Midwall Ejection Fraction for Assessing Systolic Performance of the Hypertrophic Left Ventricle

Overview

Journal Cardiovasc Ultrasound

Publisher Biomed Central

Specialties Cardiology & Vascular Diseases
Radiology

Date 2012 Nov 22

PMID 23167789

Citations 9

Authors

Hisao Yoshikawa

Makoto Suzuki

Go Hashimoto

Yukiko Kusunose

Takenori Otsuka

Masato Nakamura

Kaoru Sugi

Affiliations

Soon will be listed here.

Abstract

Background: In patients with left ventricular hypertrophy (LVH), LV midwall fractional shortening (FS) is used as a measure of LV systolic performance that is more physiologically appropriate than conventional FS. For evaluation of LV volume and ejection fraction (EF), 2-dimensional (2D) echocardiography is more accurate than M-mode echocardiography. The purpose of this study was to assess systolic performance by midwall EF using 2D speckle tracking echocardiography (STE).

Methods: Sixty patients were enrolled in the study. Patients were divided into two groups with LVH (n = 30) and without LVH (control group, n = 30). LV systolic function was compared between the two groups and the relationships of left ventricular mass index (LVMI) with LV systolic parameters, including midwall EF, were investigated.

Results: Midwall EF in the LVH group was significantly lower than that in the control group (42.8±4.4% vs. 48.1±4.1%, p <0.0001). Midwall FS was also significantly lower in the LVH group (13.4±2.8% vs. 16.1±1.5%, p <0.0001), but EF did not differ significantly between the two groups. There were significant correlations between midwall EF and LVMI (r=0.731, p <0.0001) and between midwall FS and LVMI (r=0.693, p <0.0001), with midwall EF having the higher correlation.

Conclusions: These results show that midwall EF can be determined using 2D STE. Midwall EF can be used to monitor LV systolic dysfunction, which is not possible with conventional EF. Evaluation of midwall EF may allow assessment of new parameters of LV systolic function in patients with LV geometric variability.

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References

Shimizu G, Hirota Y, Kita Y, Kawamura K, Saito T, Gaasch W . Left ventricular midwall mechanics in systemic arterial hypertension. Myocardial function is depressed in pressure-overload hypertrophy. Circulation. 1991; 83(5):1676-84. DOI: 10.1161/01.cir.83.5.1676. View

Wachtell K, Rokkedal J, Bella J, Aalto T, Dahlof B, Smith G . Effect of electrocardiographic left ventricular hypertrophy on left ventricular systolic function in systemic hypertension (The LIFE Study). Losartan Intervention For Endpoint. Am J Cardiol. 2001; 87(1):54-60. DOI: 10.1016/s0002-9149(00)01272-8. View

Kouzu H, Yuda S, Muranaka A, Doi T, Yamamoto H, Shimoshige S . Left ventricular hypertrophy causes different changes in longitudinal, radial, and circumferential mechanics in patients with hypertension: a two-dimensional speckle tracking study. J Am Soc Echocardiogr. 2010; 24(2):192-9. DOI: 10.1016/j.echo.2010.10.020. View

Mayet J, Ariff B, Wasan B, Chapman N, Shahi M, Poulter N . Improvement in midwall myocardial shortening with regression of left ventricular hypertrophy. Hypertension. 2000; 36(5):755-9. DOI: 10.1161/01.hyp.36.5.755. View

Jacobs L, Salgo I, Goonewardena S, Weinert L, Coon P, Bardo D . Rapid online quantification of left ventricular volume from real-time three-dimensional echocardiographic data. Eur Heart J. 2005; 27(4):460-8. DOI: 10.1093/eurheartj/ehi666. View

De Simone G, Devereux R, Roman M, Ganau A, Saba P, Alderman M . Assessment of left ventricular function by the midwall fractional shortening/end-systolic stress relation in human hypertension. J Am Coll Cardiol. 1994; 23(6):1444-51. DOI: 10.1016/0735-1097(94)90390-5. View

Palmiero P, Maiello M, Nanda N . Is echo-determined left ventricular geometry associated with ventricular filling and midwall shortening in hypertensive ventricular hypertrophy?. Echocardiography. 2008; 25(1):20-6. DOI: 10.1111/j.1540-8175.2007.00564.x. View

Jenkins C, Moir S, Chan J, Rakhit D, Haluska B, Marwick T . Left ventricular volume measurement with echocardiography: a comparison of left ventricular opacification, three-dimensional echocardiography, or both with magnetic resonance imaging. Eur Heart J. 2008; 30(1):98-106. DOI: 10.1093/eurheartj/ehn484. View

Devereux R, De Simone G, Pickering T, Schwartz J, Roman M . Relation of left ventricular midwall function to cardiovascular risk factors and arterial structure and function. Hypertension. 1998; 31(4):929-36. DOI: 10.1161/01.hyp.31.4.929. View

10.

Nishikage T, Nakai H, Mor-Avi V, Lang R, Salgo I, Settlemier S . Quantitative assessment of left ventricular volume and ejection fraction using two-dimensional speckle tracking echocardiography. Eur J Echocardiogr. 2008; 10(1):82-8. DOI: 10.1093/ejechocard/jen166. View

11.

Gorcsan 3rd J, Deswal A, Mankad S, Mandarino W, Mahler C, Yamazaki N . Quantification of the myocardial response to low-dose dobutamine using tissue Doppler echocardiographic measures of velocity and velocity gradient. Am J Cardiol. 1998; 81(5):615-23. DOI: 10.1016/s0002-9149(97)00973-9. View

12.

Kim H, Shin H, Son J, Yoon H, Park H, Cho Y . Two-dimensional strain or strain rate findings in mild to moderate diastolic dysfunction with preserved ejection fraction. Heart Vessels. 2010; 26(1):39-45. DOI: 10.1007/s00380-010-0033-0. View

13.

Biederman R, Doyle M, Young A, Devereux R, Kortright E, Perry G . Marked regional left ventricular heterogeneity in hypertensive left ventricular hypertrophy patients: a losartan intervention for endpoint reduction in hypertension (LIFE) cardiovascular magnetic resonance and echocardiographic substudy. Hypertension. 2008; 52(2):279-86. PMC: 2693884. DOI: 10.1161/HYPERTENSIONAHA.108.109819. View

14.

Schiller N, Shah P, Crawford M, DeMaria A, Devereux R, FEIGENBAUM H . Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. American Society of Echocardiography Committee on Standards, Subcommittee on Quantitation of Two-Dimensional Echocardiograms. J Am Soc Echocardiogr. 1989; 2(5):358-67. DOI: 10.1016/s0894-7317(89)80014-8. View

15.

Ishizu T, Seo Y, Enomoto Y, Sugimori H, Yamamoto M, Machino T . Experimental validation of left ventricular transmural strain gradient with echocardiographic two-dimensional speckle tracking imaging. Eur J Echocardiogr. 2010; 11(4):377-85. DOI: 10.1093/ejechocard/jep221. View

16.

Jung H, Sheehan F, Bolson E, Waiss M, Otto C . Evaluation of midwall systolic function in left ventricular hypertrophy: a comparison of 3-dimensional versus 2-dimensional echocardiographic indices. J Am Soc Echocardiogr. 2006; 19(6):802-10. DOI: 10.1016/j.echo.2006.01.007. View

17.

Ehara S, Shirai N, Okuyama T, Matsumoto K, Matsumura Y, Yoshiyama M . Absence of left ventricular concentric hypertrophy: a prerequisite for zero coronary calcium score. Heart Vessels. 2010; 26(5):487-94. DOI: 10.1007/s00380-010-0082-4. View

18.

Shimizu G, Zile M, Blaustein A, Gaasch W . Left ventricular chamber filling and midwall fiber lengthening in patients with left ventricular hypertrophy: overestimation of fiber velocities by conventional midwall measurements. Circulation. 1985; 71(2):266-72. DOI: 10.1161/01.cir.71.2.266. View

19.

Devereux R, Reichek N . Echocardiographic determination of left ventricular mass in man. Anatomic validation of the method. Circulation. 1977; 55(4):613-8. DOI: 10.1161/01.cir.55.4.613. View

20.

Schussheim A, Devereux R, De Simone G, Borer J, Herrold E, LARAGH J . Usefulness of subnormal midwall fractional shortening in predicting left ventricular exercise dysfunction in asymptomatic patients with systemic hypertension. Am J Cardiol. 1997; 79(8):1070-4. DOI: 10.1016/s0002-9149(97)00049-0. View