Left Ventricular Global Strain for Estimating Relaxation and Filling Pressure　– A Multicenter Study –

Abstract

Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp that these parameters do not necessarily correlate with invasively measured LV filling pressure in patients with hypertrophic cardiomyopathy, 2 severely reduced LV systolic function, 3 and heart failure with preserved ejection fraction (EF). 4 Editorial p 1104Reasons for inaccuracies with tissue Doppler-derived parameters could include angle dependency and myocardial tethering, levated left ventricular (LV) filling pressure results in shortness of breath, which is both a major symptom and a prognostic predictor for heart failure. Therefore, noninvasive estimation of LV filling pressure is considered a goal of routine echocardiography. Recent recommendations encourage using tissue Doppler-derived early-diastolic mitral annular velocity (e´) as a parameter of LV relaxation and the ratio of early-diastolic LV inflow velocity (E) to e´ (E/e´) to indicate LV filling pressure. Background: Speckle-tracking echocardiography (STE)-derived parameters may have better correlation with left ventricular (LV) relaxation and filling pressure than tissue Doppler-derived parameters. However, it has not been elucidated which parameter -strain or strain rate -and which direction of myocardial deformation -longitudinal or circumferential -is the most useful marker of LV relaxation and filling pressure.

Left Ventricular Mass Influences Relationship Between Filling Pressure and Early-Diastolic Ratio of Inflow Velocity to Mitral Annular Velocity (E/e′)

“…8 The present study further elucidated that (1) the coincidence of hypertension and LVEF Abbreviations as in Tables 1-3.…”

“…15 However, the SMAP study, which we conducted in clinical patients referred for cardiac catheterization, showed that e′ significantly but only weakly correlated with τ. 8 In the present analysis, we tested the determinants of e′ to clarify the factors other than τ that influence e′ because the characteristics of the studied patients could have altered the relationship between τ and e′. As a result, we found that hypertension as a comorbidity and LVEF, but not τ, were the determinants of e′.…”

“…8 Briefly, the study included 84 patients (suspected of having angina pectoris, prior myocardial infarction, dilated cardiomyopathy, HCM, and hypertensive heart disease) who underwent diagnostic cardiac catheterization in 5 institutions in Japan (Hokkaido University Hospital, Nagoya City University Hospital, Mie University Hospital, University of Tsukuba Hospital, and Tokushima University Hospital), and the utility of echocardiographic parameters for the estimation of invasively measured LV relaxation and filling pressure using a Moreover, the LV early-diastolic flow propagation velocity (Vp) was measured from the apical color M-mode Doppler image using a previously reported method. 14 Finally, the ratio of E to Vp (E/Vp) was calculated.…”

“…8 Briefly, the study protocol was written by the investigators from Hokkaido University (S.Y. and H.I.…”

Early mitral inflow velocity to left ventricular global strain ratio predicts limited exercise capacity

“…Recently, Hayashi et al. demonstrated in their prospective multicenter study that left ventricular global longitudinal strain (LVGLS) derived from 2D speckle tracking was correlated better with the time constant of LV pressure decay (τ) than E′, and E to LVGLS ratio (E/LVGLS) had a better correlation to LV mean diastolic pressure than E/E′ . These findings suggested that LVGLS was not the only utilized for the evaluation of LV systolic function, but also LV diastolic function.…”