Afterload excess and myocardial performance

Jayam, Meghana; Janosevic, Danielle; Kadiyala, Madhavi; Cao, Jie J; Pollack, Simcha; Reichek, Nathaniel

doi:10.1186/1532-429x-15-s1-p220

Cited by 2 publications

(1 citation statement)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Systolic strain is largely an ejection phase index and as such is substantially dependent on preload and afterload. 11 Although strain rate may be somewhat less influenced by loading conditions, it is hardly insensitive to those parameters. But the loading parameters required are not the hemodynamic ventricular chamber indices familiar to clinicians, such as end-diastolic pressure and volume and systolic ventricular pressure.…”

Section: Article See P 711mentioning

confidence: 99%

Right Ventricular Strain in Pulmonary Hypertension

Reichek

2013

Circ: Cardiovascular Imaging

Self Cite

View full text Add to dashboard Cite

Since 2009, there have been ≥170 articles published in the cardiopulmonary literature on right ventricular (RV) echocardiographic strain imaging, including several in Circulation: Cardiovascular Imaging. Of particular interest has been the effort to use RV echocardiographic strain imaging to assess RV systolic function in pulmonary hypertension and the relationship of RV strain to disease severity and outcomes. In this issue of Circulation: Cardiovascular Imaging, Fine et al, 1 from the Mayo Clinic echo group, report on retrospectively evaluated data on the relationship of RV strain to outcomes in the largest such study to date, encompassing 575 patients with known or suspected pulmonary hypertension without elevated pulmonary venous pressure during a median follow-up period of 16.5 months.1 The data show a strong association between reductions in mean longitudinal strain and all-cause mortality, and cardiopulmonary mortality and cardiopulmonary events. An exhaustive biostatistical analysis shows the relationship to be quantitative, stronger than that of other echo indices including tricuspid annular plane systolic excursion, independent of clinical covariates and resulting in a significant improvement in predictive value when combined with relevant clinical variables, as reflected in a significant increase in the integrated discrimination improvement index and the c-statistic for the primary end point. Thus, the results promise to improve clinical risk assessment significantly for such patients and may improve clinical decision making. Article see p 711The apparent benefit is, in large part, a reflection of the relatively weak performance of older 2-dimensional (2D) echocardiographic indices of RV performance including fractional area change and tricuspid annular plane systolic excursion in this setting. RV imaging has been a minefield for echocardiography in adults since its inception. The complexity of ventricular shape, the thinness of the RV free wall, and the limitations in adults of transthoracic and subcostal windows in permitting full visualization of the RV, particularly in the setting of RV dilatation, have conspired to limit echo effectiveness. Thus, indices of RV size and function have failed by and large to make contributions commensurate with the importance of RV dysfunction in a number of settings in adult medicine. The advent of cardiac MRI (CMR) in the 1980s led to rapid development of volumetric 3D methods for left ventricular (LV) size, function, and mass followed shortly by methods for 3D LV strain imaging which continue to be regarded, even today, as the gold standards in the cardiovascular armamentarium. But even so, evaluation of RV volume and mass remained more variable than desirable whereas RV free wall strain assessment remained elusive with CMR until recent years.2 The advent of tissue Doppler and then speckle tracking echocardiographic strain imaging have led to the explosive development of applications of LV strain imaging since 2000, largely focused on the high sensitivity of LV s...

show abstract

Section: Article See P 711mentioning

confidence: 99%

Right Ventricular Strain in Pulmonary Hypertension

Reichek

2013

Circ: Cardiovascular Imaging

Self Cite

View full text Add to dashboard Cite

show abstract

Global longitudinal strain in chronic asymptomatic aortic regurgitation: systematic review

et al. 2020

View full text Add to dashboard Cite

Chronic aortic regurgitation (AR) patients typically remain asymptomatic for a long time. Left ventricular mechanics, namely global longitudinal strain (GLS), has been associated with outcomes in AR patients. The authors conducted a systematic review to summarize and appraise GLS impact on mortality, the need for aortic valve replacement (AVR) and disease progression in AR patients. A literature search was performed using these key terms 'aortic regurgitation' and 'longitudinal strain' looking at all randomized and nonrandomized studies conducted on chronic aortic regurgitation. The search yielded six observational studies published from 2011 and 2018 with a total of 1571 patients with moderate to severe chronic AR. Only two studies included all-cause mortality as their endpoint. The other studies looked at the association between GLS with AVR and disease progression. The mean follow-up period was 4.2 years. We noted a great variability of clinical, methodological and/or statistical origin. Thus, meta-analytic portion of our study was limited. Despite a relevant heterogeneity, an impaired GLS was associated with adverse cardiac outcomes. Left ventricular GLS may offer incremental value in risk stratification and decision-making.

show abstract

Afterload excess and myocardial performance

Cited by 2 publications

References 0 publications

Right Ventricular Strain in Pulmonary Hypertension

Right Ventricular Strain in Pulmonary Hypertension

Global longitudinal strain in chronic asymptomatic aortic regurgitation: systematic review

Contact Info

Product

Resources

About