Correlation between left ventricular diastolic function before and after valve replacement surgery and myocardial ultrastructural changes in patients with left ventricular volume-overloaded valvular heart diseases

Abstract Background The left atrium (LA) is the main contributor of left ventricular (LV) filling. LA volume and volume index are routinely evaluated during echocardiographic assessment as having prognostic value in a wide range of cardiovascular pathologies. Yet, LA volume is easily affected by volume status. Thus, a non-invasive novel parameter such as indices of LA longitudinal strain (LS) have been proposed as alternative measurements. LA strain was shown to be associated with LV filling pressures and it has been suggested to provide prognostic information in patients with heart failure, atrial fibrillation, ischemic and valvular heart diseases. Nevertheless the acute effect of hemodynamic changes on LA LS indices is not well-established due to lack of evidence in healthy subjects and patient populations. The aim of this study is to evaluate the LA mechanics and change in echocardiographic methods used for assessment of LA by examining the end stage kidney patients before and after the hemodialysis (HD). Methods Patients between 18 and 85 years of age, receiving HD for at least 6 months were included. The echocardiographic images were obtained before and after HD. 2D speckle tracking strain analysis was performed for LA in 45 patients. Reference points for analysis are set on the "P" waves. LA reservoir, conduit and contraction phase LS were calculated. The changes in echocardiographic methods before and after hemodialysis were examined. Correlation between volume depletion and change in echocardiographic parameters were calculated. Results 45 patients (47.7 ± 14.7 years of age, 19 women) were included in study. The mean volume of ultrafiltration was 2755.12 ± 845.5 ml . The chamber sizes of LA are decreased after hemodialysis (LA diameter; 4.9 ± 0.8 cm vs. 4.4 ± 0.5 cm p < 0.001, LA area; 27.8 ± 4.0 cm2 vs. 19.6 ± 3.8 cm2 p < 0.001). LA reservoir phase LS measurements (% 44.6 ± 10.8 vs. % 38.15 ± 8.11 p < 0.001) showed significant changes after HD. In contrast LA contraction LS measurements (% -16.6 ± 7.0 vs. % -16.4 ± 7.1 p:0.893) did not differ after HD. The relative change in LA reservoir phase LS (r = 0.74, p:0.001) showed correlation with the ultrafiltrated volume. Conclusion LA contraction LS is a volume independent measurement obtained by 2D speckle tracking. Assessment of LA mechanics with echocardiography would be an easy and repeatable assessment which can guide to describe the cardiac pathophysiology and hemodynamics better. Moreover defining novel volume independent parameters for evaluation of LA would contribute to clinical perspectives of the patients.

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Einfluß einer dreidimensionalen Datenstabilisierung in der Radionuklidventrikulographie auf den statistischen Zählfehler der Ejektionsfraktion

Nuklearmedizin ◽

10.1055/s-0038-1629518 ◽

1990 ◽

Vol 29 (03) ◽

pp. 109-112

Author(s):

J. Mester ◽

E. Henze ◽

R. Ochsenkühn ◽

R. Lietzenmayer ◽

R. Weller ◽

...

Keyword(s):

Left Ventricular Volume ◽

Ventricular Volume ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Statistical Uncertainty ◽

Ventricular Ejection Fraction ◽

3 Dimensional ◽

Systematical Error ◽

Before And After ◽

Statistical Noise

The suitability of a 3-dimensional filter in diminishing the statistical noise of left ventricular volume curves without any systematical error in the left ventricular ejection fraction (EF) was investigated. The EF values were compared in 50 studies on 24 patients. There was no significant systematical difference between the EFs before and after filtering. The filter diminishes the statistical uncertainty of the EF by a factor of 0.47. Therefore, the method may possibly be employed in processing the left ventricular volume curves.

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Left Ventricular Mass Assessment by 1- and 2-Dimensional Echocardiographic Methods in Hemodialysis Patients: Changes in Left Ventricular Volume Using Echocardiography Before and After a Hemodialysis Session

Kidney Medicine ◽

10.1016/j.xkme.2020.06.006 ◽

2020 ◽

Vol 2 (5) ◽

pp. 578-588.e1 ◽

Cited By ~ 1

Author(s):

Charlotte Burup Kristensen ◽

Frank Steensgaard-Hansen ◽

Katrine Aagaard Myhr ◽

Niels Jørgen Løkkegaard ◽

Stine Høyer Finsen ◽

...

Keyword(s):

Left Ventricular Mass ◽

Left Ventricular Volume ◽

Ventricular Volume ◽

Hemodialysis Patients ◽

Left Ventricular ◽

Hemodialysis Session ◽

Ventricular Mass ◽

Before And After

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Changes in left ventricular volume and systolic function before and after the closure of ductus arteriosus in full-term infants

Early Human Development ◽

10.1016/0378-3782(95)01695-3 ◽

1996 ◽

Vol 44 (1) ◽

pp. 77-85 ◽

Cited By ~ 25

Author(s):

Yasushi Takahashi ◽

Kenji Harada ◽

Akira Ishida ◽

Masamichi Tamura ◽

Toshimasa Tanaka ◽

...

Keyword(s):

Left Ventricular Volume ◽

Systolic Function ◽

Ductus Arteriosus ◽

Ventricular Volume ◽

Left Ventricular ◽

Full Term ◽

Term Infants ◽

Before And After

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Determinants of diastolic myocardial tissue Doppler velocities: influences of relaxation and preload

Journal of Applied Physiology ◽

10.1152/jappl.2001.90.1.299 ◽

2001 ◽

Vol 90 (1) ◽

pp. 299-307 ◽

Cited By ~ 119

Author(s):

Michael S. Firstenberg ◽

Neil L. Greenberg ◽

Michael L. Main ◽

Jeanne K. Drinko ◽

Jill A. Odabashian ◽

...

Keyword(s):

Doppler Echocardiography ◽

Left Ventricular Volume ◽

Ventricular Volume ◽

Tissue Doppler ◽

Left Ventricular ◽

Myocardial Tissue ◽

High Fidelity ◽

Ventricular Relaxation ◽

Before And After ◽

Preload Reduction

Myocardial tissue Doppler echocardiography (TDE) has been proposed as a tool for the assessment of diastolic function. Controversy exists regarding whether TDE measurements are influenced by preload. In this study, left ventricular volume and high-fidelity pressures were obtained in eight closed-chest dogs during intermittent caval occlusion. The time constant of isovolumic ventricular relaxation (τ) was altered with varying doses of dobutamine and esmolol. Peak early diastolic myocardial ( E m) and transmitral ( E) velocities were measured before and after preload reduction. The relative effects of changes in preload and relaxation were determined for E m and compared with their effects on E. The following results were observed: caval occlusion significantly decreased E (Δ E = 16.4 ± 3.3 cm/s, 36.6 ± 13.7%, P < 0.01) and E m (Δ E m = 1.3 ± 0.4 cm/s, 32.5 ± 26.1%, P < 0.01) under baseline conditions. However, preload reduction was similar for E under all lusitropic conditions ( P = not significant), but these effects on E m decreased with worsening relaxation. At τ < 50 ms, changes in E m with preload reduction were significantly greater (Δ E m = 2.8 ± 0.6 cm/s) than at τ = 50–65 ms (Δ E m = 1.2 ± 0.2 cm/s) and at τ >65 ms (Δ E m = 0.5 ± 0.1 cm/s, P < 0.05). We concluded that TDE E m is preload dependent. However, this effect decreases with worsening relaxation.

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