Santoro, Ciro (2020) New perspectives in cardiac imaging based on novel echocardiographic techniques. [Tesi di dottorato]


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Item Type: Tesi di dottorato
Lingua: English
Title: New perspectives in cardiac imaging based on novel echocardiographic techniques
Date: 10 December 2020
Number of Pages: 61
Institution: Università degli Studi di Napoli Federico II
Department: Scienze Biomediche Avanzate
Dottorato: Cardiovascular Pathophysiology and Therapeutics
Ciclo di dottorato: 33
Coordinatore del Corso di dottorato:
Galderisi, MaurizioUNSPECIFIED
Date: 10 December 2020
Number of Pages: 61
Uncontrolled Keywords: Echocardiography, strain analysis, cardiovascular disease
Settori scientifico-disciplinari del MIUR: Area 06 - Scienze mediche > MED/09 - Medicina interna
Area 06 - Scienze mediche > MED/11 - Malattie dell'apparato cardiovascolare
Date Deposited: 07 Jan 2021 11:15
Last Modified: 07 Jun 2023 10:20


The use of cardiac ultrasound has currently become a pivotal tool in the hand of the clinician that integrate sign and symptoms of the clinical examination and giving relevant information to diagnose and treat cardiovascular disease. It's high availability and the absence of radiation exposure made this diagnostic technique the preferred one in the setting of first diagnosis (i.e. screening) and follow up. The advancement in software and hardware empowered the accuracy and the resolution of the imaging overcoming almost entirely the main limitation of this tool; the inadequate acoustic windows. Another limitation that affect cardiac ultrasound is the suboptimal interobserver reproducibility due to subjective evaluation for most of the measurement computed during echocardiographic examination, particularly when assessing the global and regional systolic function of the left ventricle. Indeed, left ventricular ejection fraction (LVEF) is considered the most representative parameter of systolic function among cardiologist and non-cardiologist. However, its suboptimal reproducibility makes arduous to determine subtle changes in systolic function during the follow up. Additionally, LVEF is affected by changes in pre- and after-load, furtherly jeopardize the assessment of LV function in those conditions where dynamic changes in volume load are on the agenda, namely in valvular heart disease and in patients undergoing chemotherapy for cancer. Speckle tracking echocardiography (STE) meant to overcome mostly this limitation by using a semiautomated software that allows to determine the deformation (strain) of the myocardial fibers through the cardiac cycle. Among direction strain (i.e. longitudinal, circumferential, radial strain), the assessment of the global longitudinal strain (GLS) showed to be a pivotal diagnostic tool with prognostic impact in different conditions such as hypertension, cardiomyopathies, valvular heart disease and in the LV surveillance during anti- cancer treatment.


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