Influence of afterload on left ventricular radial and longitudinal systolic functions: a two-dimensional strain imaging study

Donal, Erwan; Bergerot, Cyrille; Thibault, Hélène; Ernande, Laura; Loufoua, Joseph; Augeul, Lionel; Ovize, Michel; Dérumeaux, Geneviève

doi:10.1093/ejechocard/jep095

Cited by 163 publications

(121 citation statements)

References 33 publications

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“…Cross‐sectional and experimental studies suggest that longitudinal strain may serve as a marker of subendocardial cardiac dysfunction during the very early stages of disease progression, at which time circumferential and radial strains may remain preserved or even increase to compensate for relative decrements in the subendocardium, thus serving to maintain global pump function 16, 42. Our data also support this hypothesis, where individuals in the lowest (ie, best) tertile of circumferential strain at baseline appeared to fare just as poorly or even worse than those in the middle tertile with respect to risk for all‐cause mortality (Figure 1F).…”

Section: Discussionmentioning

confidence: 99%

Distinct Aspects of Left Ventricular Mechanical Function Are Differentially Associated With Cardiovascular Outcomes and All‐Cause Mortality in the Community

Cheng

McCabe

Larson

et al. 2015

JAHA

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BackgroundThere are few data relating novel measures of left ventricular (LV) mechanical function to cardiovascular disease (CVD) outcomes in the community. Whether distinct components of LV mechanical function provide information regarding risk for different CVD outcomes is unclear.Methods and ResultsWe used speckle tracking echocardiography to quantify distinct components of LV mechanical function (measured as LV strain in multiple planes) in 2831 Framingham Offspring Study participants (mean age, 66 years; 57% women, 97% with LV fractional shortening >0.29). Participants were followed for 6.0±1.2 years for onset of 69 coronary heart disease (CHD), 71 heart failure (HF), and 199 mortality events. Adjusting for CVD risk factors, longitudinal LV strain appeared associated with incident CHD (hazards ratio [HR] per SD increment, 1.29; 95% confidence interval [CI], 1.00–1.67; P=0.05), whereas circumferential and radial strain were not (P>0.37 for both); however, the association of longitudinal strain with CHD was nonsignificant after Bonferroni correction. By contrast, circumferential strain was a significant predictor of incident HF (HR per SD increment, 1.79; 95% CI, 1.35–2.37; P<0.0001). Decrements in circumferential, radial, and longitudinal strain measures were related to all‐cause mortality (P<0.008 for all). Results remained similar in multivariable models adjusting additionally for the conventional echocardiographic measures of LV mass and fractional shortening.ConclusionsIn our large, community‐based sample, distinct components of LV mechanical function were associated with specific CVD outcomes. Additional studies are needed to replicate these findings and investigate the prognostic and therapeutic utility of these novel measures of LV mechanical function.

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Section: Discussionmentioning

confidence: 99%

Distinct Aspects of Left Ventricular Mechanical Function Are Differentially Associated With Cardiovascular Outcomes and All‐Cause Mortality in the Community

Cheng

McCabe

Larson

et al. 2015

JAHA

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“…All patients in our study had a normal EF, a parameter that is used to express absence of failure of the global LV function; however, this index is subject to variations depending on the chamber's geometry, afterload and increase in mass [33][34][35], among other variables. Hence, EF is more precise to evaluate pump function than ventricular function, since it mainly expresses the radial function of the myocardium and is less affected by abnormalities of the subendocardium [36].…”

Section: Discussionmentioning

confidence: 99%

Severe aortic stenosis with preserved ejection fraction and evidence of impairment in structure, myocardial strain and ventricular function: A new contribution to clinical decision making

et al. 2015

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Background: Left ventricular ejection fraction (LVEF) is among the parameters that are usually employed to define surgical timing of severe aortic stenosis (AS G1: 328 ± 66, G2a: 376 ± 22, G2b: 385 ± 13, p < 0.01; collagen volume [%]: G1: 4.77 ± 1.27, G2a: 8.40 ± 1.27, G2b: 11.05 ± 3.08, p < 0.01; LVEDP normalized by diastolic diameter [mm Hg/mm]: G1: 0.27 ± 0.01, G2a: 0.39 ± 0.06, G2b: 0.44 ± 0.11, p < 0.02; +dP/dt max /LVEDP [mm Hg/s/mm Hg]: G1: 176 ± 45, G2a: 89.6 ± 20, G2b: 113.1 ± 41, p < 0.01; p < 0.05 (Cardiol J 2015; 22, 6: 613-621)

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“…These recent parameters of systolic function are also affected by afterload changes but might be less load-dependent than conventional parameters (11,32). The combined assessment of longitudinal and radial function of the left ventricle may be more sensitive and accurate in detecting subclinical changes in LV performance than conventional echocardiographic methods (33).…”

Section: Discussionmentioning

confidence: 99%

Subclinical left ventricular systolic dysfunction in patients with mild-to-moderate rheumatic mitral stenosis and normal left ventricular ejection fraction: an observational study

Yıldırımtürk

Helvacıoğlu²,

Tayyareci³

et al. 2013

Anadolu Kardiyol Derg

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Subclinical left ventricular systolic dysfunction in patients with mild-to-moderate rheumatic mitral stenosis and normal left ventricular ejection fraction: an observational studyHafif orta derecede romatizmal mitral kapak darlığı ve normal sol ventrikül ejeksiyon fraksiyonu olan hastalarda subklinik sol ventrikül sistolik disfonksiyonu: Bir gözlemsel çalışma Original Investigation Özgün Araşt›rma 328ÖZET Amaç: Tanı ve tedavideki gelişmelere rağmen mitral kapak darlığı (MD) genç erişkinlerde morbiditenin önemli bir sebebidir. Genellikle, MD olan hastalarda sol ventrikül (SV) fonksiyonları iyi korunmuştur. Ancak bazı çalışmalarda saf MD olan hastalarda SV sistolik fonksiyonlarının bozulduğu gösterilmiştir. Bu çalışmanın amacı; izole hafif-orta MD olan, normal SV ejeksiyon fraksiyonlu hasta kohortunda doku Doppler görüntüleme (DDG) ve hız vektör görüntüleme (HVG) yöntemlerini kullanarak, bu hastalarda subklinik sol ventrikül sistolik disfonksiyon varlığını araştırmaktır. Yöntemler: İzole hafif-orta MD olan 50 hasta (%84 kadın, ortalama yaş 49.1±10.0 yıl) ve 60 sağlıklı kişi (%76.7 kadın, ortalama yaş 49.1±10.5 yıl) göz-lemsel kesitsel çalışmaya dahil edildi. Tüm hastalara konvansiyonel ekokardiyografi, DDG ve HVG ile strain (S) ve strain oranı (SR) analizi yapıldı. Bulgular: MD olan hastalarda ortalama transmitral gradient 6.4±3.0 mmHg ve ortalama mitral kapak alanı 1.45±0.36 cm 2 olarak bulundu. MD olan hastalarda hem longitüdinal hem de sirkümferensiyal S ve SR değerleri belirgin olarak düşük bulundu (p<0.001). DDG ile elde edilen izovolümik akselerasyon (IVA) ve sistolik dalga hızı (Sa) da izole MD olan hastalarda düşük olarak ölçüldü (p<0.001). SV ejeksiyon fraksiyonu deformasyon indeksleri ile korelasyon göstermemekte idi. Deformasyon indeksleri transmitral gradiyent ya da mitral kapak alanı ile ilişkili değildi. Sonuç: Normal ejeksiyon fraksiyonu olan izole MD olan hastalarda HVG ile elde edilen deformasyon parametreleri subklinik sistolik disfonksiyonu gös-terebilir. Bu bulgular mitral kapak cerrahisi için optimal zamanlamanın belirlenmesinde faydalı olabilir. (Anadolu Kardiyol Derg 2013; 13: 328-36) Anahtar kelimeler: Sol ventrikül, sistolik fonksiyon, deformasyon görüntüleme, mitral kapak darlığı, hız vektör görüntüleme

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Influence of afterload on left ventricular radial and longitudinal systolic functions: a two-dimensional strain imaging study

Cited by 163 publications

References 33 publications

Distinct Aspects of Left Ventricular Mechanical Function Are Differentially Associated With Cardiovascular Outcomes and All‐Cause Mortality in the Community

Distinct Aspects of Left Ventricular Mechanical Function Are Differentially Associated With Cardiovascular Outcomes and All‐Cause Mortality in the Community

Severe aortic stenosis with preserved ejection fraction and evidence of impairment in structure, myocardial strain and ventricular function: A new contribution to clinical decision making

Subclinical left ventricular systolic dysfunction in patients with mild-to-moderate rheumatic mitral stenosis and normal left ventricular ejection fraction: an observational study

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