Cumulative Impact of Cardiovascular Risk Factors on Regional Left Ventricular Function and Reserve: Progressive Long-Axis Dysfunction with Compensatory Radial Changes

Vinereanu, Dragoş; Madler, C.; Gherghinescu, C.; Ciobanu, A.; Fraser, Alan G.

doi:10.1111/j.1540-8175.2011.01456.x

Cited by 14 publications

(10 citation statements)

References 31 publications

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“…The pattern of progression that was observed supports the conceptual framework for the natural history of subclinical changes in regional and global LV function that is proposed in Figure 3 with the type 2 diabetic subjects moving over 5 years. Same pattern was also suggested by our studies in patients with hypertension with or without associated diabetes 24,25 …”

Section: Discussionsupporting

confidence: 87%

“…Same pattern was also suggested by our studies in patients with hypertension with or without associated diabetes. 24,25 This study is the only one to review in such detail a cohort of diabetic patients after five years. From et al reported changes in LV function in diabetic patients over time, including progression towards heart failure.…”

Section: Progression Of Diabetic Cardiomyopathymentioning

confidence: 99%

See 1 more Smart Citation

Progression of Subclinical Myocardial Dysfunction in Type 2 Diabetes after 5 years Despite Improved Glycemic Control

Vintila¹,

Roberts

Vinereanu³

et al. 2012

Echocardiography

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Section: Discussionsupporting

confidence: 87%

Section: Progression Of Diabetic Cardiomyopathymentioning

confidence: 99%

Progression of Subclinical Myocardial Dysfunction in Type 2 Diabetes after 5 years Despite Improved Glycemic Control

Vintila¹,

Roberts

Vinereanu³

et al. 2012

Echocardiography

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“…Additionally, E/E' was negatively correlated with GCS. Hence we could see that the level of glycemic control was closely related to LV systolic function in the diabetic patients, which further confirmed previous studies [18,22,23]. One proposed pathophysiological mechanism is that the long-term toxicity of high glycemia could increase the deposition of advanced glycation end products (AGEs) in myocardial cells and bring more cross-links between collagen and elastin, causing lower flexibility but greater stiffness in the myocardium [24].…”

Section: Factors Influencing Systolic Function In Diabetic Patientssupporting

confidence: 74%

Subclinical impairment of left ventricular function in diabetic patients with or without obesity

Wang

Gao

Tan

et al. 2014

Herz

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“…11,12) Noninvasive prediction of future LV systolic dysfunction is feasible with tissue velocity imaging (TVI) by Doppler ultrasound, but Doppler TVI had limitations because circumferential and radial strain could not be evaluated with Doppler TVI. However, these limitations of Doppler TVI have been overcome with the development of 2DSTE, and 3-dimensional multidirectional strain or strain rate analysis is now feasible.…”

Section: Discussionmentioning

confidence: 99%

Patterns of Decrease in Multidirectional Myocardial Deformations in Patients With Fluctuating Left Ventricular Ejection Fraction

et al. 2014

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SummaryFew studies have examined the variations in longitudinal/circumferential/radial strain (LS/CS/RS) and strain rate (LSr/CSr/RSr) in individual hearts when the left ventricular ejection fraction (LVEF) has changed. We hypothesized the relationships of strain/strain rate and LVEF are not linear, but vary with multiple inflection points (IPs) in individual hearts.Twenty-five patients with fluctuating LVEF (ΔLVEF > 10%) who had 2-D speckle tracking echocardiography available for analysis were enrolled. After models of best fit were obtained from the 'collective' plots to determine inflection points, the decrements of slopes above inflection points (IP) were compared with those below IPs in the 'individual hearts' plots.In the 'collective' plots, both LS and LSr linearly decreased in proportion to LVEF when LVEF ≥ 40% but remained constant regardless of LVEF when LVEF < 40% (IPs when LVEF = 40%, P < 0.0001). The RS-LVEF relationship was sigmoid with two IPs when LVEF = 30% and 50% (P < 0.0001). However, in the 'individual hearts' plots, the decrements of slopes above and below IPs were not different for LS-LVEF and LSr-LVEF, and marginally different for RS-LVEF (P = 0.049, across IP when LVEF = 50%).Collectively, the relationship of LS/LSr/RS and LVEF seemed to be not linear, but inflective, however, we could not prove the inflective relationship in individual hearts with fluctuating LVEF. Further study with more patients is needed to prove our hypothesis. (Int Heart J 2014; 55: 319-325) Key words: Heart failure, Myocardial strain, Strain rate imaging L eft ventricular (LV) systolic work is produced by a combination of the following 3-dimensional myocardial deformations: longitudinal, circumferential and radial strain.Longitudinal strain and strain rate can be measured by Doppler tissue velocity imaging (TVI), which seems superior to conventional echocardiographic parameters at predicting LV systolic dysfunction in various cardiac diseases. 1-3)Since the introduction of 2-dimensional speckle tracking echocardiography (2DSTE) to the field of cardiac imaging, radial and circumferential strain can be analyzed in addition to longitudinal strain. Furthermore, early detection of ischemic heart disease and various cardiomyopathies is now feasible with 2DSTE. 4-7)Despite these advances, the variations in multidirectional myocardial deformations in individual hearts with fluctuating LV systolic function have not yet been fully elucidated.We previously described a different pattern of multidirectional impairment in doxorubicin-induced cardiomyopathy models in rats, 8) and tried to prove a similar pattern of impairment in human subjects in the current study, by investigating functional changes in each LV axis by analyzing longitudinal/ circumferential/radial strain (LS/CS/RS) and strain rate (LSr/ CSr/RSr) of LV with fluctuating LVEF.We also hypothesized the decrements in strain and strain rate are not constant but inflective as LVEF decreases, and the patterns of decrease in longitudinal strain/strain rate are different ...

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Cumulative Impact of Cardiovascular Risk Factors on Regional Left Ventricular Function and Reserve: Progressive Long-Axis Dysfunction with Compensatory Radial Changes

Cited by 14 publications

References 31 publications

Progression of Subclinical Myocardial Dysfunction in Type 2 Diabetes after 5 years Despite Improved Glycemic Control

Progression of Subclinical Myocardial Dysfunction in Type 2 Diabetes after 5 years Despite Improved Glycemic Control

Subclinical impairment of left ventricular function in diabetic patients with or without obesity

Patterns of Decrease in Multidirectional Myocardial Deformations in Patients With Fluctuating Left Ventricular Ejection Fraction

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