Long axis function in disease

Henein, Michael Y.; Gibson, D G

doi:10.1136/hrt.81.3.229

Cited by 195 publications

(135 citation statements)

References 23 publications

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“…Systolic RVP increased concomitantly, exceeding systemic BP. Subendocardial fibers probably are the first muscle fibers that become ischemic when an imbalance in oxygen delivery or coronary blood supply occurs (12,34). Hypoperfusion has been associated with decreased longitudinal strain, followed by diminished circumferentially and finally radial function in an animal model (35), which agrees with the observed differences in the longitudinal and radial contraction pattern in the hypoxic pigs.…”

Section: Function In Hypoxemic Newborn Pigssupporting

confidence: 75%

“…Longitudinal shortening, however, is described as an index of global LV function (9) and is significantly depressed during regional ischemia in humans and experimental animal models (10,11). LV longitudinal shortening is supposed to be a sensitive marker of ischemia because the subendocardial muscle fibers of LV are the most susceptible to ischemia (12). However, LV function is a result of the combined contraction of the differently oriented muscle fibers (13).…”

mentioning

confidence: 99%

“…Previous research has studied myocardial contraction patterns, including changes in contraction during regional ischemia and reperfusion (12,(15)(16)(17). Human studies have shown that longitudinal movement derived from the subendocardial and subepicardial muscle fibers slightly precede radial movements resulting from circumferential and radial fibers (18).…”

mentioning

confidence: 99%

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Reduced Left Ventricular Function in Hypoxemic Newborn Pigs: A Strain Doppler Echocardiographic Study

Børke¹,

Edvardsen²,

Fugelseth

et al. 2006

Pediatr Res

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Myocardial dysfunction, hypotension, and increased pulmonary artery pressure are induced by asphyxia in neonates. We sought to define left ventricular (LV) systolic function by measuring longitudinal and radial contraction by strain Doppler echocardiography (SDE) in hypoxemic newborn pigs. Hypoxemia was induced in 11 anesthetized and instrumented newborn pigs by ventilation with 8% O 2 in nitrogen. When mean arterial blood pressure (BP) decreased to 15 mm Hg or arterial base excess reached Ϫ20 mmol/L or less, the pigs were reoxygenated and ventilated for 150 min. Echocardiography was performed at baseline and during hypoxemia and reoxygenation. Baseline measurements of myocardial peak systolic strain demonstrated normal longitudinal shortening and radial thickening. During hypoxemia, systolic longitudinal shortening in the mid-posterior and septal segments changed to systolic stretching. Peak strain in the mid-lateral and anterior segments decreased but without signs of paradox wall motion. Short-axis peak strain remained positive during hypoxemia, although the amplitude was reduced and delayed with respect to timing. In the newborn pig heart, we found a complex and heterogeneous systolic pattern with distinct regional differences during global hypoxemia. Rapid changes in LV function during hypoxemia and reoxygenation are assessable by SDE, and the results indicate that longitudinal systolic contraction is more vulnerable to hypoxemic changes than radial contraction. To explore the full picture of a global hypoxemic injury, both long-and short-axis functions have to be considered.

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Section: Function In Hypoxemic Newborn Pigssupporting

confidence: 75%

mentioning

confidence: 99%

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Reduced Left Ventricular Function in Hypoxemic Newborn Pigs: A Strain Doppler Echocardiographic Study

Børke¹,

Edvardsen²,

Fugelseth

et al. 2006

Pediatr Res

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“…102 Hypertension, like other progressive myocardial diseases for example, coronary artery disease and hypertrophic cardiomyopathy, preferentially affects subendocardial function and the longitudinal fibres running along it. 103 The epicardial function may remain relatively unaffected. Thus, in HFNEF, LV longitudinal and radial strains are reduced but circumferential strain and torsion, which reflect subepicardial function, are normal at least at rest.…”

Section: 66mentioning

confidence: 99%

Hypertension and heart failure: a dysfunction of systole, diastole or both?

et al. 2008

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The pathological myocardial hypertrophy associated with hypertension contains the seed for further maladaptive development. Increased myocardial oxygen consumption, impaired epicardial coronary perfusion, ventricular fibrosis and remodelling, abnormalities in long-axis function and torsion, cause, to a varying degree, a mixture of systolic and diastolic abnormalities. In addition, chronotropic incompetence and peripheral factors such as lack of vasodilator reserve and reduced arterial compliance further affect cardiac output particularly on exercise. Many of these factors are common to hypertensive heart failure with a normal ejection fraction as well as systolic heart failure. There is increasing evidence that these apparently separate phenotypes are part of a spectrum of heart failure differing only in the degree of ventricular remodelling and volume changes. Furthermore, dichotomizing heart failure into systolic and diastolic clinical entities has led to a paucity of clinical trials of therapies for heart failure with a normal ejection fraction. Therapies aimed at reversing myocardial fibrosis, and targets outside the heart such as enhancing vasodilator reserve and improving chronotropic incompetence deserve further study and may improve the exercise capacity of hypertensive heart failure patients. Hypertension heart disease with heart failure is simply not a dysfunction of systole and diastole. Other peripheral factors including heart rate and vasodilator response with exercise may deserve equal attention in an attempt to develop more effective treatments for this disorder.

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“…The fibers responsible for short-axis shortening and thickening of the left ventricle are circumferentially located at the midwall. The longitudinally orientated fibers are predominantly located at the subendocardium and they are responsible for long-axis shortening and twisting of the left ventricle (1). Standard echocardiographic measurements, such as endocardial fractional shortening ( e FS) and ejection fraction (EF), reflect chamber dynamics and they are not direct measurements of the longitudinal fiber function (2).…”

Section: Introductionmentioning

confidence: 99%

Assessment of longitudinal left ventricular systolic function by different echocardiographic modalities in patients with newly diagnosed mild-to-moderate hypertension

Atılgan

Bilge²,

Onur³

et al. 2010

Anadolu Kardiyol Derg

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Objective: Standard echocardiographic methods reflect chamber dynamics and do not provide a direct measure of myocardial fiber shortening. Therefore we evaluated longitudinal left ventricular myocardial function by tissue Doppler echocardiography; strain (S), strain rate (SR), tissue Doppler velocity (TDV) in newly diagnosed mild to moderate hypertensive patients. Methods: Our cross-sectional and observational study population consisted of 57 patients and 48 normotensive control subjects. Patients with obesity, diabetes mellitus, regional wall motion abnormality, secondary hypertension and a history or clinical evidence of cardiovascular disease, arrhythmias or conduction abnormalities were excluded from the study. Ejection fraction, endocardial fractional shortening ( e FS), meridional end-systolic stress ( m ESS), stress-adjusted e FS (observed /predicted e FS) were measured by M-mode echocardiography. Relationship between the left ventricular mass index and mESS was assessed by Pearson's linear regression model. Results: Hypertensive patients had significantly decreased longitudinal myocardial function compared to control subjects determined by septal (-1.25±0.30 vs. -1.02±0.33, p<0.001) and lateral (-1.20±0.28 vs. 1.02±0.41, p<0.01) SR (1/s) measurements. However, there was no significant correlation between the m ESS and strain-strain rate measurements in both normal and hypertensive subjects.

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Long axis function in disease

Cited by 195 publications

References 23 publications

Reduced Left Ventricular Function in Hypoxemic Newborn Pigs: A Strain Doppler Echocardiographic Study

Reduced Left Ventricular Function in Hypoxemic Newborn Pigs: A Strain Doppler Echocardiographic Study

Hypertension and heart failure: a dysfunction of systole, diastole or both?

Assessment of longitudinal left ventricular systolic function by different echocardiographic modalities in patients with newly diagnosed mild-to-moderate hypertension

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