Echocardiographic reference ranges for normal non-invasive myocardial work indices: results from the EACVI NORRE study

Manganaro, Roberta; Marchetta, Stella; Dulgheru, Raluca; Ilardi, Federica; Sugimoto, Tadafumi; Robinet, Sébastien; Cimino, Sara; Go, Yun Yun; Bernard, Anne; Kacharava, George; Athanassopoulos, George; Barone, Daniele; Baroni, Monica; Cardim, Nuno; Hagendorff, Andreas; Hristová, Krasimira; López‐Fernández, Teresa; Morena, Gonzalo de la; Popescu, Bogdan A; Pěnička, Martin; Özyiğit, Tolga; Carbonero, D. Rodrigo; Veire, Nico Van de; Bardeleben, Ralph Stephan von; Vinereanu, Dragoş; Zamorano, José Luís; Roşca, Monica; Călin, Andreea; Moonen, Marie; Magné, Julien; Cosyns, Bernard; Galli, Elena; Donal, Erwan; Carerj, Scipione; Zito, Concetta; Santoro, Ciro; Galderisi, Maurizio; Badano, Luigi P.; Lang, Roberto M.; Oury, Cécile; Lancellotti, Patrizio

doi:10.1093/ehjci/jey188

Cited by 243 publications

(272 citation statements)

References 28 publications

(34 reference statements)

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“…In a large multicenter study, the median GWI of healthy subjects was 1896 ± 308 mm Hg%. 15 Other studies showed significantly lower GWI values of 1078 ± 506 mm Hg% in patients with dilated cardiomyopathy. 10 We focused on patients with severe heart failure in a center specialized in heart transplantation and assist device implantation.…”

Section: Discussionmentioning

confidence: 91%

“…Normal values have recently been published and work indices have been measured in patients with heart failure . This work describes for the first time the relation between classic prognostic parameters and work indices in a heart failure population.…”

Section: Discussionmentioning

confidence: 99%

“…14 Normal values have recently been published and work indices have been measured in patients with heart failure. 7,9,15 This work describes for the first time the relation between classic prognostic parameters and work indices in a heart failure population. We retrospectively analyzed data from patients who presented in our outpatient heart failure unit between October 2018 and February 2019.…”

Section: Discussionmentioning

confidence: 99%

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Global work index correlates with established prognostic parameters of heart failure

et al. 2020

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Aim Identification of patients with heart failure and a poor prognosis is paramount to ensure timely and adequate treatment. We investigated the relationship between the new measures of noninvasive pressure‐strain analysis, such as the global work index (GWI), and established prognostic parameters of echocardiography, cardiopulmonary exercise test (CPX), and N‐terminal pro‐B‐type natriuretic peptide (NT‐pro‐BNP). Methods and Results We retrospectively analyzed data of 51 patients with heart failure. Echocardiography and CPX were performed, and NT‐pro‐BNP was determined. Patients with a GWI < 500 mm Hg% had a mean LVEDV of 286.1 ± 100.8 mL, an LVEF of 21.3 ± 5.7%, and a stroke volume (SV) of 45.9 ± 11.6 mL, and patients with a GWI > 1000 mm Hg% had an LVEDV of 147.9 ± 39.6 mL, an LVEF of 42.6 ± 4.8%, and a SV of 70.9 ± 14.3 mL. The GWI also showed a significant correlation with peak oxygen consumption (peak VO2) (r = .521; P < .001) and with NT‐pro‐BNP (r = .635; P < .001). Patients with a GWI of <500 mm Hg% had a significantly higher NT‐pro‐BNP (median 2415 pg/mL [IQR 1071, 5933]) and a lower peak VO2 (9.5 mL/min/kg ± 2.6) compared to patients with a GWI of >1000 mm Hg% (NT‐pro‐BNP median 253 pg/mL [IQR 150, 549]; peak VO2 15.6 ± 4.2 mL/min/kg). Conclusion GWI correlates with known prognostic markers of heart failure. A GWI of <500 mm Hg% was a predictor of severely impaired ejection fraction, very low exercise capacity, and strongly elevated NT‐pro‐BNP, indicating a poor prognosis.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Global work index correlates with established prognostic parameters of heart failure

et al. 2020

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“…The above results illustrated that subclinical changes in LV systolic function have occurred in athletes and MW indexes were more sensitive to provide early diagnosis value for LV performance among athletes. 24 According to the ROC analysis about LVMW parameters, GWE (AUC = 0.733) was considered of being the best predictor of LV systolic function in athletes and superior to GLS (AUC = 0.627) which was principally limited by the defect of being load-dependent and might lead to errors in judging LV performance. 25 Limitations Several limitations to this study need to be acknowledged as follows: (i) The sample scale was small.…”

Section: Discussionmentioning

confidence: 99%

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

Hua

Chen

et al. 2020

Preprint

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Background The health of athletes has been recognized as a worldwide public concern with more reported sudden cardiac deaths (SCD). Therefore, early detection of abnormal heart function in athletes can help reduce the risk of exercise. A novel valid non-invasive method to evaluate left ventricular (LV) myocardial work (MW) using LV pressure-strain loop (PSL), was used in this paper to explore LV systolic function in young male strength athletes. Methods 36 professional young male strength athletes (the athlete group) and 32 healthy, age-matched young men (the control group) were involved in the study. The LVMW parameters were calculated as the area of PSL by two-dimensional speckle tracking echocardiography (2D-STE) and peak systolic LV pressure. The differences between two groups of data and the predictive efficacy of MW parameters for LV systolic function were analyzed. Results The athlete group had significantly higher values of global wasted myocardial work (GWW) and peak strain dispersion (PSD) than did the control group (P༜0.05).Global myocardial work index (GWI), global constructive myocardial work (GCW) and global longitudinal strain (GLS) were lower in the athlete group than that in the control group, although statistical significance was not reached (P༞0.05). Due to the proportion of GWW and GCW, statistically significant reduction was found in global myocardial work efficiency (GWE) in the athlete group. The best predictor of LV myocardial contractile performance in the athletes using receiver operating characteristic curve (ROC) was GWE, with the area under ROC (AUC) of 0.733, sensitivity of 83.3% and specificity of 59.4%. Conclusions Subclinical changes have appeared in the hearts of young male strength athletes after long-term intensive exercise and LVMW parameters by PSL play an important role in the evaluation of athlete’s LV contractile performance.

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“…For example, increased afterload may cause lower LV strain, leading to misjudgment of the real LV systolic function [10]. Myocardial work (MW), which is derived from 2D-STI, combines the LV pressure (derived from the systolic pressure in the brachial artery) measured using a noninvasive method and the longitudinal strain data for the LV myocardium to establish the LV pressure-strain loops (PSL) [11]. This approach can be used to examine the dynamic changes in LV MW when LV becomes deformed due to overcoming the afterload.…”

Section: Introductionmentioning

confidence: 99%

Value of quantitative analysis of left ventricular systolic function in patients on maintenance hemodialysis based on myocardial work technique

Liu

Feng²,

Song

et al. 2020

Preprint

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Background: To detect the left ventricular (LV) systolic function in maintenance hemodialysis (MHD) patients by using myocardial work (MW) technique. And investigated the clinical value of the MW technique for the quantitative analysis of left ventricular (LV) systolic function in MHD patients with left ventricular hypertrophy (LVH).Methods: A total of 58 MHD patients and 29 normal subjects were registered in this study. The MHD patients were divided into the non-left ventricular hypertrophy (NLVH) group (n=32) and the LVH group (n=26) according to the LV myocardial index (LVMI). MW was used to generated the LV global longitudinal strain (GLS), global work index (GWI), global constructive work (GCW), global wasted work (GWW), global work efficiency (GWE. GLS and the MW parameters (GWI, GCW, GWW, GWE) were compared between groups and the correlations between these parameters and the LV ejection fraction (LVEF) in the LVH group were examined. The receiver operating characteristic (ROC) curve was used to evaluate the efficacy of MW parameters and GLS for the assessment of LV systolic dysfunction in MHD patients with LVH.Results: The LVH group had significantly lower GWE, GWI, GCW, and GLS but higher GWW than the control and NLVH groups. Compared with the control group, the NLVH group had significantly lower GWE and GLS and higher GWW, but no significant differences in GWI, GCW were observed between these two groups. The LVEF was negatively correlated with GWW in MHD patients, but positively correlated with GWI, GWE, and GCW in the LVH group. Receiver operating characteristic curve (ROC) analysis revealed that GWE, GWW, GWI, and GCW had appreciable area under the curve (AUC), sensitivity, and specificity for evaluating LV function in LVH patients. Conclusion: MW parameters can be effectively used to evaluate the LV systolic function in MHD patients with or without LVH.

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Echocardiographic reference ranges for normal non-invasive myocardial work indices: results from the EACVI NORRE study

Abstract: To obtain the normal ranges for 2D echocardiographic (2DE) indices of myocardial work (MW) from a large group of healthy volunteers over a wide range of ages and gender.

Cited by 243 publications

References 28 publications

Global work index correlates with established prognostic parameters of heart failure

Global work index correlates with established prognostic parameters of heart failure

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

Value of quantitative analysis of left ventricular systolic function in patients on maintenance hemodialysis based on myocardial work technique

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