Regional ejection fraction and regional area strain for left ventricular function assessment in male patients after first-time myocardial infarction

Teo, Soo-Kng; Vos, FM; Tan, Ru San; Zhong, Liang; Su, Yi

doi:10.1098/rsif.2015.0006

Cited by 12 publications

(4 citation statements)

References 34 publications

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“…Cardiovascular magnetic resonance (CMR) offers an alternative noninvasive modality of choice for evaluation of cardiac anatomy, ventricular function (5), contractility (38), wall stress (39,40), and regional area strain (29,35). However, there still lacks simple, validated CMR technique to quantitatively measure the AVJ deformation.…”

Section: Cardiovascular Magnetic Resonance-derived Atrioventricular Junction (Avj) Velocities Correlate Significantly With Tissue Dopplermentioning

confidence: 99%

Automated quantitative assessment of cardiovascular magnetic resonance-derived atrioventricular junction velocities

Leng

Zhao

Huang

et al. 2015

American Journal of Physiology-Heart and Circulatory Physiology

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The assessment of atrioventricular junction (AVJ) deformation plays an important role in evaluating left ventricular systolic and diastolic function in clinical practice. This study aims to demonstrate the effectiveness and consistency of cardiovascular magnetic resonance (CMR) for quantitative assessment of AVJ velocity compared with tissue Doppler echocardiography (TDE). A group of 145 human subjects comprising 21 healthy volunteers, 8 patients with heart failure, 17 patients with hypertrophic cardiomyopathy, 52 patients with myocardial infarction, and 47 patients with repaired Tetralogy of Fallot were prospectively enrolled and underwent TDE and CMR scan. Six AVJ points were tracked with three CMR views. The peak systolic velocity (Sm1), diastolic velocity during early diastolic filling (Em), and late diastolic velocity during atrial contraction (Am) were extracted and analyzed. All CMR-derived septal and lateral AVJ velocities correlated well with TDE measurements (Sm1: r = 0.736; Em: r = 0.835; Am: r = 0.701; Em/Am: r = 0.691; all p < 0.001) and demonstrated excellent reproducibility [intrastudy: r = 0.921-0.991, intraclass correlation coefficient (ICC): 0.918-0.991; interstudy: r = 0.900-0.970, ICC: 0.887-0.957; all p < 0.001]. The evaluation of three-dimensional AVJ motion incorporating measurements from all views better differentiated normal and diseased states [area under the curve (AUC) = 0.918] and provided further insights into mechanical dyssynchrony diagnosis in HF patients (AUC = 0.987). These findings suggest that the CMR-based method is feasible, accurate, and consistent in quantifying the AVJ deformation, and subsequently in diagnosing systolic and diastolic cardiac dysfunction.

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Section: Cardiovascular Magnetic Resonance-derived Atrioventricular Junction (Avj) Velocities Correlate Significantly With Tissue Dopplermentioning

confidence: 99%

Automated quantitative assessment of cardiovascular magnetic resonance-derived atrioventricular junction velocities

Leng

Zhao

Huang

et al. 2015

American Journal of Physiology-Heart and Circulatory Physiology

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“…LV remodeling involves wall thinning, infarct expansion at the borderzone [10], scar tissue formation, and eventual LV dilatation followed by ventricular dysfunction [11–12], altering the cellular, structural and mechanical properties of the heart [13–15]. …”

Section: Introductionmentioning

confidence: 99%

Efficacy of intramyocardial injection of Algisyl-LVR for the treatment of ischemic heart failure in swine

Choy

Leng

Acevedo-Bolton

et al. 2018

International Journal of Cardiology

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Background: Progressive thinning and dilation of the LV due to ischemic heart failure (IHF) increases wall stress and myocardial oxygen consumption. Injectable biopolymers implanted in the myocardial wall have been used to increase wall thickness to reduce chamber volume, decrease wall stress, and improve cardiac function. We sought to evaluate the efficacy of a biopolymer (Algisyl-LVR) to prevent left ventricular (LV) remodeling in a swine model of IHF. Methods: IHF was induced in 11 swine by occluding the marginal obtuse branches of the left circumflex artery. Eight weeks later, Algisyl-LVR was injected into the LV myocardial free wall in five of the 11 animals. Echocardiographic examinations were done every 2 weeks for 16 weeks. Results: Within eight weeks of treatment, the ejection fraction increased from 30.5% ± 7.7% to 42.4% ± 3.5% (treated group) vs. 37.3% ± 3.8% to 34.3% ± 2.9% (control), p < 0.01. Stroke volume increased from 18.5 ± 9.3 mL to 41.3 ± 13.3 mL (treated group) vs. 25.4 ± 2.3 mL to 31.4 ± 5.3 mL (control), p < 0.05. Wall thickness in end-diastole of the infarcted region changed from 0.69 ± 0.06 cm to 0.81 ± 0.13 cm (treated group) vs. 0.73 ± 0.09 cm to 0.68 ± 0.11 cm (control), p < 0.05. Sphericity index remained almost unchanged after treatment, although differences were found at the end of the study between both groups (p < 0.001). Average myofiber stress changed from 16.3 ± 5.8 kPa to 10.2 ± 4.0 kPa (treated group) vs. 15.2 ± 4.8 kPa to 17.9 ± 5.6 kPa (control), p < 0.05. Conclusions: Algisyl-LVR is an effective strategy that serves as a micro-LV assist device to reduce stress and hence prevent or reverse maladaptive cardiac remodeling caused by IHF in swine.

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“…The regional ejection fraction ( EF ) is a measure of the pumping efficiency of a particular LV segment and was previously derived (Wisneski et al, 1981 ; Teo et al, 2015 ). The EF i for the i-th segment is calculated as…”

Section: Methodsmentioning

confidence: 99%

Left Ventricular Wall Stress Is Sensitive Marker of Hypertrophic Cardiomyopathy With Preserved Ejection Fraction

et al. 2018

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Hypertrophic cardiomyopathy (HCM) patients present altered myocardial mechanics due to the hypertrophied ventricular wall and are typically diagnosed by the increase in myocardium wall thickness. This study aimed to quantify regional left ventricular (LV) shape, wall stress and deformation from cardiac magnetic resonance (MR) images in HCM patients and controls, in order to establish superior measures to differentiate HCM from controls. A total of 19 HCM patients and 19 controls underwent cardiac MR scans. The acquired MR images were used to reconstruct 3D LV geometrical models and compute the regional parameters (i.e., wall thickness, curvedness, wall stress, area strain and ejection fraction) based on the standard 16 segment model using our in-house software. HCM patients were further classified into four quartiles based on wall thickness at end diastole (ED) to assess the impact of wall thickness on these regional parameters. There was a significant difference between the HCM patients and controls for all regional parameters (P < 0.001). Wall thickness was greater in HCM patients at the end-diastolic and end-systolic phases, and thickness was most pronounced in segments at the septal regions. A multivariate stepwise selection algorithm identified wall stress index at ED (σi,ED) as the single best independent predictor of HCM (AUC = 0.947). At the cutoff value σi,ED < 1.64, both sensitivity and specificity were 94.7%. This suggests that the end-diastolic wall stress index incorporating regional wall curvature—an index based on mechanical principle—is a sensitive biomarker for HCM diagnosis with potential utility in diagnostic and therapeutic assessment.

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Regional ejection fraction and regional area strain for left ventricular function assessment in male patients after first-time myocardial infarction

Cited by 12 publications

References 34 publications

Automated quantitative assessment of cardiovascular magnetic resonance-derived atrioventricular junction velocities

Automated quantitative assessment of cardiovascular magnetic resonance-derived atrioventricular junction velocities

Efficacy of intramyocardial injection of Algisyl-LVR for the treatment of ischemic heart failure in swine

Left Ventricular Wall Stress Is Sensitive Marker of Hypertrophic Cardiomyopathy With Preserved Ejection Fraction

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