Influence of cardiac shape on left ventricular twist

2010 ◽  
Vol 108 (1) ◽  
pp. 146-151 ◽  
Author(s):  
Bas M. van Dalen ◽  
Floris Kauer ◽  
Wim B. Vletter ◽  
Osama I. I. Soliman ◽  
Heleen B. van der Zwaan ◽  
...  
Keyword(s):  
Healthy Volunteers ◽  
Systolic Function ◽  
Left Ventricular ◽  
Lv Function ◽  
Total Study Population ◽  
Internal Dimension ◽  
Apical Rotation ◽  
Sphericity Index ◽  
And Gender ◽  
Lv Systolic Function

The dynamic interaction between subendocardial and subepicardial fibre helices in the left ventricle (LV) leads to a twisting deformation, which has an important role in LV function. This study sought to assess the influence of cardiac shape on LV twist in the normal and dilated human heart. The study comprised 45 dilated cardiomyopathy (DCM) patients and 60 for age- and gender-matched healthy volunteers. Speckle tracking echocardiography was used to determine basal and apical LV peak systolic rotation (Rotmax) and instantaneous LV peak systolic twist (Twistmax). LV sphericity index was calculated by dividing the LV maximal long-axis internal dimension by the maximal short-axis internal dimension at end-diastole. A parabolic relation between the sphericity index and apical Rotmaxor Twistmaxwas identified in the total study population ( R2= 0.56 and R2= 0.54, respectively; both P < 0.001) and healthy volunteers ( R2= 0.39 and R2= 0.25, respectively; both P < 0.001), whereas these relations were linear in DCM patients ( R2= 0.40 and R2= 0.43, respectively; both P < 0.001). In a multivariate analysis, LV sphericity index was the strongest independent predictor of apical Rotmaxand Twistmax. In conclusion, LV apical rotation and twist are significantly influenced by LV configuration. Taking the important function of LV twist into account, this finding highlights the vital influence of cardiac shape on LV systolic function.

scholarly journals Acute recoordination rather than functional hemodynamic improvement determines reverse remodelling by cardiac resynchronisation therapy

2021 ◽  
Author(s):  
Philippe C. Wouters ◽  
Geert E. Leenders ◽  
Maarten J. Cramer ◽  
Mathias Meine ◽  
Frits W. Prinzen ◽  
...  
Keyword(s):  
Systolic Function ◽  
Cardiac Resynchronisation Therapy ◽  
Left Ventricular ◽  
Lv Function ◽  
Peak Strain ◽  
Cardiac Resynchronisation ◽  
Reverse Remodelling ◽  
Resynchronisation Therapy ◽  
Lv Systolic Function

AbstractPurpose: Cardiac resynchronisation therapy (CRT) improves left ventricular (LV) function acutely, with further improvements and reverse remodelling during chronic CRT. The current study investigated the relation between acute improvement of LV systolic function, acute mechanical recoordination, and long-term reverse remodelling after CRT. Methods: In 35 patients, LV speckle tracking longitudinal strain, LV volumes & ejection fraction (LVEF) were assessed by echocardiography before, acutely within three days, and 6 months after CRT. A subgroup of 25 patients underwent invasive assessment of the maximal rate of LV pressure rise (dP/dtmax,) during CRT-implantation. The acute change in dP/dtmax, LVEF, systolic discoordination (internal stretch fraction [ISF] and LV systolic rebound stretch [SRSlv]) and systolic dyssynchrony (standard deviation of peak strain times [2DS-SD18]) was studied, and their association with long-term reverse remodelling were determined. Results: CRT induced acute and ongoing recoordination (ISF from 45 ± 18 to 27 ± 11 and 23 ± 12%, p < 0.001; SRS from 2.27 ± 1.33 to 0.74 ± 0.50 and 0.71 ± 0.43%, p < 0.001) and improved LV function (dP/dtmax 668 ± 185 vs. 817 ± 198 mmHg/s, p < 0.001; stroke volume 46 ± 15 vs. 54 ± 20 and 52 ± 16 ml; LVEF 19 ± 7 vs. 23 ± 8 and 27 ± 10%, p < 0.001). Acute recoordination related to reverse remodelling (r = 0.601 and r = 0.765 for ISF & SRSlv, respectively, p < 0.001). Acute functional improvements of LV systolic function however, neither related to reverse remodelling nor to the extent of acute recoordination. Conclusion: Long-term reverse remodelling after CRT is likely determined by (acute) recoordination rather than by acute hemodynamic improvements. Discoordination may therefore be a more important CRT-substrate that can be assessed and, acutely restored.

scholarly journals Correlation between hemoglobin level and left ventricular systolic functions and dimensions in children with chronic severe anemia

2011 ◽  
Vol 51 (2) ◽  
pp. 79
Author(s):  
Erlina Masniari Napitupulu ◽  
Fera Wahyuni ◽  
Tina Christina L. Tobing ◽  
Muhammad Ali ◽  
Bidasari Lubis
Keyword(s):  
Systolic Function ◽  
Pearson Correlation ◽  
Systolic Dysfunction ◽  
Univariate Analysis ◽  
Left Ventricular Systolic Function ◽  
Left Ventricular ◽  
Lv Function ◽  
Severe Anemia ◽  
Cross Sectional ◽  
Lv Systolic Function

Background Chronic severe anemia is a connnon disease. Cardiac output may increase when the hemoglobin (Hb) level decreases to < 7 g/dL for 3 months or more. Alteration of left ventricular (LV) function occurs frequently in children 'With chronic severe anemia, in the {onn of concentric LV hypertrophy, LV dilatation with or v.ithout LV hypertrophy, or systolic dysfunction. Objective To examine the correlation between Hb level and alteration of LV systolic function in children with chronic severe anemia. Methods We conducted a cross-sectional study in Adam Malik Hospital from October to December 2009. Subjects were chronic severely anemic children. Left ventricular systolic function (ejection fraction/EF, fractional shortening/FS) and dimensions (left ventricular end diastolic diameter/LVEDD and left ventricular end systolic diameter/LVESD) were measured using Hitachi EUB 5500 echocardiography unit. Univariate analysis  and Pearson correlation were performed.Results Thirty children were enrolled in the study. The mean of age was 113.5 months (SD 53.24). Hb values ranged from 2.1 to 6.9 g/dL with mean value of 4.6 g/dL (SD 1.44). Mean duration of anemia was 3.9 months (SD 0.70). Chronic severe anemia was not associated \\lith decreased LV systolic function [EF 62.2% (SD 9.16), r =0.296, P=0.112; FS 33.8% (SD 7.26), r =0.115, P=0.545], nor LV dimension changes [LVEDD 40.2 mm (SD 6.85), r = -0.192, P=0.308; LVESD 26.2 mm (SD 4.98), r=-0.266, P=0.156]. Conclusion There was no correlation between Hb level in chronically anemic children and changes in LV systolic function or dimension.

Abstract 15362: Epicardial Adipose Tissue Effects on Systolic Function: A Direct or Systemic Metabolic Effect?

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Shiva Reddy ◽  
Aditi Shankar ◽  
Katrin A Dias ◽  
James P Macnamara ◽  
Christopher M Hearon ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Epicardial Adipose Tissue ◽  
Systolic Function ◽  
Left Ventricular ◽  
Lv Function ◽  
Ectopic Fat ◽  
Paracrine Effects ◽  
Regional Strain ◽  
Data Points ◽  
Lv Systolic Function

Introduction: Obesity is associated with increased epicardial adipose tissue (EAT). It is unknown if this ectopic fat deposit has direct cardiotoxic paracrine effects on regional systolic function. We have previously shown that EAT mediates diastolic dysfunction via systemic effects, rather than localized effects. We similarly hypothesized regional EAT deposits would have no effect on the left ventricular (LV) strain of adjoining myocardial segments. Methods: We studied 28 obese healthy adults (mean age 48 ± 5 yrs, BMI 38.2 ± 5.0 kg/m 2 ). EAT was quantified on each individual MRI slice from base to apex and summed to obtain total volume. It was then separated into anterior, lateral, and inferior regions corresponding to the adjacent LV segments. Using MRI feature tracking, global longitudinal LV strain (GLS) and peak regional anterior, inferior, and lateral LV strain were quantified. Associations between total EAT and GLS, and between regional EAT and corresponding regional strain were determined by linear regression. Results: Mean total EAT volume was 69.6 ± 29.8 mL and mean GLS was -19.4 ± 2.0%. Individual data points for EAT and longitudinal strain are shown in the figure. Greater total EAT volume was modestly associated with decreased GLS (r2 = 0.127). However, anterior, lateral, and inferior EAT volume did not correlate with a decrease in corresponding regional strain (r2 = 0.003, r2 = 0.088, r2 = 0.016, respectively). Conclusion: In obese adults, total EAT volume was associated with a decrease in global LV systolic function measured by GLS. There was no association between regional EAT depots and corresponding regional LV function to suggest localized metabolic cardiotoxic effect. These preliminary results support our previous findings that EAT has little paracrine effect on cardiac function. Rather, EAT likely represents an additional depot of ectopic fat reflective of a general metabolic abnormality.

P901 Left ventricular diastolic and systolic functions are compromised in patients with hypothyroidism

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
R Tafarshiku ◽  
M Y Henein ◽  
V Berisha-Muharremi ◽  
I Bytyci ◽  
P Ibrahimi ◽  
...  
Keyword(s):  
Diastolic Function ◽  
Systolic Function ◽  
White Blood Cells ◽  
Left Ventricular ◽  
Blood Analysis ◽  
Lv Function ◽  
Anthropometric Parameters ◽  
Age And Gender ◽  
And Gender ◽  
Lv Diastolic Function

Abstract Background and Aim Long standing hypothyroidism may impair myocardial relaxation, but its effect on systolic myocardial function is still controversial. The aim of this study was to investigate left ventricular (LV) systolic and diastolic function in patients with hypothyroidism. Methods This study included 81 (age 42 ± 13 years, 92% female) patients with hypothyroidism, and 22 age and gender matched controls. All subjects underwent a detailed clinical examination followed by a complete biochemical blood analysis including thyroid function assessment and anthropometric parameters measurements. LV function was assessed by 2 dimensional, M-mode and Tissue-Doppler Doppler echocardiographic examination performed in the same day. Results Patients had lower waist/hip ratio (p &lt; 0.001), higher urea level (p = 0.002) and lower white blood cells (p = 0.011), compared to controls. All other clinical, biochemical and anthropometric data did not differ between the two groups. Patients had impaired LV diastolic function (lower E wave [p &lt; 0.001], higher A wave [p = 0.028], lower E/A ratio [p &lt; 0.001], longer E wave deceleration time [p = 0.01], and higher E/e’ ratio [p &lt; 0.001]), compared with controls. Although LV global systolic function did not differ between groups, LV longitudinal systolic function was compromised in patients (lateral mitral annular plane systolic excursion - MAPSE [p = 0.005], as were lateral and septal TDI s’ [p &lt; 0.001 for both]). Conclusion In patients with hypothyroidism, in addition to compromised LV diastolic function, LV longitudinal systolic function is also impaired compared to healthy subjects of the same age and gender. These findings suggest significant subendocardial function impairment, reflecting potentially micro-circulation disease, that requires optimum management.

scholarly journals Valve Replacement for Aortic Stenosis in Patients With Poor Left Ventricular Function

Circulation ◽  
1999 ◽  
Vol 100 (suppl_2) ◽  
Author(s):  
Julian Collinson ◽  
Michael Henein ◽  
Marcus Flather ◽  
John R. Pepper ◽  
Derek G. Gibson
Keyword(s):  
Aortic Stenosis ◽  
Systolic Function ◽  
Left Ventricular ◽  
Lv Function ◽  
Valve Prosthesis ◽  
Transthoracic Doppler Echocardiography ◽  
Early Improvement ◽  
Lv Dysfunction ◽  
Lv Systolic Function ◽  
Fractional Shortening

Background —Long-standing aortic stenosis causes significant left ventricular (LV) dysfunction, which may progress irreversibly. In many cases, LV function can be salvaged by aortic valve surgery, although debate exists regarding the best valve prosthesis to use. Methods and Results —We studied 33 patients retrospectively who had significant aortic stenosis and impaired LV systolic function, as assessed by transthoracic Doppler echocardiography. Patients were assessed preoperatively and before discharge from the hospital. A total of 20 patients received a stentless (homograft or Toronto) valve, and 13, a stented valve. No patient had significant aortic regurgitation or other valvular disease. Preoperatively, fractional shortening was 18.8±5.5% in the stentless group and 18.6±3.8% in the stented group. Postoperatively, it was 25.6±6.9% ( P <0.001 compared with baseline) and 17.0±2.8%, respectively ( P <0.001 compared with stentless group). Fractional shortening improved because of a reduction in LV end-systolic and end-diastolic dimensions in the stentless group. Systolic long axis function at the LV free wall also recovered, with an increase in systolic excursion and both peak shortening and lengthening rates. No change was noted in mitral valve Doppler patterns. Conclusions —Patients who received a stentless valve demonstrated a significantly greater early improvement in LV systolic function compared with those who received a stented valve.

scholarly journals Alteration of Cardiovascular Structure and Function in Patients Undergoing Peritoneal Dialysis

2015 ◽  
Vol 5 (2) ◽  
pp. 135-144
Author(s):  
Damir R. Rebić ◽  
Senija R. Rašić ◽  
Muamer D. Dervišević ◽  
Aida H.M. Hamzić-Mehmedbašić ◽  
Alma M. Muslimović ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Systolic Function ◽  
Intima Media Thickness ◽  
Female Gender ◽  
Left Ventricular ◽  
Lv Function ◽  
Uremic Cardiomyopathy ◽  
Lv Systolic Function ◽  
Systolic And Diastolic Function ◽  
Negative Predictor

Aims: Cardiovascular alterations contribute to a high mortality rate in patients with end-stage renal disease (ESRD). The aims of the present study are to evaluate left ventricular (LV) function and common carotid artery (CCA) parameters and to determine risk factors associated with these changes in patients undergoing peritoneal dialysis (PD). Methods: This longitudinal prospective study was conducted in 50 ESRD patients in whom PD had been initiated and who were observed for 18 months after the commencement of dialysis treatment, with echocardiography and CCA ultrasound parameter evaluation. Results: LV hypertrophy was observed in 78% of patients at baseline and in 60% after 18 months of PD treatment. LV systolic and diastolic function was found to be significantly better after 18 months of PD treatment. Examining predictors of LV systolic function, it was found that total cholesterol was an independent positive predictor and endothelin-1 (ET-1) an independent negative predictor of LV systolic function after 18 months of treatment with PD (p < 0.001). Independent negative predictors of diastolic LV function were hemoglobin and type 2 diabetes mellitus, and daily collection of urine was an independent positive predictor (p < 0.001). Female gender was an independent negative predictor of CCA intima-media thickness, whereas body mass index, ET-1 and C-reactive protein were independent positive predictors (p < 0.001). Conclusions: The results suggest several novel modifiable mechanisms related to the short-term effects of dialysis that are potentially implicated in the development of uremic cardiomyopathy.

scholarly journals Best anesthetics for assessing left ventricular systolic function by echocardiography in mice

2015 ◽  
Vol 308 (12) ◽  
pp. H1525-H1529 ◽  
Author(s):  
Ronald E. Pachon ◽  
Bruce A. Scharf ◽  
Dorothy E. Vatner ◽  
Stephen F. Vatner
Keyword(s):  
Heart Rate ◽  
Systolic Function ◽  
Left Ventricular Systolic Function ◽  
Conscious State ◽  
Left Ventricular ◽  
Lv Function ◽  
The Past ◽  
Anesthetic Agents ◽  
Lv Systolic Function ◽  
Randomized Crossover Study

Our review of the literature of the major cardiovascular journals for the past three years showed that for all studies using anesthesia for mouse echocardiography, the predominant anesthetic was isoflurane, which was used in 76% of the studies. The goal of this investigation was to determine if isoflurane is indeed the best anesthetic. Accordingly, we compared isoflurane with 2,2,2-tribromoethanol (Avertin), ketamine-xylazine, and ketamine on different days in the same 14 mice, also studied in the conscious state without anesthesia. A randomized crossover study design was employed to compare the effects on left ventricular (LV) systolic function and heart rate of the four different anesthetic agents assessed by transthoracic echocardiography. As expected, each anesthetic depressed LV ejection fraction and heart rate when compared with values in conscious mice. Surprisingly, isoflurane was not the best, but actually second to last in maintaining normal LV function and heart rate. The anesthetic with the least effect on LV function and heart rate was ketamine alone at a dose of 150 mg/kg, followed by Avertin at 290 mg/kg, isoflurane at 3% induction and 1 to 2% maintenance, and lastly ketamine-xylazine at 100 and 10 mg/kg, respectively. In summary, these results indicate that ketamine alone exerts the least depressant effects on LV function and heart rate, with Avertin second, suggesting that these anesthetics should be used when it is not feasible to study the animals in the conscious state as opposed to the most commonly used anesthetic, isoflurane.

scholarly journals Impacts of Different Anesthetic Agents on Left Ventricular Systolic Function in Mice Assessed by Echocardiography

2019 ◽  
pp. 365-374 ◽  
Author(s):  
C. LI ◽  
J. DAI ◽  
F. WU ◽  
H. ZHANG
Keyword(s):  
Heart Rate ◽  
Time Trends ◽  
Chloral Hydrate ◽  
Systolic Function ◽  
Left Ventricular Systolic Function ◽  
Conscious State ◽  
Left Ventricular ◽  
Lv Function ◽  
Anesthetic Agents ◽  
Lv Systolic Function

The present experiments were performed to study the effects and time trends of different anesthetic agents on the left ventricular (LV) systolic function and heart rate by high-resolution echocardiography in mice. Ten male C57BL/6J mice were submitted to echocardiography imaging separated by 72-hour intervals under the following conditions: 1) conscious mice, 2) mice anesthetized with isoflurane (ISO, inhaled), 3) mice anesthetized with tribromoethanol (TBE, intraperitoneal), 4) mice anesthetized with chloral hydrate (CH, intraperitoneal), and 5) mice anesthetized with pentobarbital sodium (PS, intraperitoneal). The effect of ISO, TBE, CH, and PS on LV systolic function was measured at 0, 1, 2, 3, 4, 6, 8, and 10 min after anesthesia. The results showed that LV systolic function and heart rate (HR) of anesthetized mice were reduced significantly (P<0.05), compared with results in the same mice studied in the conscious state. In addition, the results indicated that the anesthetic with the least effect on LV function was CH, and followed by TBE, PS, ISO. We conclude that different anesthetic agents always depressed the HR and LV systolic function of mice, and, furthermore, the effects and time trends of different anesthetics on LV function are different. In echocardiographic experiments, we should choose proper anesthetic agents according to the experimental requirements.

scholarly journals Effect of pericardial incision on left ventricular morphology and systolic function in patients during coronary artery bypass grafting

2020 ◽  
Author(s):  
Lan-Ting Zhao ◽  
Lu Liu ◽  
Ping-Ping Meng ◽  
Yong-Huai Wang ◽  
Meng Li ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Circumferential Strain ◽  
Systolic Function ◽  
Artery Bypass ◽  
Radial Strain ◽  
Left Ventricular ◽  
Bypass Grafting ◽  
Sphericity Index ◽  
Lv Systolic Function

Abstract Background: Accurate assessment of left ventricular (LV) systolic function is important after coronary artery bypass grafting (CABG). LV ejection fraction (LVEF) is conventionally used to evaluate LV systolic function; deformation parameters can be used to detect subtle LV systolic dysfunction. It is unclear whether an incised pericardium without sutures during CABG could affect LV morphology and function. We investigated the effect of pericardial incision on LV morphology and systolic function during CABG. Methods: Intraoperative transesophageal echocardiography was performed in 27 patients during elective off-pump beating heart CABG 5 minutes before and after pericardial incision. LV longitudinal and mid-cavity transversal diameters, sphericity index, volumes, and LVEF were measured. LV global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS), and twist obtained by two-dimensional speckle tracking echocardiography were measured simultaneously. Results: LV mid-cavity transversal diameter increased, while the LV sphericity index decreased (P<0.001) immediately after pericardial incision. The GLS, GCS, and twist significantly decreased, while the GRS notably increased (P<0.001). The LV volumes and LVEF remained unchanged. Conclusions: Pericardial incision immediately transformed LV morphology from an ellipsoid to sphere, with decreased longitudinal and circumferential strain and twist, and increased radial strain, while LVEF remained unchanged. This should be considered when evaluating LV systolic function in patients after CABG.

Atrial septal defect blunts the impairment of left ventricular function during the Mueller maneuver

1994 ◽  
Vol 77 (4) ◽  
pp. 1999-2004 ◽  
Author(s):  
J. Virolainen ◽  
M. Ventila ◽  
M. Kupari
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Systolic Function ◽  
Intrathoracic Pressure ◽  
Left Ventricular ◽  
Lv Function ◽  
Flow Ratio ◽  
Mueller Maneuver ◽  
Shortening Rate ◽  
Lv Systolic Function

To investigate whether atrial septal defect (ASD) modifies the left ventricular (LV) hemodynamic response to a fall of intrathoracic pressure (Mueller maneuver), we studied 15 patients with an uncomplicated ASD and 16 healthy control subjects. LV function was measured by M-mode and Doppler echocardiography at rest and during the maneuver. Indicator-dilution technique was used to quantify the pulmonary-to-systemic flow ratio. During comparable changes (means +/- SE) of intrathoracic pressure (-33 +/- 2 mmHg in persons with ASD vs. -34 +/- 2 mmHg in those without), LV systolic function and filling diminished in both groups but patients with ASD showed smaller reductions in LV stroke dimension (-0.9 +/- 0.5 vs. -2.5 +/- 0.4 mm; P = 0.016), peak diameter shortening rate (-4 +/- 2 vs. -12 +/- 2 mm/s; P = 0.007), transmitral velocity-time integral (-1.0 +/- 0.3 vs. -2.2 +/- 0.4 cm; P = 0.022), and cardiac output (-6 +/- 3 vs. -18 +/- 3%; P = 0.029). The pulmonary-to-systemic flow ratio increased from 2.1 +/- 0.1 to 2.6 +/- 0.2 in the ASD group (P = 0.014). In conclusion, LV function diminishes significantly in healthy persons during the Mueller maneuver. In patients with ASD, the changes are directionally similar but quantitatively smaller. An interatrial communication mitigates the impairment of LV function after an acute and sustained drop of intrathoracic pressure.

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