scholarly journals The recent advances, drawbacks, and the future directions of CMRI in the diagnosis of IHD

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Moram A. Fagiry ◽  
Ikhlas Abdelaziz ◽  
Rob Davidson ◽  
Mustafa Z. Mahmoud
Keyword(s):  
Systolic Function ◽  
Diagnostic Value ◽  
Left Ventricular ◽  
Lv Function ◽  
Conventional Coronary Angiography ◽  
Future Directions ◽  
Systolic Volume ◽  
End Diastolic Volume ◽  
Recent Advances ◽  
The Future

AbstractIschemic heart disease (IHD), also known as coronary artery disease (CAD), is a leading cause of morbidity and mortality in adults. The aims of this research were to study the recent advances on the prognostic and diagnostic value, drawbacks, and the future directions of cardiac magnetic resonance imaging (CMRI) in the diagnosis of IHD. One hundred patients with IHD who had been clinically diagnosed were enrolled in this study prospectively. CMRI; Siemens Magnetom Sola 1.5 T MRI scanner was used to examine the patients. To confirm the diagnosis, conventional coronary angiography was used. CMRI revealed that the left ventricular (LV) volumes and systolic function of male and female patients differed by age decile were 28.9 ± 3.5%; 32 ± 1.7%, 53.3 ± 11.2; 58 ± 6.6 ml, 100.6 ± 7.1; 98.3 ± 14.7 bpm, 5.4 ± 1.4; 5.8 ± 1.5 L/min, 189 ± 14.3; 180 ± 10.9 ml, and 136 ± 3.1; 123 ± 4.4 ml for the left ventricle ejection fraction (LVEF), stroke volume (SV), heart rate, cardiac output, end diastolic volume (EDV), and end systolic volume (ESV), respectively. CMRI has sensitivity, specificity, and accuracy of 97%, 33.33%, and 95.15%, respectively. Finally, CMRI provides a comprehensive assessment of LV function, myocardial perfusion, and viability, as well as coronary anatomy.

scholarly journals Prognostic value of NT-proBNP for myocardial recovery in peripartum cardiomyopathy (PPCM)

2021 ◽  
Author(s):  
J. Hoevelmann ◽  
E. Muller ◽  
F. Azibani ◽  
S. Kraus ◽  
J. Cirota ◽  
...  
Keyword(s):  
Prognostic Value ◽  
Systolic Function ◽  
Point Of Care ◽  
Diagnostic Value ◽  
Left Ventricular ◽  
Peripartum Cardiomyopathy ◽  
Lv Function ◽  
Myocardial Recovery ◽  
End Diastolic Volume

Abstract Introduction Peripartum cardiomyopathy (PPCM) is an important cause of pregnancy-associated heart failure worldwide. Although a significant number of women recover their left ventricular (LV) function within 12 months, some remain with persistently reduced systolic function. Methods Knowledge gaps exist on predictors of myocardial recovery in PPCM. N-terminal pro-brain natriuretic peptide (NT-proBNP) is the only clinically established biomarker with diagnostic value in PPCM. We aimed to establish whether NT-proBNP could serve as a predictor of LV recovery in PPCM, as measured by LV end-diastolic volume (LVEDD) and LV ejection fraction (LVEF). Results This study of 35 women with PPCM (mean age 30.0 ± 5.9 years) had a median NT-proBNP of 834.7 pg/ml (IQR 571.2–1840.5) at baseline. Within the first year of follow-up, 51.4% of the cohort recovered their LV dimensions (LVEDD < 55 mm) and systolic function (LVEF > 50%). Women without LV recovery presented with higher NT-proBNP at baseline. Multivariable regression analyses demonstrated that NT-proBNP of ≥ 900 pg/ml at the time of diagnosis was predictive of failure to recover LVEDD (OR 0.22, 95% CI 0.05–0.95, P = 0.043) or LVEF (OR 0.20 [95% CI 0.04–0.89], p = 0.035) at follow-up. Conclusions We have demonstrated that NT-proBNP has a prognostic value in predicting LV recovery of patients with PPCM. Patients with NT-proBNP of ≥ 900 pg/ml were less likely to show any improvement in LVEF or LVEDD. Our findings have implications for clinical practice as patients with higher NT-proBNP might require more aggressive therapy and more intensive follow-up. Point-of-care NT-proBNP for diagnosis and risk stratification warrants further investigation.

scholarly journals SYSTOLIC FUNCTION OF THE LEFT VENTRICLE IN PATIENTS WITH PULMONARY HYPERTENSION ON THE BACKGROUND OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE

2020 ◽  
Vol 44 (1) ◽  
pp. 12-16
Author(s):  
I. M. Fushtey ◽  
K. L. Nikolaieva
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Hypertension ◽  
Pulmonary Disease ◽  
Systolic Function ◽  
Left Ventricular Systolic Function ◽  
Left Ventricular ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Systolic Volume ◽  
End Diastolic Volume

Abstract Chronic obstructive pulmonary disease (COPD) greatly affects the quality of life, significantly limiting the physical capabilities of people suffering from it. The prevalence of COPD worldwide is about 7,6 %, and it is one of the main causes of morbidity and mortality in today’s society. An urgent medical and social problem of our time is the development of pulmonary hypertension (PH) in patients with COPD. Transthoracic echocardiography is important for PH screening. It has the highest sensitivity and specificity among non-invasive examinations, and unlike catheterization of the right heart, it does not require special equipment and centers for dynamic monitoring of patients with PH. When pulmonary hypertension, there is a pronounced remodeling of the heart. At the first stage, it occurs in the right parts of the heart, and in the future, as a consequence, it is accompanied by a violation of systolic inter-ventricular interactions. Purpose of the study. To determine the characteristics of left ventricular systolic function in patients with pulmonary hypertension on the background of COPD. Materials and methods. Results of the study are based on data from a comprehensive survey of 170 COPD patients aged 40 to 65 years, 123 of which had pulmonary hypertension and 47 ones had no pulmonary hypertension. Results and discussion. In the group of patients with PH on the background of COPD, the shock volume was 74,72 cm3 (64,60–83,09) and it was significantly lower compared to the level of 82,04 cm3 (75,20–87,76) of the COPD group without PH (p < 0,05). Such echocardiographic index as left ventricular ejection fraction in groups of patients with COPD with PH and without it, was 57,59% (53,84–62,19) and 59,44% (56,67–61,88), respectively, and it was significantly lower compared to the level of 64,62% (62,86–67,91) of healthy individuals (p < 0,05). There was a straight increase in end-diastolic volume and end-systolic volume in the subgroup of patients with COPD duration > 12 years compared to the subgroup ≤ 12 years, 134,17 cm3 (117,00–150,15) versus 125,52 cm3 (105,20–139,60) and 57,37 cm3 (51,70–65,60) versus 51,40 cm3 (43,08–59,84), respectively (p < 0,05). The impact volume had no significant differences between subgroups depending on the duration of COPD (p > 0,05). The level of LV ejection fraction was significantly lower in the subgroup of COPD duration > 12 years 56,64% (52,65–59,73) against the subgroup ≤ 12 years (p < 0,05). There were no significant differences between the levels of systolic heart function indicators: end-diastolic volume, end-systolic volume, shock volume, and LV EF depending on the stage of COPD (p > 0,05). Correlation analysis revealed significant relationships between the following indicators: duration of COPD and ESV (R = +0,24, p = 0,008); duration of COPD and LV EF (R = –0,25, p = 0,006); MPAP and EDV (R = –0,22, p = 0.02);MPAP and SV (R = –0,26, p = 0,004); MPAP and LV EF (R = –0,21, p = 0,02). Keywords: left ventricular systolic function, pulmonary hypertension, chronic obstructive pulmonary disease, mean pulmonary artery pressure.

scholarly journals Agreement in Left Ventricular Function Measured by Echocardiography and Cardiac Magnetic Resonance in Patients With Chronic Coronary Total Occlusion

2021 ◽  
Vol 8 ◽  
Author(s):  
Jiahui Li ◽  
Lijun Zhang ◽  
Yueli Wang ◽  
Huijuan Zuo ◽  
Rongchong Huang ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Pearson Correlation ◽  
Left Ventricular ◽  
Lv Function ◽  
Total Occlusion ◽  
Systolic Volume ◽  
End Diastolic Volume ◽  
End Systolic Volume ◽  
The Difference ◽  
Ventricular Motion

Aims: To determine the agreement between two-dimensional transthoracic echocardiography (2DTTE) and cardiovascular magnetic resonance (CMR) in left ventricular (LV) function [including end-systolic volume (LVESV), end-diastolic volume (LVEDV), and ejection fraction (LVEF)] in chronic total occlusion (CTO) patients.Methods: Eighty-eight CTO patients were enrolled in this study. All patients underwent 2DTTE and CMR within 1 week. The correlation and agreement of LVEF, LVESV, and LVEDV as measured by 2DTTE and CMR were assessed using Pearson correlation, Kappa analysis, and Bland–Altman method.Results: The mean age of patients enrolled was 57 ± 10 years. There was a strong correlation (r = 0.71, 0.90, and 0.80, respectively, all P &lt; 0.001) and a moderately strong agreement (Kappa = 0.62, P &lt; 0.001) between the two modalities in measurement of LV function. The agreement in patients with EF ≧50% was better than in those with an EF &lt;50%. CTO patients without echocardiographic wall motion abnormality (WMA) had stronger intermodality correlations (r = 0.84, 0.96, and 0.87, respectively) and smaller biases in LV function measurement.Conclusions: The difference in measurement between 2DTTE and CMR should be noticed in CTO patients with EF &lt;50% or abnormal ventricular motion. CMR should be considered in these conditions.

scholarly journals Assessment of Longitudinal Reproducibility of Mice LV Function Parameters at 11.7 T Derived from Self-Gated CINE MRI

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Zhi Zuo ◽  
Anne Subgang ◽  
Alireza Abaei ◽  
Wolfgang Rottbauer ◽  
Detlef Stiller ◽  
...  
Keyword(s):  
Cardiac Mri ◽  
Left Ventricular ◽  
Cine Mri ◽  
Lv Function ◽  
Longitudinal Assessment ◽  
Systolic Volume ◽  
Adult Mice ◽  
End Diastolic Volume ◽  
Standardized Protocol ◽  
End Systolic Volume

The objective of this work was the assessment of the reproducibility of self-gated cardiac MRI in mice at ultra-high-field strength. A group of adult mice (n=5) was followed over 360 days with a standardized MR protocol including reproducible animal position and standardized planning of the scan planes. From the resulting CINE MRI data, global left ventricular (LV) function parameters including end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), ejection fraction (EF), and left ventricular mass (LVM) were quantified. The reproducibility of the self-gated technique as well as the intragroup variability and longitudinal changes of the investigated parameters was assessed. Self-gated cardiac MRI proved excellent reproducibility of the global LV function parameters, which was in the order of the intragroup variability. Longitudinal assessment did not reveal any significant variations for EDV, ESV, SV, and EF but an expected increase of the LVM with increasing age. In summary, self-gated MRI in combination with a standardized protocol for animal positioning and scan plane planning ensures reproducible assessment of global LV function parameters.

scholarly journals Darbepoetin-α prevents progressive left ventricular dysfunction and remodeling in nonanemic dogs with heart failure

2008 ◽  
Vol 295 (6) ◽  
pp. H2475-H2482 ◽  
Author(s):  
Sharad Rastogi ◽  
Makoto Imai ◽  
Victor G. Sharov ◽  
Sudhish Mishra ◽  
Hani N. Sabbah
Keyword(s):  
Heart Failure ◽  
Caspase 3 ◽  
Hypoxia Inducible Factor ◽  
Left Ventricular ◽  
Stem Cell Marker ◽  
Lv Function ◽  
Systolic Volume ◽  
Beneficial Effects ◽  
End Diastolic Volume ◽  
End Systolic Volume

In anemic patients with heart failure (HF), erythropoietin-type drugs can elicit clinical improvement. This study examined the effects of chronic monotherapy with darbepoetin-α (DARB) on left ventricular (LV) function and remodeling in nonanemic dogs with advanced HF. HF [LV ejection fraction (EF) ∼25%] was produced in 14 dogs by intracoronary microembolizations. Dogs were randomized to once a week subcutaneous injection of DARB (1.0 μg/kg, n = 7) or to no therapy (HF, n = 7). All procedures were performed during cardiac catheterization under general anesthesia and under sterile conditions. LV end-diastolic volume (EDV), end-systolic volume (ESV), and EF were measured before the initiation of therapy and at the end of 3 mo of therapy. mRNA and protein expression of caspase-3, hypoxia inducible factor-1α, and the bone marrow-derived stem cell marker c-Kit were determined in LV tissue. In HF dogs, EDV and ESV increased and EF decreased after 3 mo of followup. Treatment with DARB prevented the increase in EDV, decreased ESV, and increased EF. DARB therapy also normalized the expression of HIF-1α and active caspase-3 and enhanced the expression of c-Kit. We conclude that chronic monotherapy with DARB prevents progressive LV dysfunction and dilation in nonanemic dogs with advanced HF. These results suggest that DARB elicits beneficial effects in HF that are independent of the presence of anemia.

Viability and functional recovery after chronic total occlusion percutaneous coronary intervention

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
R De Winter ◽  
S.P Schumacher ◽  
H Everaars ◽  
W.J Stuijfzand ◽  
P.A Van Diemen ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Functional Recovery ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Lv Function ◽  
Wall Thickening ◽  
Total Occlusion ◽  
Systolic Volume ◽  
End Diastolic Volume ◽  
Percutaneous Coronary

Abstract Background Current guidelines advocate viability assessment to guide percutaneous coronary intervention (PCI) of chronic coronary total occlusions (CTO). Purpose Aim of the present study was to evaluate viability as well as global and regional functional recovery after successful CTO PCI using quantitative cardiac magnetic resonance (CMR) imaging. Methods 132 patients with sequential CMR at baseline and 3-months after successful CTO PCI were prospectively recruited between 2013 and 2018. Segmental wall thickening (SWT) and percentage late gadolinium enhancement (LGE) were quantitatively measured per segment. Viability was defined as dysfunctional myocardium (&lt;2.84mm SWT) with no or limited scar (≤50% LGE). Results Significant improvements in left ventricular (LV) ejection fraction (from 48.1±11.8 to 49.5±12.1%, p&lt;0.01), LV end-diastolic volume (from 99.1±31.8 to 95.7±30.2ml, p&lt;0.01), and LV end-systolic volume (from 54.4±30.5 to 51.2±29.3ml, p&lt;0.01) were observed after CTO PCI. CTO segments with viability (N=216, (31%)) demonstrated a significantly higher increase in SWT (0.80±1.39mm) compared to CTO segments with pre-procedural preserved function (N=456 (65%), 0.07±1.43mm, p&lt;0.01) or extensive scar (LGE &gt;50%, N=26 (4%), −0.08±1.09mm, p&lt;0.01). Improvement in SWT was comparable between segments with viability if further stratified to 0, &gt;0–25, and &gt;25–50% hyperenhancement (p=0.94). Patients with ≥2 CTO segments viability showed more SWT increase in the CTO territory compared to patients with 0–1 segment viability (0.49±0.93 vs. 0.12±0.98mm, p=0.03). Conclusions Improvements in LV function and volumes were significant but modest following CTO PCI. Detection of dysfunctional myocardial segments without extensive scar (≤50% LGE) as a marker for viability may aid in identifying subjects with significant regional functional recovery after CTO PCI. Funding Acknowledgement Type of funding source: None

Abstract 14385: The Exist of Enlarged Left Ventricular Diastolic Volume is Not a Predictor of Irreversible Left Ventricular Systolic Function in Patients With Atrial Arrhythmia

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Hisao Matsuda ◽  
Airi Noda ◽  
Yui Nakayama ◽  
Toru Nakanishi ◽  
Mizuho Kasahara ◽  
...  
Keyword(s):  
Left Ventricular Systolic Dysfunction ◽  
Systolic Function ◽  
Systolic Dysfunction ◽  
Left Ventricular Systolic Function ◽  
Left Ventricular ◽  
Rhythm Control ◽  
Atrial Arrhythmia ◽  
Systolic Volume ◽  
End Diastolic Volume ◽  
Control Therapy

Introduction: Atrial arrhythmia (AA) and left ventricular systolic dysfunction (LVSD) frequently co-exist, which loom as burgeoning public health problems. It is difficult to determine whether a tachycardia is the indicator or consequence of LVSD in patients with tachycardia and LVSD. Tachycardia mediated cardiomyopathy (TCM) raises a “chicken or egg” question. Regardless of the etiology, the patients with severe LVSD are considered as the candidate for the implantation of cardioverter defibrillator as primary prevention. It is well known that the LVSD improves after the successful treatment of AA in TCM population. However, enlarged left ventricular end-diastolic dimension (LVDd) is considered as a parameter of irreversible LVSD. Hypothesis: Enlarged LVDd could not be a predictor for irreversible LVSD in patients with AA. Methods: We assessed patients with persistent AA and heart failure (Ejection Fraction (EF) <45%) who were received aggressive rhythm control therapy and maintained sinus rhythm with catheter ablation, electrical cardioversion and anti arhythmic drugs. Echocardiographic parameters and brain natriuretic peptide (BNP) were evaluated before and after the treatment. Results: Twenty-five patients with persistent AA and LVSD (23 men; mean age 63.8±9.3 years) were enrolled in this study. After restored and maintained SR, EF and left ventricular end-systolic volume (ESV) and BNP were improved in all patients respectively (EF 30.7±10.7 to 54.0±7.3%, ESV; 82.1±32.4 to 50.6±24.1ml, BNP; 379.2±237.9 to 48.0±29.7pg/ml P<0.001). In the other hand, there were no significant improvement of LVDd and left ventricular end-diastolic volume (EDV) (LVDd; 54.7±7.6 to 54.3±5.5mm P=0.68, EDV; 120.1±37.9 to 108.2±38.0ml P=0.16). Enlarged LVDd >60mm were observed in 5 patients (25%) before the treatment. EF was normalized in patients with severe LVSD (EF<35%, n=13; 52%). Conclusions: The unnecessary device implantation could be avoided in patients with AA and severe LVSD with aggressive rhythm control therapy. Even in the patients with severe LVSD and enlarged LVDd, LVSD is reversible when AA exists.

NT-pro-BNP levels in patients with acute pulmonary embolism are correlated to right but not left ventricular volume and function

2012 ◽  
Vol 108 (08) ◽  
pp. 367-372 ◽  
Author(s):  
Frederikus A. Klok ◽  
Noortje van der Bijl ◽  
Albert de Roos ◽  
Lucia J. M. Kroft ◽  
Menno V. Huisman ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Acute Pulmonary Embolism ◽  
Systolic Function ◽  
Ventricular Volume ◽  
Left Ventricular ◽  
Lv Function ◽  
Relative Contribution ◽  
End Diastolic Volume ◽  
The Right ◽  
Enddiastolic Volume

SummaryN-terminal pro-Brain Natriuretic Peptide (NT-pro-BNP) is primarily secreted by left ventricular (LV) stretch and wall tension. Notably, NT-pro-BNP is a prognostic marker in acute pulmonary embolism (PE), which primarily stresses the right ventricle (RV). We sought to evaluate the relative contribution of the RV to NT-pro-BNP levels during PE. A posthoc analysis of an observational prospective outcome study in 113 consecutive patients with computed tomography (CT)-proven PE and 226 patients in whom PE was clinically suspected but ruled out by CT. In all patients RV and LV function was established by assessing ECG-triggered-CT measured ventricular end-diastolic-volumes and ejection fraction (EF). NT-pro-BNP was assessed in all patients. The correlation between RV and LV end-diastolic-volumes and systolic function was evaluated by multiple linear regression corrected for known con-founders. In the PE cohort increased RVEF (β-coefficient (95% confidence interval [CI]) –0.044 (± –0.011); p<0.001) and higher RV enddiastolic-volume (β-coefficient 0.005 (± 0.001); p<0.001) were significantly correlated to NT-pro-BNP, while no correlation was found with LVEF ( β-coefficient 0.005 (± 0.010); p=0.587) and LV end-diastolic-volume (β-coefficient –0.003 (± 0.002); p=0.074). In control patients without PE we found a strong correlation between NT-pro-BNP levels and LVEF ( β-coefficient –0.027 (± –0.006); p<0.001) although not LV enddiastolic-volume (β-coefficient 0.001 (± 0.001); p=0.418). RVEF (β-co-efficient –0.002 (± –0.006); p=0.802) and RV end-diastolic-volume (β-coefficient <0.001 (± 0.001); p=0.730) were not correlated in patients without PE. In PE patients, lower RVEF and higher RV end-diastolic-volume were significantly correlated to NT-pro-BNP levels as compared to control patients without PE. These observations provide patho-physiological ground for the well-known prognostic value of NT-pro-BNP in acute PE.

P5259Evaluation of functional impairment and cardiac remodelling in isolated left branch bundle block using magnetic resonance imaging

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
J Salatzki ◽  
T Fischer ◽  
M Ochs ◽  
P Fortner ◽  
K Hirschberg ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Negative Correlation ◽  
Myocardial Strain ◽  
Lateral Wall ◽  
Left Ventricular ◽  
Lv Function ◽  
Positive Correlation ◽  
Systolic Volume ◽  
End Diastolic Volume ◽  
Qrs Duration

Abstract Introduction Left bundle-branch block (LBBB) is associated with underlying cardiovascular abnormalities, such as dilated cardiomyopathy and coronary heart disease. However, an isolated LBBB can be found in individuals without detectable cardiovascular disease. Echocardiographic studies demonstrated a reduced left ventricular (LV) ejection fraction (EF) and an increased LV cavity volume and mass in patients with isolated LBBB. Recent studies have shown larger cavity volumes (end-diastolic volume – EDV; end-systolic volume – ESV) and lower LVEF using CMR. However, there is still limited data on cardiac function, volumes and mass and the correlation between the parameters and the QRS duration (QRS) in patients with isolated LBBB. Purpose In this retrospective study LV function, volume, mass, T1-values and myocardial strain were measured and correlation between QRS duration in patients with isolated LBBB was identified using CMR. Methods Potential cases were identified from our local database, who underwent CMR during 2015–2018. We excluded patients with echocardiographic abnormalities besides abnormal septal motion or greater than a mild valve disease, known cardiovascular disease (coronary artery disease, cardiomyopathy or arrhythmia), history of potential cardiotoxic chemotherapy. We could identify 26 adults, who underwent CMR in a 1.5- or 3-Tesla scanner. LBBB was confirmed by ECG prior to CMR by a cardiologist. T1-values (MOLLI) were available in 19 patients. Myocardial strain (tissue tracking) could be performed in 23 patients. Associations were tested using Pearson's correlation analysis. Results 26 patients (age 61.5±9.6 years, 19 women, BMI 25.4 (18.2–38.1)) with isolated LBBB were included (QRS duration: 138±12ms). CMR results in the cohort revealed a reduced LVEF (53.4±3,8%) and slightly enlarged LV cavity when corrected to body-surface area (BSA) (LV-EDV/BSA: 83.7±13.8ml/m2; LV-ESV/BSA: 39.3±8.6ml/m2), when compared to normal values from the study center. There is a negative correlation between LVEF and QRS duration (r=−0.550, p<0.05) and a positive correlation between QRS duration and LV-EDV/BSA (r=0.627, p<0.05) as well as between QRS and LV-ESV/BSA (r=0.661, p<0.05). In addition, there is a positive correlation between QRS duration and myocardial mass (r=0.645, p<0.05), septal myocardial thickness (r=0.405, p<0.05) and lateral wall thickness (r=0.495, p<0.05). In addition, there is a positive correlation between LV longitudinal strain and QRS (r=0.449, p<0.05). T1-values were in normal range. There is no correlation between QRS and T1-values. Conclusion Using CMR a negative correlation between LV function and QRS duration and the positive correlation between LV volumes and QRS duration in patients with isolated LBBB could be identified. The absence of significant myocardial fibrosis with normal T1-values indicates an electromechanical dissociation rather than an underlying myocardial abnormality as an explanation for the reduced LVEF.

Impaired subendocardial contractile myofiber function in asymptomatic aged humans, as detected using MRI

2006 ◽  
Vol 291 (4) ◽  
pp. H1573-H1579 ◽  
Author(s):  
Joost Lumens ◽  
Tammo Delhaas ◽  
Theo Arts ◽  
Brett R. Cowan ◽  
Alistair A. Young
Keyword(s):  
Left Ventricular ◽  
Lv Function ◽  
Aged Group ◽  
Systolic Volume ◽  
Local Loss ◽  
Functional Changes ◽  
End Diastolic Volume ◽  
Tissue Tagging ◽  
End Systolic Volume ◽  
Aged Subjects

With aging, structural and functional changes occur in the myocardium without obvious impairment of systolic left ventricular (LV) function. Transmural differences in myocardial vulnerability for these changes may result in increase of transmural inhomogeneity in contractile myofiber function. Subendocardial fibrosis and impairment of subendocardial perfusion due to hypertension might change the transmural distribution of contractile myofiber function. The ratio of LV torsion to endocardial circumferential shortening (torsion-to-shortening ratio; TSR) during systole reflects the transmural distribution of contractile myofiber function. We investigated whether the transmural distribution of systolic contractile myofiber function changes with age. Magnetic resonance tissue tagging was performed to derive LV torsion and endocardial circumferential shortening. TSR was quantified in asymptomatic young [age 23.2 (SD 2.6) yr, n = 15] and aged volunteers [age 68.8 (SD 4.4) yr, n = 16]. TSR and its standard deviation were significantly elevated in the aged group [0.47 (SD 0.12) aged vs. 0.34 (SD 0.05) young; P = 0.0004]. In the aged group, blood pressure and the ratio of LV wall mass to end-diastolic volume were mildly elevated but could not be correlated to the increase in TSR. There were no significant differences in other indexes of systolic LV function such as end-systolic volume and ejection fraction. The elevated systolic TSR in the asymptomatic aged subjects suggests that aging is associated with local loss of contractile myofiber function in the subendocardium relative to the subepicardium potentially caused by subclinical pathological incidents.

Sign in / Sign up

Export Citation Format

Share Document