Myocardial Work in Echocardiography

Marzlin, Nathan; Hays, Allison G.; Peters, Matthew; Kaminski, Abigail; Roemer, Sarah; O’Leary, Patrick; Kroboth, Stacie; Harland, Daniel R; Khandheria, Bijoy K.; Jain, Renuka

doi:10.1161/circimaging.122.014419

Cited by 32 publications

(28 citation statements)

References 100 publications

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“…206 Moreover, GLS is an important predictor of outcome during a long-term follow-up in chronic ischemic cardiomyopathy. 85 Increased mechanical dispersion assessed by STE has been associated with an increased risk of arrhythmic events, independently of LVEF in after myocardial infarction. 207…”

Section: Coronary Artery Disease (Cad)mentioning

confidence: 99%

“…GLS has been shown to be a predictor of event‐free and total survival in myocardial infarction with or without ST‐segment elevation 206 . Moreover, GLS is an important predictor of outcome during a long‐term follow‐up in chronic ischemic cardiomyopathy 85 …”

Section: Principal Clinical Applications Of Left Ventricular Strain A...mentioning

confidence: 99%

“…Once the blood pressure data is entered into the software, a myocardial work bull's-eye plot, akin to the GLS analysis, is generated. 85 Four parameters are calculated (Table 6): Global Work Index (GWI), Global Constructive Work (GCW), Global Wasted Work (GWW), and Global Work Efficiency (GWE). 86 Based on large studies, [86][87][88][89] the average of LLN of GWI is 1442 mmHg%.…”

Section: Myocardial Workmentioning

confidence: 99%

“…This systolic pressure value is then input into the echocardiography system for subsequent myocardial work analysis. Once the blood pressure data is entered into the software, a myocardial work bull's‐eye plot, akin to the GLS analysis, is generated 85 . Four parameters are calculated (Table 6): Global Work Index (GWI), Global Constructive Work (GCW), Global Wasted Work (GWW), and Global Work Efficiency (GWE) 86 .…”

Section: Other Strain Applicationsmentioning

confidence: 99%

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Myocardial strain of the left ventricle by speckle tracking echocardiography: From physics to clinical practice

Gherbesi,

Gianstefani,

Angeli

et al. 2024

Echocardiography

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Speckle tracking echocardiography (STE) is a reliable imaging technique of recognized clinical value in several settings. This method uses the motion of ultrasound backscatter speckles within echocardiographic images to derive myocardial velocities and deformation parameters, providing crucial insights on several cardiac pathological and physiological processes. Its feasibility, reproducibility, and accuracy have been widely demonstrated, being myocardial strain of the various chambers inserted in diagnostic algorithms and guidelines for various pathologies. The most important parameters are Global longitudinal strain (GLS), Left atrium (LA) reservoir strain, and Global Work Index (GWI): based on large studies the average of the lower limit of normality are −16%, 23%, and 1442 mmHg%, respectively. For GWI, it should be pointed out that myocardial work relies primarily on non‐invasive measurements of blood pressure and segmental strain, both of which exhibit high variability, and thus, this variability constitutes a significant limitation of this parameter. In this review, we describe the principal aspects of the theory behind the use of myocardial strain, from cardiac mechanics to image acquisition techniques, outlining its limitation, and its principal clinical applications: in particular, GLS have a role in determine subclinical myocardial dysfunction (in cardiomyopathies, cardiotoxicity, target organ damage in ambulatory patients with arterial hypertension) and LA strain in determine the risk of AF, specifically in ambulatory patients with arterial hypertension.

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Section: Coronary Artery Disease (Cad)mentioning

confidence: 99%

Section: Principal Clinical Applications Of Left Ventricular Strain A...mentioning

confidence: 99%

Section: Myocardial Workmentioning

confidence: 99%

Section: Other Strain Applicationsmentioning

confidence: 99%

See 2 more Smart Citations

Myocardial strain of the left ventricle by speckle tracking echocardiography: From physics to clinical practice

Gherbesi,

Gianstefani,

Angeli

et al. 2024

Echocardiography

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“…Recently, MW indices have proven to be superior to traditional indexes of LV systolic function in younger athletes related to exercise capacity (Tokodi et al., 2021; D’Andrea et al., 2020) and useful as early predictors of adverse cardiac remodeling in the general population (Sahiti et al., 2021). Therefore, the noninvasive MW parameters serve as promising markers of cardiac performance in athletes (Marzlin et al., 2023) and of potential utility in the differentiation between exercise‐induced and pathologic cardiac remodeling. MW assessments in athletes are novel, and there is currently limited data available, especially in the setting of slightly older exercisers, which may have pronounced cardiac remodeling.…”

Section: Introductionmentioning

confidence: 99%

Echocardiographic assessment of myocardial efficiency predicts exercise performance

Erevik,

Kleiven,

Frøysa

et al. 2024

European Journal of Sport Science

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Cardiac function is a major determinant of cardiopulmonary fitness. This study aimed to determine if novel echocardiographic myocardial function and efficiency parameters at rest can predict exercise performance during different types of prolonged high‐intensity endurance exercise. Echocardiography was performed before exercise in 40 healthy (75% males) 50.3 ± 9.1‐year‐old recreational athletes. Echocardiographic parameters at rest were compared with exercise performance assessed by power output during two different exercises: A lactate threshold and cardiopulmonary exercise test (La‐CPET) and a 91‐km mountain bike sport cycling race. The La‐CPET had a median duration of 43 (40, 45) minutes and a mean power output of 2.9 ± 0.5 W/kg. The race had a median duration of 236 (214, 268) minutes and a mean power output of 2.1 ± 0.5 W/kg. There was moderate left ventricular (LV) dilatation in individuals with the highest performance. The myocardial efficiency parameter, global wasted work (GWW), was positively correlated with race duration (rho = 0.42, p = 0.008) and negatively correlated with mean power output during both the La‐CPET (rho = −0.43, p = 0.007) and the race (rho = −0.44, p = 0.005). In multivariable models, including LV volumes, left GWW remained an independent predictor of race duration (beta = 0.40, p = 0.007) and of mean power output during the La‐CPET (beta = −0.40, p = 0.006) and the race (beta = −0.43, p = 0.003). The novel echocardiographic myocardial efficiency parameter, GWW, measured at rest, is an independent predictor of prolonged high‐intensity endurance exercise performance in healthy middle‐aged athletes. These findings suggest that resting myocardial efficiency parameters may aid the identification of exercise‐induced LV dilatation.

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Myocardial inefficiency in asynchronous segmental early relaxation with exercise: A case series

Allwood

2024

Sonography

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Asynchronous segmental early relaxation phenomenon (ASERP) is a condition infrequently reported in exercise stress echocardiography and is characterised by sudden localised outward motion of the left ventricle during the isovolumic relaxation period. ASERP has been seen on angiographic studies at rest, which examined the extent of wall motion from end‐diastolic and end‐systolic frames. However, this method does not allow for an assessment of the timing of wall motion. With technological advances in echocardiography, advanced tools such as two‐dimensional (2D) speckle‐tracking and myocardial work, may allow for the precise timing and extent of ASERP to be more accurately identified during systole and diastole and provide assessment of myocardial performance. Two cases of ASERP are reported occurring in those with a high hemodynamic response and exaggerated systolic blood pressure response with exercise. The diagnostic characteristics of ASERP will be explored, including the use of 2D speckle‐tracking and myocardial work.

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Myocardial Work in Echocardiography

Cited by 32 publications

References 100 publications

Myocardial strain of the left ventricle by speckle tracking echocardiography: From physics to clinical practice

Myocardial strain of the left ventricle by speckle tracking echocardiography: From physics to clinical practice

Echocardiographic assessment of myocardial efficiency predicts exercise performance

Myocardial inefficiency in asynchronous segmental early relaxation with exercise: A case series

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