Correlation between non-invasive myocardial work indices and main parameters of systolic and diastolic function: results from the EACVI NORRE study

Abstract

Aims The present study sought to evaluate the correlation between indices of non-invasive myocardial work (MW) and left ventricle (LV) size, traditional and advanced parameters of LV systolic and diastolic function by 2D echocardiography (2DE). Methods and results A total of 226 (85 men, mean age: 45 ± 13 years) healthy subjects were enrolled at 22 collaborating institutions of the Normal Reference Ranges for Echocardiography (NORRE) study. Global work index (GWI), global constructive work (GCW), global work waste (GWW), and global work efficiency (GWE) were estimated from LV pressure-strain loops using custom software. Peak LV pressure was estimated non-invasively from brachial artery cuff pressure. LV size, parameters of systolic and diastolic function and ventricular-arterial coupling were measured by echocardiography. As advanced indices of myocardial performance, global longitudinal strain (GLS), global circumferential strain (GCS), and global radial strain (GRS) were obtained. On multivariable analysis, GWI was significantly correlated with GLS (standardized beta-coefficient = −0.23, P < 0.001), ejection fraction (EF) (standardized beta-coefficient = 0.15, P = 0.02), systolic blood pressure (SBP) (standardized beta-coefficient = 0.56, P < 0.001) and GRS (standardized beta-coefficient = 0.19, P = 0.004), while GCW was correlated with GLS (standardized beta-coefficient = −0.55, P < 0.001), SBP (standardized beta-coefficient = 0.71, P < 0.001), GRS (standardized beta-coefficient = 0.11, P = 0.02), and GCS (standardized beta-coefficient = −0.10, P = 0.01). GWE was directly correlated with EF and inversely correlated with Tei index (standardized beta-coefficient = 0.18, P = 0.009 and standardized beta-coefficient = −0.20, P = 0.004, respectively), the opposite occurred for GWW (standardized beta-coefficient =−−0.14, P = 0.03 and standardized beta-coefficient = 0.17, P = 0.01, respectively). Conclusion The non-invasive MW indices show a good correlation with traditional 2DE parameters of myocardial systolic function and myocardial strain.

Assessment of left ventricular systolic function by non-invasive pressure-strain loop area in young male strength athletes

“…22,23 The description of these changes has led to a more comprehensive understanding of reduced longitudinal strain of LV, as well as the decrease of GWI and GCW that could be supposed to re ect LV performance and mechanics globally. 11 In this study, compared with the control group, the reduction in GWI and GCW in the athlete group was not statistically signi cant, but suggested that the myocardial metabolism was decreased and LV systolic function was impaired to some extent. Signi cantly, increased PSD in the athlete group draw attention to the points that the systolic synchronization of LV had been destroyed and nonuniformity of ventricular wall motion would reduce the mechanical e ciency during cardiac ejection.…”

“…9 The clinical values of this new approach have potential in predicting response to cardiac resynchronization therapy and assessing myocardial contractility in hypertension and dilated cardiomyopathy. 10,11 The purpose of this study aimed to: (i) describe the basic echocardiography characteristics of LV in the hearts of the athletes and (ii) explore the possibility of LVMW parameters to evaluate myocardial function among the athletes.…”

Tocilizumab improves oxidative stress and endothelial glycocalyx: A mechanism that may explain the effects of biological treatment on COVID-19

“…We measured the myocardial global work index (GWI-mmHg%) as the area under the curve from mitral valve closure to mitral valve opening using dedicated software (EchoPac PC 203, GE Healthcare, Horten, Norway) to construct pressure-LV longitudinal myocardial strain loop by speckle tracking echocardiography ( Ikonomidis et al, 2019a ; Manganaro et al, 2020 ). Furthermore, the software calculated the global constructive work (GCW-mmHg%) as work performed during shortening in systole adding negative work during lengthening in isovolumetric relaxation and the wasted myocardial work (GWW-mmHg%) as negative work performed during lengthening in systole adding work performed during shortening in isovolumetric relaxation.…”

“…Furthermore, the software calculated the global constructive work (GCW-mmHg%) as work performed during shortening in systole adding negative work during lengthening in isovolumetric relaxation and the wasted myocardial work (GWW-mmHg%) as negative work performed during lengthening in systole adding work performed during shortening in isovolumetric relaxation. The constructive work divided by the sum of constructive and wasted work provides the global work efficiency (GWE-%) ( Manganaro et al, 2020 ). The inter- and intra-observer reproducibility for GWI were ≤8% and ≤9% respectively.…”

New capabilities in assessing the left ventricular contractility by two-dimensional speckle tracking echocardiography

“…выявлена статистически значимая корреляция между показателями работы и деформационными характеристиками миокарда у 226 здоровых субъектов (45 ± 13 лет). Наибольшая корреляция наблюдалась между GCW и GLS (-0,55; p < 0,001) [41]. Интересные результаты представлены в исследовании E. Boe, где была продемонстрирована большая чувствительность и специфичность индекса регионарной работы миокарда (81 и 82%) против GLS (78 и 65% соответственно) в способности вывлять коронарную окклюзию у больных инфарктом миокарда без подъема сегмента ST [42].…”