Left Ventricular Longitudinal and Radial Synchrony and Their Determinants in Healthy Subjects

Ng, Arnold C.T.; Tran, Da T.; Newman, Mark; Allman, Christine; Vidaic, Jane; Lo, S.; Hopkins, A.; Leung, Dominic Y.

doi:10.1016/j.echo.2008.05.002

Cited by 39 publications

(29 citation statements)

References 27 publications

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“…Therefore of the 13 cohorts (12 studies) of normal healthy men that would be classified as including people with mild LVH, five would also contain men with moderate LVH. [13][14][15][16][17] The LVM from eight cohorts matched the upper ASE reference limit ( ± 10 g) 12,[18][19][20][21][22][23][24] (two studies included subjects from the cohorts used to create the reference range, 12,22 and one appears to be the study on which the twodimensional reference ranges were based 23 ), and LVM from seven cohorts was less than the upper ASE reference limit. 12,[25][26][27][28][29][30] Of those that were less than the upper ASE reference limit, three studies from Asia 25,26,30 had upper values on average 38 g less than the ASE reference limits for m-mode or two-dimensional measurements.…”

Section: Menmentioning

confidence: 99%

“…As occurred in men, indexation of mass by BSA did not remove the disparity between studies and the reference ranges, and actually seemed to increase the heterogeneity (Figure 3b). Of the 12 cohorts with an upper value within 10 g of the upper ASE reference limit for LVM, three were reclassified as exceeding the upper ASE reference 26,28,30 and one reclassified as falling below the upper ASE reference 24 after indexation by BSA.…”

Section: Menmentioning

confidence: 99%

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Geographic variation in left ventricular mass and mass index: a systematic review

et al. 2011

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Left ventricular (LV) hypertrophy, defined as an abnormal increase in LV mass (LVM), is an important prognostic indicator and therapeutic target. LVM is often divided by body surface area to derive indexed mass; however, this does not correctly identify pathological LV hypertrophy in all people, especially when body composition is altered, or in different ethnic groups. We evaluated published ranges of echocardiographic LVM in healthy adult populations from different countries, excluding control groups, and compared them with the American Society of Echocardiography reference ranges. A total of 33 studies met the inclusion criteria. In men and women, there was wide variation in the ranges of LVM with a tendency for the upper limit to increase geographically westward; this variation remained for indexed mass. Several ranges fell outside the upper reference limits: in men, 13 of the mass ranges and 16 of indexed mass; and in women, 8 mass and 16 indexed mass. This review has shown that current guidelines may need revision as some published series suggest that greater LV mass should be considered normal. This may be explained by ethnic differences and supports the need for widely applicable and ethnically diverse reference ranges to be established.

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Section: Menmentioning

confidence: 99%

Section: Menmentioning

confidence: 99%

Geographic variation in left ventricular mass and mass index: a systematic review

et al. 2011

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“…Cardiac EMD data could provide important mechanistic insights with respect to "exercise-induced cardiac fatigue." Cardiac timing data (onset QRS to peak SЈ) using TDI (Yu et al 2003) has been used to assess both intra-ventricular (LV segment to LV segment) and inter-ventricular (LV to RV segments) synchrony in healthy subjects (Ng et al 2008) and patients with heart failure (Yu et al 2003). Despite evidence that the impact of prolonged exercise on ventricular function may induce segmental speciWc changes in wall function (Douglas et al 1990b;George et al 2009), there has been no attempt to quantify movement (dys)synchrony within or between ventricles as a consequence of acute endurance exercise.…”

Section: Introductionmentioning

confidence: 99%

Evidence of increased electro-mechanical delay in the left and right ventricle after prolonged exercise

et al. 2009

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We assessed the time delay from the onset of QRS (Q) to peak systolic (S') and diastolic (E') tissue velocities in the left (LV) and right ventricle (RV) before and after prolonged exercise. Nineteen well-trained runners (mean +/- SD age, 41 +/- 9 years) had tissue-Doppler echocardiography performed before and after an 89 km ultra-marathon race. Longitudinal tissue motion was analysed in LV basal and mid-wall segments and RV free wall. Electromechanical coupling was assessed by the delay between Q and S' as well as E' tissue velocities. Average data for all segments were adjusted for the R-R interval. Comparisons were made by paired t-tests. An increase in electro-mechanical delay (EMD) was reported post-exercise in systole (Q-S' LV: 131 +/- 20 vs. 175 +/- 27 ms; RV: 171 +/- 34 vs. 258 +/- 35 ms; P < 0.05) and diastole (Q-E' LV: 486 +/- 51 vs. 647 +/- 44 ms; RV: 500 +/- 80 vs. 690 +/- 75 ms; P < 0.05). Further, post-race peak tissue velocities in basal LV and RV wall segments were reduced (P < 0.05). Recovery from prolonged running was associated with an increased "EMD", and reduced peak tissue velocities, in both ventricles.

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“…Additionally, radial thickening is a major factor of LV contraction, and short-axis dynamics are important markers for dyssynchrony [11]. Another study showed that two-dimensional speckle-derived radial synchrony is independent of clinical and echocardiographic variables, and that LV longitudinal synchrony does not correlate with radial synchrony [17]. Furthermore, the longitudinal motion appears to be less sensitive to dyssynchrony than radial motion by strain assessment [11].…”

Section: Discussionmentioning

confidence: 96%

Relationship of myocardial mechanics and regional volume change in patients with left ventricular systolic dysfunction

Mukerji

Xie

2010

Int J Cardiovasc Imaging

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The contraction and rotation of left ventricular (LV) segments in a synchronous fashion is vital for cardiac pump function. However, no data exist regarding the relationship of LV segmental mechanics and regional volume change in patients with LV systolic dysfunction. Thirty-two patients with EF < 50% and fifty-two normal subjects were enrolled. The radius strain and rotation were assessed in six segments at three short axis views using speckle tracking imaging. The mean and standard deviation (SD) of the strain peak time index (SPTI%) and the rotation peak time index (RPTI%) for each view were calculated as representing myocardial segmental synchrony. The mean and the SD of the 4-D mini-volume time index (VMTI, %) from 16 regions were calculated as representing regional volume change using real-time three-dimensional echocardiography (RT-3DE). The SD for each time index was averaged as the systolic dyssynchrony index (SDI) in both groups. The differences of the SPTI and the RPTI to the VMTI (T(sv) and T(rv)) were calculated as dyssynchrony between myocardial segmental mechanics and regional volume change. The time interval of the RPTI between apical and basal rotation (T(abrot)) was also calculated. The relationship of T(sv), T(rv) and T(abrot) to LV ejection fraction (EF) was then analyzed. In patients with LV systolic dysfunction, both peak strain and peak rotation occurred later than the regional minimum volume (55.3 ± 11.1% vs. 45.9 + 5.5%; 50.4 ± 8.7% vs. 45.9 ± 5.5% (both P < 0.05) as compared with normal subjects (41.1 ± 6.6% vs. 40.3 ± 3.8%; 44.1 ± 7.5% vs. 40.3 ± 3.8%). The SDI in each time index is also significantly wider than in normal subjects (P < 0.001). In addition, there was a negative correlation between T(sv), T(rv) and T(abrot) with EF, respectively (P < 0.05). In patients with abnormal LV systolic function the rotation occurs significantly later than regional volume change as compared with normal subjects. There is a negative correlation between this time delay and LVEF. Thus, the relationship of myocardial segmental change and regional volume change could provide insight into intraventricular dyssynchrony in patients with LV systolic dysfunction.

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Left Ventricular Longitudinal and Radial Synchrony and Their Determinants in Healthy Subjects

Cited by 39 publications

References 27 publications

Geographic variation in left ventricular mass and mass index: a systematic review

Geographic variation in left ventricular mass and mass index: a systematic review

Evidence of increased electro-mechanical delay in the left and right ventricle after prolonged exercise

Relationship of myocardial mechanics and regional volume change in patients with left ventricular systolic dysfunction

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