS values are significantly reduced in LVNC irrespective of whether the end-systolic or end-diastolic AVA area is greater. Full article

Background: Hypertrophic cardiomyopathy (HCM) is frequently associated with preserved left ventricular ejection fraction (LVEF), yet subclinical myocardial dysfunction often escapes detection using conventional imaging. Cardiac magnetic resonance (CMR) with feature tracking (FT) enables precise assessment of myocardial deformation and mechanics. Methods: In this prospective case–control study, we evaluated 150 HCM patients and 100 age- and sex-matched healthy controls using standardized CMR protocols. Global longitudinal strain (GLS), circumferential strain (GCS), radial strain (GRS), and left ventricular (LV) torsion were quantified via FT-CMR. Myocardial fibrosis was assessed through late gadolinium enhancement (LGE), native T1 mapping, and extracellular volume (ECV). Results: HCM patients showed significantly impaired strain and torsion metrics compared with controls: GLS (−16% vs. −20%), GCS (−18% vs. −21%), GRS (29% vs. 38%), and global LV torsion (1.27°/cm vs. 1.95°/cm), all p < 0.001. These abnormalities were also observed in LGE-negative patients, suggesting early functional remodeling. Global LV torsion demonstrated the highest diagnostic performance for LGE detection (AUC = 0.995), surpassing those of GLS (0.877), native T1 (0.731), and ECV (0.657). A cut-off value of 0.7°/cm provided optimal sensitivity and specificity, and was associated with adverse prognosis in survival analysis. Conclusions: CMR-derived strain and torsion parameters detect early myocardial dysfunction in HCM beyond conventional markers. Global LV torsion, in particular, emerges as a sensitive and robust non-invasive marker with diagnostic and prognostic potential. Full article

The anisotropic nature of cup ears formed during the deep drawing of sheet metals is governed by the distribution of crystallographic orientation in interaction between earing. In this study, we examined the orientation development of a cube-oriented aluminum single crystal to couple the deep drawing kinematics with the formation of anisotropic orientations. A quarter model of a circular deep-drawn blank was simulated in the finite element software using a user-defined material subroutine. A cube-oriented aluminum single crystal was designed to serve as a reference and trace the orientation evolution in the deep drawing process. After the deep drawing, the bottom, wall, and flange of the drawn cup were investigated at azimuthal angles ($\alpha$ ) of 0° and 45° with respect to the radial direction (RD) in terms of the orientation. Our findings show that the change in the lattice orientation could be attributed to the rotation induced by drawing and bending processes under kinematic constraints. Thus, the initial cube orientation developed into different orientations during the deep drawing. The type-A slip system mainly contributed to the radial strain at α = 0°, and type-B and C slip systems accounted for the longitudinal and circumferential strains at α = 45°. Full article

Background: Breast and hematological cancer treatments, especially with anthracyclines, have been shown to be associated with an increased risk of cardiotoxicity (CTX). An accurate prediction of cardiotoxicity risk and early detection of myocardial injury may allow for effective cardioprotection to be instituted and tailored to reverse cardiac dysfunction and prevent the discontinuation of essential cancer treatments. Objectives: The PRoactive Evaluation of Function to Evade Cardio Toxicity (PREFECT) study sought to evaluate the ability of fast-strain-encoded (F-SENC) cardiac magnetic resonance imaging (CMR) and 2D echocardiography (2D Echo) to stratify patients at risk of CTX prior to initiating cancer treatment, detect early signs of cardiac dysfunction, including subclinical CTX (sub-CTX) and CTX, and monitor for recovery (REC) during cardioprotective therapy. Methods: Fifty-nine patients with breast cancer or lymphoma were prospectively monitored for CTX with F-SENC CMR and 2D Echo over at least 1 year for evidence of cardiac dysfunction during anthracycline based chemotherapy. F-SENC CMR also monitored myocardial deformation in 37 left ventricular (LV) segments to obtain a MyoHealth risk score based on both longitudinal and circumferential strain. Sub-CTX and CTX were classified based on pre-specified cardiotoxicity definitions. Results: CTX was observed in 9/59 (15%) and sub-CTX in 24/59 (41%) patients undergoing chemotherapy. F-SENC CMR parameters at baseline predicted CTX with a lower LVEF (57 ± 5% vs. 61 ± 5% for all, p = 0.05), as well as a lower MyoHealth (70 ± 9 vs. 79 ± 11 for all, p = 0.004) and a worse global circumferential strain (GCS) (−18 ± 1 vs. −20 ± 1 for all, p < 0.001). Pre-chemotherapy MyoHealth had a higher accuracy in predicting the development of CTX compared to CMR LVEF and 2D Echo LVEF (AUC = 0.85, 0.69, and 0.57, respectively). The 2D Echo parameters on baseline imaging did not stratify CTX risk. F-SENC CMR obtained good or excellent images in 320/322 (99.4%) scans. During cancer treatment, MyoHealth had a high accuracy of detecting sub-CTX or CTX (AUC = 0.950), and the highest log likelihood ratio (indicating a higher probability of detecting CTX) followed by F-SENC GLS and F-SENC GCS. CMR LVEF and CMR LV stroke volume index (LVSVI) also significantly worsened in patients developing CTX during cancer treatment. Conclusions: F-SENC CMR provided a reliable and accurate assessment of myocardial function during anthracycline-based chemotherapy, and demonstrated accurate early detection of CTX. In addition, MyoHealth allows for the robust identification of patients at risk for CTX prior to treatment with higher accuracy than LVEF. Full article

Objectives: This study aimed to evaluate the ability of three-dimensional (3D) speckle tracking echocardiography (STE) to detect acute coronary occlusions in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) and its potential diagnostic advantage over two-dimensional (2D) STE. Methods: Fifty-six patients with NSTE-ACS (mean age 64 ± 11 years; 80% male) underwent 2D and 3D transthoracic echocardiography prior to coronary angiography. Global longitudinal strain (GLS), global circumferential strain (GCS), and 3D ejection fraction (EF) were analyzed. Acute coronary occlusion was defined as TIMI flow 0–1 in the presumed culprit artery. Results: Acute coronary occlusion was present in 16 patients (29%). Patients with occlusion had significantly more impaired strain compared to those without: 3D GLS (−12.5 ± 2.7% vs. −15.5 ± 2.1%, p < 0.001), 2D GLS (−12.6 ± 2.8% vs. −15.6 ± 2.0%, p < 0.001), 3D GCS (−24.8 ± 4.4% vs. −27.8 ± 4.3%, p = 0.02), and 2D GCS (−18.1 ± 5.5% vs. −22.9 ± 4.7%, p = 0.002). In contrast, 3D EF did not differ significantly between groups (52.5 ± 4.7% vs. 54.7 ± 5.7%, p = 0.16). Receiver operating characteristic analysis showed that 3D and 2D GLS had the highest diagnostic performance (AUCs 0.81 and 0.78), while 3D EF had the lowest (AUC 0.61). Feasibility was lower for 3D STE (86%) than for 2D longitudinal strain (95%, p = 0.03). Conclusions: Both 3D and 2D GLS showed higher diagnostic accuracy than 3D EF in identifying acute coronary occlusion in NSTE-ACS patients. While 3D STE enables simultaneous assessment of multiple parameters, it did not offer incremental diagnostic value over 2D STE and had lower feasibility. Full article

Background: This study investigates the potential mechanisms behind changes in cardiac structure and function in long COVID patients. Methods: This study involved 176 consecutive outpatients in follow-up care (average age 55.9 years; 58.5% male) who experienced symptoms for over 12 weeks (average 6.2 ± 2.7 months), following coronavirus infection (COVID-19). Results: The patients with long COVID and cardiovascular manifestations were significantly more hospitalized (88.5% vs. 75.9%) and had longer hospital stays. Significant echocardiography changes were observed in the left ventricular ejection fraction (LVEF) (59.6 ± 5.4% vs. 62.5 ± 3.8%); longitudinal strain (LS) in the sub-endocardium and intra-myocardium layers (−20.9 vs. −22.0% and −18.6 vs. −19.5%); circumferential strain (CS) in the sub-epicardium layers (−9.6 vs. −10.5%); and CS post-systolic shortening (CS PSS) (0.138 vs. 0.088 s). Additionally, pathological cardiac magnetic resonance (CMR) findings were seen in 58.2% of the group of patients with long COVID and cardiovascular manifestation; 43.3% exhibited positive late gadolinium enhancement (LGE), 21.0% had elevated native T1 mapping, and 22.4% had elevated native T2 mapping. Conclusions: Most patients with long COVID showed structural and functional changes in their cardiovascular systems, primarily caused by prolonged inflammation. Using multimodality imaging is important for uncovering the mechanisms to predict chronic myocarditis, early-stage heart failure, and pre-ischemic states, which can lead to serious complications. Recognizing the specific cardiovascular phenotypes associated with long COVID is essential in order to provide timely and appropriate treatment. Full article

A pipe subjected to an evenly distributed internal pressure is investigated in this theoretical paper. The pipe has a thin wall that is built-up by a functionally graded engineering material. The circumferential stresses and strains in the pipe wall are investigated. In essence, the current investigation is non-linear since the wall behaves as a non-linear elastic body with non-linearly distributed properties through the wall thickness. The different stages of the work of the wall are investigated and the corresponding parameters of stressed and strained state are derived. The dependence of the pressure on the material and geometrical parameters are studied. Full article

This study investigates the shell hydroforming of 1.2 mm-thick AA5052 aluminum alloy sheets to produce hemispherical domes which possess inherent spatial symmetry about their central axis. Shell hydroforming is widely used in fabricating lightweight, high-strength components for aerospace, automotive, and energy applications. The forming process was driven by a spatially symmetrical internal pressure distribution applied uniformly across the blank to maintain balanced deformation and minimize geometrical distortion. Experimental trials aimed at achieving a dome depth of 50 mm revealed wrinkle formation at the blank periphery caused by circumferential compressive stresses symmetrical in nature with respect to the dome’s central axis. To better understand the forming behavior, a validated 3D finite element (FE) model was developed, capturing key phenomena such as material flow, strain rate evolution, hydrostatic stress distribution, and wrinkle development under symmetric boundary conditions. The effects of the internal pressure (IP), blank holding force (BHF), coefficient of friction (CoF), and flange radius (FR) were systematically studied. A strain rate of 0.1 s⁻¹ in the final stage improved material flow, while a symmetric tensile hydrostatic stress of 160 MPa facilitated dome expansion. Although tensile stresses can induce void growth, the elevated strain rate helped suppress it. An optimized parameter set of IP = 5.43 MPa, BHF = 140 kN, CoF = 0.04, and FR = 5.42 mm led to successful formation of the 50 mm dome with 19.38% thinning at the apex. Internal pressure was identified as the most critical factor influencing symmetric formability. A process window was established to predict symmetric failure modes such as wrinkling and bursting. Full article

The leak-before-break (LBB) concept is widely used in the design and estimation of piping systems of nuclear power plants, which requires considerable test work to obtain the fracture resistance (J-R) curves of nuclear pipes. The application of numerical ductile fracture simulation can effectively limit the test work. In this study, an extended stress-modified critical strain (SMCS) model is applied to simulate the crack growth behaviors of full-scale nuclear pipes (SA312 TP304L stainless steel) with a circumferential through-wall crack under a four-point bending load. The LBB evaluation is performed based on the J-R curves of CT specimens and full-scale pipes obtained from fracture resistance tests and numerical simulations. It shows that due to the high crack-tip constraint effect, CT specimens may cause lots of conservatism in the LBB evaluation of nuclear pipes, while the application of numerical ductile fracture simulation can largely reduce the conservatism. Full article

As a part of the mining-induced stress redistribution process during coal mining, the repeated loading and unloading process with increasing peak stresses will cause more severe deformation and damage to mining roadways, which is different from the findings in other underground engineering practices. Consequently, cyclic triaxial compression tests with increasing amplitudes were carried out to investigate the mechanical behavior, acoustic emission (AE) characteristics, and damage evolution of coal materials. It is found that peak deviatoric stress and axial residual strain at the failure of coal specimens increase with increasing confining pressures, while the changes in circumferential strain are not obvious. Moreover, the failure patterns of coal specimens exhibit shear failure due to the constraint of confining pressures while some local tensile cracks occur near the shear bands at both ends of the specimens. After that, the damage evolution of coal specimens was analyzed against the regularity of AE counts and energies to develop a damage evolution model. It is concluded that the damage evolution model can not only quantify the deformation and failure process of the coal specimens under cyclic loads with increasing amplitudes but also takes into account both the initial damage due to natural defects and the induced damage by the cyclic loads in previous cycles. Full article