In this retrospective study 420 echocardiograms from a single center were reviewed showing that TAPSE was acquired in 66% while TA TDI s' signals were recorded in 98% of all echocardiograms. Based on these results greater efforts are required to standardize acquisition and reporting of objective measurements of RV function.
BackgroundEven though left atrial (LA) size and function are intimately related to left ventricular (LV) diastolic dysfunction, the role of LA with regard to LV systolic function is less clear. Consequently, we examined the potential association that might exist between measures of longitudinal LV systolic shortening and LA dilation using LA volume index (LAVI).MethodsIn this retrospective analysis, data from 75 echocardiograms (mean age 53 ± 14; range 24 - 89 years; mean body surface area (BSA) 2.0 ± 0.3) were analyzed.ResultsPeak global longitudinal (PGLS) correlated best with LV mass index (LVMI) followed by mitral annular systolic excursion (MAPSE), and age. Similar results were obtained when analyzing the best variables that correlated with LAVI. Finally, MAPSE correlated best with PGLS, then with MA tissue Doppler systolic velocity, BSA, and LAVI in that order. All patients had normal LV ejection fraction (LVEF) and normal sinus rhythm when studied.ConclusionsLAVI does not directly affect LV systolic function and longitudinal measures of LV shortening are mainly dependent on LV mass. Additional studies are now required to determine how these associations vary when different degrees of LV dilatation and systolic dysfunction are included in the analysis.
BackgroundThough diastolic interrogation of the mitral annulus (MA) using tissue Doppler imaging (TDI) has been quite useful in assessing left ventricular (LV) diastolic function, the relative contribution of the previous cycle MA systolic displacement or velocity components to subsequent LV diastole has not been previously investigated. We therefore sought to determine the association between MA systolic dynamics and LV diastolic function parameters.MethodsFor this retrospective study, only complete echocardiograms having good endocardial border resolution of both left atrial (LA) and LV chambers with M-mode (MAPSE) and tissue Doppler of the lateral MA (MA TDI S’) as well as complete Doppler data to perform assessment of LV diastole were included in our analysis.ResultsData from 100 patients (mean age 54 ± 14) showed that both MA systolic displacement and velocity correlate with LV ejection fraction (P < 0.05). Only MA displacement was associated with age and LV mass. Most importantly no correlation was found between MAPSE and LV diastole. However, in sharp contrast MA TDI S’ correlated with MA relaxation velocities during both early and late LV diastole.ConclusionEven though MAPSE and MA TDI S’ are surrogate measures of LV ejection fraction, only MA TDI S’ correlates with diastolic MA velocities as no correlation was identified between MAPSE and measures of LV diastole. Additional studies are now warranted to explore whether a reduced MA TDI S’ may affect the symptomatic profile or the overall prognosis of patients with LV diastolic dysfunction.
Background
Even though the tricuspid annulus (TA) is anatomically and functionally related to right atrioventricular dependence and tricuspid annular plane systolic excursion (TAPSE) is a well-known measure of right ventricular (RV) systolic function, there is paucity of data regarding the potential impact that right atrial (RA) size and function have on TAPSE. Hence, we sought to determine whether RA volumetric and longitudinal measures affect TAPSE in patients with chronic pulmonary hypertension (cPH).
Methods
In this retrospective study, echocardiographic data from 110 patients were reviewed and the studied population was divided into Group I consisting of 50 patients (50±11 years) without PH and Group II that included 60 patients (55±14 years) with cPH.
Results
Even though RA areas, RA fractional area change, and maximal long-axis length measurements were abnormal in cPH patients, TA tissue Doppler imaging systolic velocity and RV fractional area change were the only useful variables in identifying patients with abnormal TAPSE (P<.0001 and P=.018, respectively). Additionally, TAPSE was independent of all RA measures, left ventricular ejection fraction, and age (P>.05).
Conclusions
Based on these results, TAPSE does not appear to be influenced by either RA size or function. Additional studies using strain echocardiography to interrogate RA mechanics might now be very useful to advance our understanding of TA motion in cPH patients given recent data showing that RA function accounts for a significantly greater proportion of total right heart function in patients with cPH than in normal subjects.
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