Right ventricular myocardial work: proof-of-concept for non-invasive assessment of right ventricular function

Butcher, Steele C; Fortuni, Federico; Montero-Cabezas, José M.; Abou, Rachid; Mahdiui, Mohammed El; Bijl, Pieter van der; Velde, Enno T. van der; Marsan, Nina Ajmone; Bax, Jeroen J.; Delgado, Victoria

doi:10.1093/ehjci/jeaa261

Cited by 53 publications

(84 citation statements)

References 29 publications

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“…MW has already been investigated recently in right ventricle (RV) and seems to correlate better than other conventional echocardiography parameters with invasive stroke volume and stroke volume index [55]. However, this method needs further research and development to estimate the real global RV performance because we are at the moment restricted to include only the segments that we can appreciate from 4C view; 4D echocardiography may give an answer to this problem.…”

Section: Right Ventricle Assessmentmentioning

confidence: 99%

Myocardial Work: Methodology and Clinical Applications

et al. 2021

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A precise and accurate assessment of left ventricular (LV) contractility is of utmost importance in terms of prognosis in most cardiac pathologies. Given the limitations of ejection fraction (EF) and global longitudinal strain (GLS) due to their load dependency, a novel imaging tool called myocardial work (MW) has emerged as a promising method for LV performance evaluation. MW is a novel, less load-dependent method based on computation of myocardial strain–arterial blood pressure curves. This method provides a more detailed assessment of segmental and global LV function incorporating the patient’s LV pressure and is derived by brachial artery pressure utilizing an empiric reference curve adjusted to the duration of the isovolumic and ejection phases as determined by echocardiography. The clinical implications of this unique method have been expanding in the last few years, which attest to the robust additive role of MW in routine practice.

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Section: Right Ventricle Assessmentmentioning

confidence: 99%

Myocardial Work: Methodology and Clinical Applications

et al. 2021

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“…As previously described, non-invasive MW indices are currently measured with a software validated for the measurement of LV MW. Recently, a proof-of-concept study showed the feasibility of right ventricle (RV) MW indices measurement in a small population of HFrEF [ 65 ]. In addition to the reduction of RV GWI, GCW, GWE and increase of GWW in HF patients compared to controls, they demonstrated that RV GCW is the only echocardiographic parameter associated with invasively measured stroke volume [ 65 ].…”

Section: Emerging Areas Of Applicationmentioning

confidence: 99%

“…Recently, a proof-of-concept study showed the feasibility of right ventricle (RV) MW indices measurement in a small population of HFrEF [ 65 ]. In addition to the reduction of RV GWI, GCW, GWE and increase of GWW in HF patients compared to controls, they demonstrated that RV GCW is the only echocardiographic parameter associated with invasively measured stroke volume [ 65 ]. Therefore, MW seems to also be able to provide an all-around evaluation of the RV function, integrating information on contractility, dyssynchrony and pulmonary pressure, and overcoming the limitations of other standard parameters such as TAPSE, RV GLS or fractional area change [ 66 ].…”

Section: Emerging Areas Of Applicationmentioning

confidence: 99%

Myocardial Work by Echocardiography: Principles and Applications in Clinical Practice

Ilardi

D’Andrea

D’Ascenzi

et al. 2021

JCM

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Left ventricular (LV) global longitudinal strain (GLS) has established itself in the last decade as a reliable, more objective method for the evaluation of LV systolic function, able to detect subtle abnormalities in LV contraction even in the presence of preserved ejection fraction (EF). However, recent studies have demonstrated that GLS, similar to LV EF, has important load dependency. Non-invasive myocardial work (MW) quantification has emerged in the last years as an alternative tool for myocardial function assessment. This new method, incorporating measurement of strain and LV pressure, has shown to overcome GLS and LV EF limitations and provide a loading-independent evaluation of myocardial performance. The presence of a commercially available echocardiographic software for the non-invasive MW calculation has allowed the application of this new method in different settings. This review sought to provide an overview on the current knowledge of non-invasive MW estimation, showing its potential applications and possible added value in clinical practice.

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“…e outcomes are encouraging, but they rather indicate a dependence of stroke volume on the variations in skin warming, age, and pulse pressure of the patient; hence, it is not an automatic technique of stroke volume quantification. In [8], another technique has been suggested particularly for noninvasive stroke volume estimation via indirect myocardial work evaluation. Nonetheless, the basic concept is based on echocardiography that is not appropriate for continuous assessment.…”

Section: Introductionmentioning

confidence: 99%

Stroke Volume Estimation from Respiratory Inductive Plethysmography: Double Empirical Decomposition

Abdulhay

Guméry

Ilango³

et al. 2022

Scientific Programming

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In this study, we have developed a “double-empirical mode decomposition algorithm” to estimate cardiac stroke volume from respiratory inductive plethysmography (RIP) signals. The algorithm consists of first an ensemble empirical mode decomposition (EEMD) to extract the cardiorespiratory components. Then, it is followed by an empirical mode decomposition (EMD) to extract only the cardiac components. This double approach permits (a) solving problems of mixing between cardiac and respiratory components (mode and scale mixing), (b) cardiogenic oscillations extraction in the respiratory inductive plethysmography signal, and (c) subsequent estimation of stroke volume. The algorithm is applied to simulated and real RIP signals. The simulated signals are generated by a cardiorespiratory model previously published by the authors. The real signals are measured via a developed inductive vest. In the real case, the values of estimated stroke volumes are compared to the values obtained by thoracocardiographic filter-based method. In the simulated case, the values are compared to the simulated cardiac activity. The results of comparison through Bland and Altman indicate an error lying in the range ±10%. In contrast to thoracocardiography, the proposed method consists of a promising tool for continuous noninvasive adaptive cardiac monitoring that does not need adjusting parameters or cut-off based on ECG. Also, in comparison to echocardiography and impedance-based methods, it does not necessitate the presence of an expert and is not too sensitive to current penetration.

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Right ventricular myocardial work: proof-of-concept for non-invasive assessment of right ventricular function

Cited by 53 publications

References 29 publications

Myocardial Work: Methodology and Clinical Applications

Myocardial Work: Methodology and Clinical Applications

Myocardial Work by Echocardiography: Principles and Applications in Clinical Practice

Stroke Volume Estimation from Respiratory Inductive Plethysmography: Double Empirical Decomposition

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