Two-Dimensional Echocardiographic Analysis of the Dynamic Geometry of the Left Ventricle: The Basis for an Improved Model of Wall Motion

Assmann, Patricia E.; Slager, Cornelis J.; Dreysse, Stephan; Borden, S. G. van der; Oomen, Jan A.; Roelandt, Jos R.T.C.

doi:10.1016/s0894-7317(88)80021-x

Cited by 65 publications

(28 citation statements)

References 20 publications

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“…In the presence of contractile dysfunction and concentric left ventricular hypertrophy, radial wall thickening (end-systolic thickness minus enddiastolic thickness) may be nearly normal. As the external volume of the heart changes little during the cardiac cycle, [7][8][9] the endocardial displacement and EF will be normal. The pathogenesis of HFPEF may be explained by the combination of concentric LVH and contractile dysfunction even though EF is preserved.…”

Section: Heart Failure With Preserved Ejection Fraction: Is It Due Tomentioning

confidence: 99%

Heart Failure With Preserved Ejection Fraction: Is it Due to Contractile Dysfunction?

MacIver

2009

Circ J

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Section: Heart Failure With Preserved Ejection Fraction: Is It Due Tomentioning

confidence: 99%

Heart Failure With Preserved Ejection Fraction: Is it Due to Contractile Dysfunction?

MacIver

2009

Circ J

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“…These findings suggested that neither method is Motion of mitral annulus and adjacent segments of the ventricular myocardium -In view of the relatively fi xed position of the ventricular apex during the cardiac cycle 14 -with LV relatively preserved as to its geometry -changes on the longitudinal axis would refl ect volumetric changes, as indicated by Sohn et al 16 . In this study,…”

Section: Danzmann Et Al Assessment Of Left Ventricular Diastolic Funcmentioning

confidence: 99%

Análise da função diastólica do ventrículo esquerdo em hipertensos sob variação de condições hemodinâmicas provocadas: estudo comparativo entre o doppler transmitral e tissular

Danzmann¹,

Freitas²,

Araujo³

et al. 2006

Arq. Bras. Cardiol.

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OBJECTIVETo evaluate the behavior of LV diastolic displacement velocities of basal posterior septum near mitral ring segment obtained by tissue Doppler in relation to mitral fl ow velocities of hypertensive subjects, submitted to preload increase by left inferior limbs elevation for 5 minutes, and during 1 minute of handgrip (conditions 1 and 2, respectively). METHODSTwenty fi ve outpatients (15 men, 52±11 years), with arterial hypertension > 3 years, by the transmitral fl ow Doppler variables: E, A and E/A, and of tissue Doppler: E', A' and E'/A', in basal situation and in conditions 1 and 2. For comparison of results in basal situation with conditions 1 and 2 a paired t test was applied. RESULTSE(cm/s) varied from 68,88 ± 11,94 to 75,82 ± 15,71* and E'(cm/s) varied from 8,22 ± 2,30 to 8,31 ± 2,24 in condition 1 (p<0.05). In addition, a comparison of variation percent (%) of Doppler transmitral indices with corresponding tissue Doppler indices variation % showed a signifi cant difference between E and E', with preload increase (p=0.01). CONCLUSIONPatients with left ventricular adaptation to systemic arterial hypertension showed less modifi cation of the index E´ than E, after preload increase maneuver, an evidence that may suggest its more ample utilization in the context of echocardiographic left ventricular diastolic function evaluation. KEY WORDSLeft ventricular diastolic function; arterial hypertension; tissue Doppler.

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“…The concept of almost invariable total heart volume during the heart cycle, with reciprocal filling and emptying of the LV and left atrium and almost constant outer diameter of the ventricle, is well established and confirmed by different modalities (1,(3)(4)(5). While the ventricle shortens in the long axis, the walls thicken, with an inward motion of the endocardial part of the wall but hardly any concentric motion of the epicardial part.…”

Section: Misinterpretation About the Contribution Of The Left Ventricmentioning

confidence: 99%

Misinterpretation About the Contribution of the Left Ventricular Long-Axis Shortening to the Stroke Volume

Wandt¹,

Brodin²,

Lundbäck³

2006

American Journal of Physiology-Heart and Circulatory Physiology

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The mitral annulus (MA) has a complex shape and motion, and its excursion has been correlated to left ventricular (LV) function. During the cardiac cycle the annulus' excursion encompasses a volume that is part of the total LV volume change during both filling and emptying. Our objective was to evaluate the contribution of MA excursion and shape variation to total LV volume change. Nine healthy subjects aged 56 Ϯ 11 (means Ϯ SD) years underwent transesophageal echocardiography (TEE). The MA was outlined in all time frames, and a four-dimensional (4-D) Fourier series was fitted to the MA coordinates (3-D ϩ time) and divided into segments. The annular excursion volume (AEV) was calculated based on the temporally integrated product of the segments' area and their incremental excursion. The 3-D LV volumes were calculated by tracing the endocardial border in six coaxial planes. The AEV (10 Ϯ 2 ml) represented 19 Ϯ 3% of the total LV stroke volume (52 Ϯ 12 ml). The AEV correlated strongly with LV stroke volume (r ϭ 0.73; P Ͻ 0.05). Peak MA area occurred during middiastole, and 91 Ϯ 7% of reduction in area from peak to minimum occurred before the onset of LV systole. The excursion of the MA accounts for an important portion of the total LV filling and emptying in humans. These data suggest an atriogenic influence on MA physiology and also a sphincterlike action of the MA that may facilitate ventricular filling and aid competent valve closure. This 4-D TEE method is the first to allow noninvasive measurement of AEV and may be used to investigate the impact of physiological and pathological conditions on this important aspect of LV performance Misinterpretation About the Contribution of the Left Ventricular Long-Axis Shortening to the Stroke VolumeTo the Editor: In a recent article in the American Journal of Physiology-Heart and Circulatory Physiology, Carlhäll and coworkers (2) reported that the long-axis shortening of the left ventricle (LV), measured as the mitral annular excursion, only accounts for 19% of the stroke volume (SV).The concept of almost invariable total heart volume during the heart cycle, with reciprocal filling and emptying of the LV and left atrium and almost constant outer diameter of the ventricle, is well established and confirmed by different modalities (1, 3-5). While the ventricle shortens in the long axis, the walls thicken, with an inward motion of the endocardial part of the wall but hardly any concentric motion of the epicardial part.Concerning the question of the relative contribution of the systolic shortening of the LV to the total SV, two recent studies (3, 4) favor a contribution of ϳ80% (75% and 82%, respectively). The difference between these findings and the calculation by Carlhäll and coworkers (2) that the long-axis shortening, measured as the mitral annular excursion, only accounts for 19% of the total SV, must be discussed. In the study of Carlhäll et al., as well as in the studies concluding ϳ80% contribution, the volume change (⌬V) during systole has been calculated as the cros...

show abstract

Two-Dimensional Echocardiographic Analysis of the Dynamic Geometry of the Left Ventricle: The Basis for an Improved Model of Wall Motion

Cited by 65 publications

References 20 publications

Heart Failure With Preserved Ejection Fraction: Is it Due to Contractile Dysfunction?

Heart Failure With Preserved Ejection Fraction: Is it Due to Contractile Dysfunction?

Análise da função diastólica do ventrículo esquerdo em hipertensos sob variação de condições hemodinâmicas provocadas: estudo comparativo entre o doppler transmitral e tissular

Misinterpretation About the Contribution of the Left Ventricular Long-Axis Shortening to the Stroke Volume

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