Assessment of Left Ventricular Global Myocardial Work in Patients With Different Degrees of Coronary Artery Stenosis by Pressure-Strain Loops Analysis

Wang, Ranran; Tian, Tian; Li, Shouqiang; Leng, Xiaoping; Tian, Jing

doi:10.1016/j.ultrasmedbio.2020.09.017

Cited by 14 publications

(21 citation statements)

References 23 publications

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“…When MWs were compared with GLS in this cohort, we found that the assessment of GWI (AUC = 0.760) was superior to the assessment of GLS (AUC = 0.690) and the diagnostic accuracy of GWI was better in terms of sensitivity and speci city. For the de nition of CAD in our cohort is 50% stenosis, the diagnostic accuracy of GWI in our cohort shows relatively lower AUC compared with GWI (AUC = 0.786-0.806) obtained from two other cohorts whose classi cation standard is ≥ 70% stenosis [8,19].…”

Section: Discussionmentioning

confidence: 66%

Diagnostic Value of Global and Regional Myocardial Work in Coronary Artery Disease with Normal Ejection Fraction and Wall Motion

Guo

Zhang

Zhu

et al. 2021

Preprint

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Background: The potential of global and regional myocardial work (MW) parameters for detecting moderate, clinically unapparent coronary artery disease (CAD) remains unclear. This study aimed to evaluate the diagnostic power of global and regional MW to detect CAD in patients with normal left ventricular ejection fraction and wall motion. Methods: One hundred and seventy-six consecutive patients with clinically suspected CAD were prospectively included. All subjects underwent comprehensive echocardiographic evaluation and coronary angiography. Noninvasive MW indices include global work index (GWI), global work efficiency (GWE), global constructive work (GCW), global wasted work (GWW) and regional MW parameters. Results: GWI, GWE and GCW were significantly impaired in patients with CAD (stenosis ≥50%) compared with patients without CAD (all P＜0.01). An optimal GWI cutoff value of 1855.5 mmHg % (sensitivity, 71.7%; specificity, 78.0%) has been defined for predicting CAD [area under the curve (AUC) value, 0.76; P = 0.000]. GWI provided incremental value over all other echocardiographic parameters in detecting CAD, including global longitudinal strain (GLS) (P＜0.05). MW parameters in left anterior descending (LAD) segments had higher diagnostic value (AUC = 0.67-0.74, all P = 0.000) than parameters in left circumflex (LCX) (AUC = 0.64, P＜0.01) or right coronary artery (RCA) territories (AUC = 0.65-0.71, all P＜0.01).Conclusions: Global and regional MW parameters assessed at rest are of good diagnostic value for detecting CAD. GWI provides incremental value over all other echocardiographic parameters in predicting CAD, including GLS. Besides, regional MW may be a useful tool to localize and detect relevant coronary artery stenosis.

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Section: Discussionmentioning

confidence: 66%

Diagnostic Value of Global and Regional Myocardial Work in Coronary Artery Disease with Normal Ejection Fraction and Wall Motion

Guo

Zhang

Zhu

et al. 2021

Preprint

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“…A number of clinical researches have been performed within the last two years, since this technique was commercially available. To date, MW has been investigated with regard to cardiac resynchronization therapy (CRT) [ 18 – 23 ], in the diagnosis of different categories of coronary heart disease [ 6 , 24 – 28 ] and in the evaluation of cardiomyopathy [ 29 – 33 ]. In addition, MW can also be used to predict and evaluate therapeutic effects [ 34 – 38 ].…”

Section: Discussionmentioning

confidence: 99%

“…Since GWE was not affected by afterload [ 7 , 40 , 41 ] and had a stable reference value in all healthy subjects, it may be more suitable than other parameters as a diagnostic index of myocardial impairment. In some studies, it has been proved that GWE is the best predictor of LV myocardial contractile performance in all MW parameters [ 27 , 28 ]. However, additional work is required to assess its efficacy in other types of heart disease.…”

Section: Discussionmentioning

confidence: 99%

Afterload-related reference values for myocardial work indices

Wang

Feng

et al. 2021

Cardiovasc Ultrasound

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Background The novel noninvasive pressure-strain loop (PSL) is a reliable tool that reflects myocardial work (MW). Systolic blood pressure (SBP) is the only independent factor for MW indices. However, afterload-related reference values have not been previously reported. The aim of the present study was to establish reference values for MW parameters by wide range SBP grading. Methods We prospectively selected healthy individuals and subjects with SBP ≥ 140 mmHg at the time of study without myocardial remodeling. MW parameters were collected and the reference values achieved were grouped by SBP in 10-mmHg. Results Significant differences were noted among the SBP-groups for global work index (GWI) and global constructive work (GCW). The majority of statistical comparisons of the differences in GWI and GCW were significant at each SBP-group. With SBP ranging from 90 to 189 mmHg, the parameters GWI and GCW tended to increase linearly with afterload. Overall, the global wasted work (GWW) tended to rise as SBP was increased, but not all of the differences noted in GWW were significant for each SBP-group. Global work efficiency (GWE) remained stable across all SBP-groups, with the exception of a slight drop noted when it exceeded 160 mmHg. Conclusions The amount of MW but not the work efficiency varied greatly according to the different afterload. This finding cannot be ignored during clinical research or diagnosis and afterload-related reference values are required to make a reasonable judgment on the myocardial function.

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“…A number of clinical researches have been performed within the last two years, since this technique was commercially available. To date, MW has been investigated with regard to cardiac resynchronization therapy (CRT) [18][19][20][21][22][23], in the diagnosis of different categories of coronary heart disease [6,[24][25][26][27][28] and in the evaluation of cardiomyopathy [29][30][31][32][33]. In addition, MW can also be used to predict and evaluate therapeutic effects [34][35][36][37][38].…”

Section: Discussionmentioning

confidence: 99%

“…Since GWE was not affected by afterload [7,40,41] and had a stable reference value in all healthy subjects, it may be more suitable than other parameters as a diagnostic index of myocardial impairment. In some studies, it has been proved that GWE is the best predictor of LV myocardial contractile performance in all MW parameters [27,28]. However, additional work is required to assess its e cacy in other types of heart disease.…”

Section: Discussionmentioning

confidence: 99%

Afterload-related reference values for myocardial work indices

Li¹,

Wang

Feng

et al. 2021

Preprint

View full text Add to dashboard Cite

Background The novel noninvasive pressure-strain loop (PSL) is a reliable tool that reflects myocardial work (MW). Systolic blood pressure (SBP) is the only independent factor for MW indices. However, afterload-related reference values have not been previously reported. The aim of the present study was to establish reference values for MW parameters by SBP grading over a wide range. Methods We prospectively selected healthy individuals and subjects with SBP ≥ 140mmHg at the time of study without myocardial remodeling. MW parameters were collected and the reference values achieved were grouped by SBP in 10-mmHg. Results Significant differences were noted among the SBP-groups for global work index (GWI) and global constructive work (GCW). The majority of statistical comparisons of the differences in GWI and GCW were significant at each SBP-group. With SBP ranging from 90 to 189mmHg, the parameters GWI and GCW tended to increase linearly with afterload. Overall, the global wasted work (GWW) tended to rise as SBP was increased, but not all of the differences noted in GWW were significant for each SBP-group. Global work efficiency (GWE) remained stable across all SBP-groups, with the exception of a slight drop noted when it exceeded 160 mmHg. Conclusions The amount of MW but not the work efficiency varied greatly according to the different afterload. This finding cannot be ignored during clinical research or diagnosis and afterload-related reference values are required to make a reasonable judgment on the myocardial function.

show abstract

Assessment of Left Ventricular Global Myocardial Work in Patients With Different Degrees of Coronary Artery Stenosis by Pressure-Strain Loops Analysis

Cited by 14 publications

References 23 publications

Diagnostic Value of Global and Regional Myocardial Work in Coronary Artery Disease with Normal Ejection Fraction and Wall Motion

Diagnostic Value of Global and Regional Myocardial Work in Coronary Artery Disease with Normal Ejection Fraction and Wall Motion

Afterload-related reference values for myocardial work indices

Afterload-related reference values for myocardial work indices

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