scholarly journals Value of Quantitative Analysis of Left Ventricular Systolic Function in Patients on Maintenance Hemodialysis Based on Myocardial Work Technique

2020 ◽  
Author(s):  
Chang Liu ◽  
Yi-Ping Feng ◽  
Zi-Ning Yan ◽  
Li Fan ◽  
Yi-Fei Rui ◽  
...  

Abstract Background: This study investigated the clinical value of the myocardial work technique for the quantitative analysis of left ventricular (LV) systolic function in maintenance hemodialysis (MHD) patients with or without left ventricular hypertrophy (LVH).Methods: A total of 58 MHD patients and 29 normal subjects were registered in this study. The MHD patients were divided into the non-left ventricular hypertrophy (NLVH) group (n=32) and the LVH group (n=26) according to the LV myocardial index (LVMI). Automated function imaging was used to analyze the dynamic images of the LV myocardium obtained in two-, three-, and four-chamber views. The blood pressure was inputted to generated the LV global longitudinal strain (GLS), myocardial global work index (GWI), global constructive work (GCW), global wasted work (GWW), global work efficiency (GWE), and peak strain dispersion (PSD). GLS, PSD, and the MW parameters (GWI, GCW, GWW, GWE) were compared between groups and the correlations between these parameters and the LV ejection fraction (LVEF) were examined. The receiver operating characteristic (ROC) curve was used to evaluate the efficacy of MW parameters and GLS for the assessment of LV systolic dysfunction in MHD patients with LVH.Results: The LVH group had significantly lower GWE, GWI, GCW, and GLS but higher GWW and PSD than the control and NLVH groups. Compared with the control group, the NLVH group had significantly lower GWE and GLS and higher GWW, but no significant differences in GWI, GCW, and PSD were observed between these two groups. The LVEF was negatively correlated with GWW in MHD patients, but positively correlated with GWI, GWE, and GCW. Area under the curve (AUC) analysis revealed that in the LVH group, GWE, GWW, GWI, and GCW had appreciable AUC, sensitivity, and specificity for evaluating LV function in LVH patients. Conclusion: MW parameters can be effectively used to evaluate the LV systolic function in MHD patients with or without LVH.

2021 ◽  
Author(s):  
Chang Liu ◽  
Yi-Ping Feng ◽  
Zi-Ning Yan ◽  
Li Fan ◽  
Yi-Fei Rui ◽  
...  

Abstract Background: This study aimed to determine the left ventricular (LV) systolic function in patients on maintenance hemodialysis (MHD) using the myocardial work (MW) technique and investigate the clinical value of the MW technique for the quantitative analysis of left ventricular (LV) systolic function in MHD patients with left ventricular hypertrophy (LVH).Methods: A total of 68 MHD patients and 35 controls were registered in this study. The MHD patients were divided into the non-left ventricular hypertrophy (NLVH) group (n=35) and the LVH group (n=33) according to the LV mass index (LVMI). MW was used to generate the LV global longitudinal strain (GLS), global work index (GWI), global constructive work (GCW), and global wasted work (GWW), global work efficiency (GWE). GLS and the MW parameters (GWI, GCW, GWW, GWE) were compared between groups and the correlations between these parameters and the LV ejection fraction (LVEF) in the LVH group were examined. The receiver operating characteristic (ROC) curve was used to evaluate the efficacy of MW parameters and GLS for the assessment of LV systolic dysfunction in MHD with LVH patients.Results: The LVH group had significantly lower GWE, GWI, GCW, and GLS but higher GWW than the control and NLVH groups. Compared with the control group, the NLVH group had significantly lower GWE and GLS and higher GWW, but no significant differences in GWI, GCW were observed between these two groups. The LVEF was negatively correlated with GWW in MHD patients, but positively correlated with GWI, GWE, and GCW in the LVH group. Receiver operating characteristic curve (ROC) analysis revealed that GWE, GWW, GWI, and GCW had appreciable area under the curve (AUC), sensitivity, and specificity for evaluating LV function in LVH patients on MHD. Conclusion: The MW parameters can quantitatively represent the LV myocardial work in MHD patients. Thus, the technique provides a new method for the quantitative evaluation of LV systolic function in MHD with LVH patients.


2020 ◽  
Author(s):  
Chang Liu ◽  
Yi-Ping Feng ◽  
Zi-Ning Yan ◽  
Li Fan ◽  
Yi-Fei Rui ◽  
...  

Abstract Background: To detect the left ventricular (LV) systolic function in maintenance hemodialysis (MHD) patients by using myocardial work (MW) technique. And investigated the clinical value of the MW technique for the quantitative analysis of left ventricular (LV) systolic function in MHD patients with left ventricular hypertrophy (LVH).Methods: A total of 58 MHD patients and 29 normal subjects were registered in this study. The MHD patients were divided into the non-left ventricular hypertrophy (NLVH) group (n=32) and the LVH group (n=26) according to the LV myocardial index (LVMI). MW was used to generated the LV global longitudinal strain (GLS), global work index (GWI), global constructive work (GCW), global wasted work (GWW), global work efficiency (GWE. GLS and the MW parameters (GWI, GCW, GWW, GWE) were compared between groups and the correlations between these parameters and the LV ejection fraction (LVEF) in the LVH group were examined. The receiver operating characteristic (ROC) curve was used to evaluate the efficacy of MW parameters and GLS for the assessment of LV systolic dysfunction in MHD patients with LVH.Results: The LVH group had significantly lower GWE, GWI, GCW, and GLS but higher GWW than the control and NLVH groups. Compared with the control group, the NLVH group had significantly lower GWE and GLS and higher GWW, but no significant differences in GWI, GCW were observed between these two groups. The LVEF was negatively correlated with GWW in MHD patients, but positively correlated with GWI, GWE, and GCW in the LVH group. Receiver operating characteristic curve (ROC) analysis revealed that GWE, GWW, GWI, and GCW had appreciable area under the curve (AUC), sensitivity, and specificity for evaluating LV function in LVH patients. Conclusion: MW parameters can be effectively used to evaluate the LV systolic function in MHD patients with or without LVH.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chang Liu ◽  
Yi-Ping Feng ◽  
Zi-Ning Yan ◽  
Li Fan ◽  
Yi-Fei Rui ◽  
...  

Abstract Background This study aimed to determine the left ventricular (LV) systolic function in patients on maintenance hemodialysis (MHD) using the myocardial work (MW) technique and investigate the clinical value of the MW technique for the quantitative analysis of left ventricular (LV) systolic function in MHD patients with left ventricular hypertrophy (LVH). Methods A total of 68 MHD patients and 35 controls were registered in this study. The MHD patients were divided into the non-left ventricular hypertrophy (NLVH) group (n = 35) and the LVH group (n = 33) according to the LV mass index (LVMI). MW was used to generate the LV global longitudinal strain (GLS), global work index (GWI), global constructive work (GCW), and global wasted work (GWW), global work efficiency (GWE). GLS and the MW parameters (GWI, GCW, GWW, GWE) were compared between groups and the correlations between these parameters and the LV ejection fraction (LVEF) in the LVH group were examined. The receiver operating characteristic (ROC) curve was used to evaluate the efficacy of MW parameters and GLS for the assessment of LV systolic dysfunction in MHD with LVH patients. Results The LVH group had significantly lower GWE, GWI, GCW, and GLS but higher GWW than the control and NLVH groups. Compared with the control group, the NLVH group had significantly lower GWE and GLS and higher GWW, but no significant differences in GWI, GCW were observed between these two groups. The LVEF was negatively correlated with GWW in MHD patients, but positively correlated with GWI, GWE, and GCW in the LVH group. Receiver operating characteristic curve (ROC) analysis revealed that GWE, GWW, GWI, and GCW had appreciable area under the curve (AUC), sensitivity, and specificity for evaluating LV function in LVH patients on MHD. Conclusions The MW parameters can quantitatively represent the LV myocardial work in MHD patients. Thus, the technique provides a new method for the quantitative evaluation of LV systolic function in MHD with LVH patients.


Author(s):  
V. N. Poptsov ◽  
E. A. Spirina ◽  
S. Yu. Ustin ◽  
S. A. Masutin ◽  
A. A. Dogonacheva ◽  
...  

Introduction. In case of donor heart shortage and expanding pool of patients waiting for heart transplantation (OHTx) liberalization of donor selection, especially use of donors with left ventricular hypertrophy (LVH), may be one of most realistic methods to extending number of OHTx.Aim: to evaluate early and late outcomes after OHTx from donors with LVH ≥1.5 cm.Methods. We reviewed 160 heart recipients who underwent OHTx from donors with LVH 1.5 cm or more from 2011 to 2017.Results. The duration of anesthesia was 6.5 ± 0.7 h, surgery – 4.7 ± 0.3 h, cardiopulmonary bypass – 63–290 (145 ± 47) min and ischemia time was – 86–426 (168 ± 44) min. ICU stay was 7.4 ± 8.5 days. Hospital mortality in the study group was 8,1% (n = 13) and 30-day survival was 91.9%. Patients with or without donor LVH had similar early and long-term survival (p = 0.659).Conclusions. Own experience demonstrates the satisfactory results of HT from donors with LVH. In more cases, LV systolic function of cardiac allograft quickly normalized in the early period after HT.


Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Takeshi Takamura ◽  
Kaoru Dohi ◽  
Katsuya Onishi ◽  
Naoki Fujimoto ◽  
Tairo Kurita ◽  
...  

Background: We tested the hypothesis that global strain rate imaging can quantify and stratify the severity of left ventricular (LV) relaxation abnormality in patients with left ventricular hypertrophy (LVH) ranged from normal to reduced LV systolic function independently from longitudinal (L), circumferential (C), and radial axes (R). Methods: Fifty-seven patients with hypertensive LVH and thirty age matched controls (Control, EF 65 ± 5 %) had echo-study with speckle tracking strain and strain rate imaging from (L), (C), and (R). LVH were divided into two groups; normal EF (LVH-NEF) defined as EF ≥ 55% (n = 35, EF 64 = 5 %), and systolic dysfunction (LVH-SD) defined as EF < 55% (n = 22, EF 48 ± 8 %). Global peak systolic strain (PSS) and peak relaxation rate (PRR) were used as indices of global LV contraction and relaxation, respectively (Vivid 7 and EchoPAC, GE Electronic). Results: PSS was maintained in LVH-NEF but reduced in LVH-SD from all three perpendicular axes. PRR (L) was impaired in LVH-NEF and was further decreased in LVH-SD (0.95 ± 0.33* and 0.58 ± 0.24* † 1/s, *p <0.05 vs. Control and † p <0.05 vs. LVH-NEF, respectively)compared to Control (1.14 ± 0.30 1/s). PRR (C) was maintained in LVH-NEF but reduced in LVH-SD (1.24 ± 0.50 and 0.73 ± 0.36 1/s*, p <0.05 vs. Control) compared to Control (1.30 ± 0.48 1/s). PRR (R) was impaired in both LVH-NEF and LVH-SD in the same degrees (-1.53 ± 0.60* and -1.27 ± 0.64* 1/s, p <0.05 vs. Control: -2.08 ± 0.84 1/s). Conclusion: Speckle tracking strain rate imaging quantified and stratified the severity of LV relaxation abnormality in patients with LVH ranged from normal to reduced LV systolic function independently from all three perpendicular ventricular axes.


2006 ◽  
Vol 291 (1) ◽  
pp. H176-H183 ◽  
Author(s):  
Kenichiro Nishikawa ◽  
Mikoto Yoshida ◽  
Masatoshi Kusuhara ◽  
Norio Ishigami ◽  
Kikuo Isoda ◽  
...  

Recent studies have identified the importance of proinflammatory cytokines in the development of left ventricular (LV) hypertrophy. However, the precise role of interleukin-1 (IL-1), one of the major proinflammatory cytokines, in the myocardium is not fully understood. In this study, we investigated the pathophysiological consequences of cardiac expression of IL-1 in vivo. We generated mice with a cardiac-specific overexpression of human IL-1α. We then analyzed their heart morphology and functions. Histological and echocardiographic analyses revealed concentric LV hypertrophy with preserved LV systolic function in the mice. Our results suggest that myocardial expression of IL-1 is sufficient to cause LV hypertrophy.


Author(s):  
Philippe C. Wouters ◽  
Geert E. Leenders ◽  
Maarten J. Cramer ◽  
Mathias Meine ◽  
Frits W. Prinzen ◽  
...  

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.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Akshar Jaglan ◽  
Sarah Roemer ◽  
Ana C Perez Moreno ◽  
Bijoy K Khandheria

Introduction: Myocardial work is a novel parameter that can be used in a clinic setting to assess left ventricular (LV) pressures and deformation. This study sought to distinguish patterns of global myocardial work index in hypertensive vs. non-hypertensive patients. Methods: Fifty (25 male, mean age 60±14 years) hypertensive patients and 15 (7 male, mean age 38±12 years) control patients underwent transthoracic echocardiography at rest. Hypertensive patients were divided into stage 1 (26 patients) and stage 2 (24 patients) based on the 2017 American College of Cardiology guidelines. We excluded patients with suboptimal image quality for myocardial deformation analysis, reduced ejection fraction (EF), valvular heart disease, and arrhythmia. Global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE) were estimated from LV pressure strain loops utilizing proprietary software from speckle-tracking echocardiography. LV systolic and diastolic pressures were estimated using a noninvasive brachial artery cuff. Results: Global longitudinal strain (GLS) and EF were preserved between the two groups with no statistically significant difference whereas there was a statistically significant difference in the GWI (p<0.01), GCW (p=0.03), GWW (p<0.01), and GWE (p=0.03) (Figure and Table). Conclusions: Myocardial work gives us a closer look at the relationship between LV pressure and contractility in settings of increased load dependency whereas LVEF and GLS cannot. We show how myocardial work is an advanced assessment of LV systolic function in hypertensive patients.


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