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Effect of Empagliflozin on Hemodynamics in Patients With Heart Failure and Reduced Ejection Fraction. J Am Coll Cardiol 2020; 76:2740-2751. [DOI: 10.1016/j.jacc.2020.10.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 10/01/2020] [Accepted: 10/02/2020] [Indexed: 01/21/2023]
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Villemain O, Correia M, Mousseaux E, Baranger J, Zarka S, Podetti I, Soulat G, Damy T, Hagège A, Tanter M, Pernot M, Messas E. Myocardial Stiffness Evaluation Using Noninvasive Shear Wave Imaging in Healthy and Hypertrophic Cardiomyopathic Adults. JACC Cardiovasc Imaging 2019; 12:1135-1145. [PMID: 29550319 PMCID: PMC6603249 DOI: 10.1016/j.jcmg.2018.02.002] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Revised: 01/31/2018] [Accepted: 02/01/2018] [Indexed: 12/28/2022]
Abstract
OBJECTIVES The goal of our study was to investigate the potential of myocardial shear wave imaging (SWI) to quantify the diastolic myocardial stiffness (MS) (kPa) noninvasively in adult healthy volunteers (HVs) and its physiological variation with age, and in hypertrophic cardiomyopathy (HCM) populations with heart failure and preserved ejection function (HFpEF). BACKGROUND MS is an important prognostic and diagnostic parameter of the diastolic function. MS is affected by physiological changes but also by pathological alterations of extracellular and cellular tissues. However, the clinical assessment of MS and the diastolic function remains challenging. SWI is a novel ultrasound-based technique that has the potential to provide intrinsic MS noninvasively. METHODS We prospectively included 80 adults: 60 HV (divided into 3 groups: 20- to 39-year old patients [n = 20]; 40- to 59-year-old patients [n = 20]; and 60- to 79-year-old patients [n = 20]) and 20 HCM-HFpEF patients. Echocardiography, cardiac magnetic resonance imaging and biological explorations were achieved. MS evaluation was performed using an ultrafast ultrasound scanner with cardiac phased array. The fractional anisotropy of MS was also estimated. RESULTS MS increased significantly with age in the HV group (the mean MS was 2.59 ± 0.58 kPa, 4.70 ± 0.88 kPa, and 6.08 ± 1.06 kPa for the 20- to 40-year-old, 40- to 60-year-old, and 60- to 80-year-old patient groups, respectively; p < 0.01 between each group). MS was significantly higher in HCM-HFpEF patients than in HV patients (mean MS = 12.68 ± 2.91 kPa vs. 4.47 ± 1.68 kPa, respectively; p < 0.01), with a cut-off at 8 kPa (area under the curve = 0.993; sensitivity = 95%, specificity = 100%). The fractional anisotropy was lower in HCM-HFpEF (mean = 0.133 ± 0.073) than in HV (0.238 ± 0.068) (p < 0.01). Positive correlations were found between MS and diastolic parameters in echocardiography (early diastolic peak/early diastolic mitral annular velocity, r = 0.783; early diastolic peak/transmitral flow propagation velocity, r = 0.616; left atrial volume index, r = 0.623) and with fibrosis markers in cardiac magnetic resonance (late gadolinium enhancement, r = 0.804; myocardial T1 pre-contrast, r = 0.711). CONCLUSIONS MS was found to increase with age in healthy adults and was significantly higher in HCM-HFpEF patients. Myocardial SWI has the potential to become a clinical tool for the diagnostic of diastolic dysfunction. (Non-invasive Evaluation of Myocardial Stiffness by Elastography [Elasto-Cardio]; NCT02537041).
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Affiliation(s)
- Olivier Villemain
- Institut Langevin, ESPCI, CNRS, Inserm U979, PSL Research University, Paris, France; Hôpital Européen Georges Pompidou, Université Paris Descartes, Cardio-Vascular Departement, UMR 970, Paris, France
| | - Mafalda Correia
- Institut Langevin, ESPCI, CNRS, Inserm U979, PSL Research University, Paris, France
| | - Elie Mousseaux
- Hôpital Européen Georges Pompidou, Université Paris Descartes, Département de Radiologie, INSERM U970, Paris, France
| | - Jérome Baranger
- Institut Langevin, ESPCI, CNRS, Inserm U979, PSL Research University, Paris, France
| | - Samuel Zarka
- Hôpital Européen Georges Pompidou, Université Paris Descartes, Cardio-Vascular Departement, UMR 970, Paris, France
| | - Ilya Podetti
- Institut Langevin, ESPCI, CNRS, Inserm U979, PSL Research University, Paris, France
| | - Gilles Soulat
- Hôpital Européen Georges Pompidou, Université Paris Descartes, Département de Radiologie, INSERM U970, Paris, France
| | - Thibaud Damy
- Department of Cardiology, AP-HP, Henri Mondor Teaching Hospital, Créteil, France
| | - Albert Hagège
- Hôpital Européen Georges Pompidou, Université Paris Descartes, Cardio-Vascular Departement, UMR 970, Paris, France
| | - Mickael Tanter
- Institut Langevin, ESPCI, CNRS, Inserm U979, PSL Research University, Paris, France
| | - Mathieu Pernot
- Institut Langevin, ESPCI, CNRS, Inserm U979, PSL Research University, Paris, France.
| | - Emmanuel Messas
- Hôpital Européen Georges Pompidou, Université Paris Descartes, Cardio-Vascular Departement, UMR 970, Paris, France
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Bakkestrøm R, Banke A, Pecini R, Irmukhamedov A, Nielsen SK, Andersen MJ, Borlaug BA, Moller JE. Cardiac remodelling and haemodynamic characteristics in primary mitral valve regurgitation. Open Heart 2018; 5:e000919. [PMID: 30613416 PMCID: PMC6307562 DOI: 10.1136/openhrt-2018-000919] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 10/02/2018] [Accepted: 11/12/2018] [Indexed: 11/16/2022] Open
Abstract
Objective To assess the association between cardiac morphology and function assessed with cardiac MRI (CMRI) and haemodynamics at rest and during exercise in patients with primary mitral regurgitation (MR). Methods In an observational study, subjects with significant primary MR (N = 46) with effective regurgitant orifice ≥ 0.30 cm2 and left ventricular (LV) ejection fraction > 60% were examined with right heart catheterisation during rest and exercise and CMRI at rest. End-diastolic pressure volume relationship (EDPVR) was assessed using a single beat method using pulmonary capillary wedge pressure (PCWP) and end-diastolic volume. Patients were divided according to normal PCWP at rest (> 12 mm Hg) and with exercise (> 28 mm Hg). Results: Resting regurgitant volume correlated positively with resting PCWP, (r = 0.42, p = 0.002). However, with exercise no association between PCWP and regurgitant volume was seen (r = 0.09, p = 0.55). At rest left atrial (LA) maximal, minimal and volume index at atrial contraction correlated positively with PCWP (r = 0.60; r = 0.55; r = 0.58, all p < 0.001); in contrast none of these correlated with exercise PCWP (all p > 0.2). EDPVR in patients with high PCWP at rest was shifted towards higher volumes for the same pressures. The opposite was seen for patients with high PCWP during exercise where estimated volumes were smaller for the same pressure than patients with normal exercise PCWP. Conclusion In patients with significant MR the degree of regurgitation and LA dilatation is associated with resting PCWP. However, with exercise this association disappears. Estimation of EDPVR suggests lower LV compliance in patients where PCWP is increased with exercise. Clinical trial registration URL: https://clinicaltrials.gov/ct2/show/NCT02961647?term=HEMI&rank=1. ID: NCT02961647
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Affiliation(s)
- Rine Bakkestrøm
- Department of Cardiology, Odense University Hospital, Odense Denmark and Odense Patient data Explorative Network OPEN, Odense, Denmark
| | - Ann Banke
- Department of Cardiology, Odense University Hospital, Odense Denmark and Odense Patient data Explorative Network OPEN, Odense, Denmark
| | - Redi Pecini
- Department of Cardiology, Odense University Hospital, Odense Denmark and Odense Patient data Explorative Network OPEN, Odense, Denmark
| | - Akhmadjon Irmukhamedov
- Department of Cardiology, Odense University Hospital, Odense Denmark and Odense Patient data Explorative Network OPEN, Odense, Denmark
| | - Søren Kristian Nielsen
- Department of Cardiology, Odense University Hospital, Odense Denmark and Odense Patient data Explorative Network OPEN, Odense, Denmark
| | - Mads J Andersen
- Department of Cardiology, Odense University Hospital, Odense Denmark and Odense Patient data Explorative Network OPEN, Odense, Denmark.,Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
| | - Barry A Borlaug
- Department of Cardiology, Odense University Hospital, Odense Denmark and Odense Patient data Explorative Network OPEN, Odense, Denmark.,Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Jacob Eifer Moller
- Department of Cardiology, Odense University Hospital, Odense Denmark and Odense Patient data Explorative Network OPEN, Odense, Denmark
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Abnormal Ventricular and Aortic Wall Properties Can Cause Inconsistencies in Grading Aortic Regurgitation Severity: A Computer Simulation Study. J Am Soc Echocardiogr 2016; 29:1122-1130.e4. [DOI: 10.1016/j.echo.2016.07.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Indexed: 11/20/2022]
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Conte L, Fabiani I, Pugliese NR, Giannini C, La Carruba S, Angelillis M, Spontoni P, De Carlo M, Petronio AS, Di Bello V. Left ventricular stiffness predicts outcome in patients with severe aortic stenosis undergoing transcatheter aortic valve implantation. Echocardiography 2016; 34:6-13. [PMID: 27779335 DOI: 10.1111/echo.13402] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES Assessment of the prognostic role of left ventricular stiffness (LVS) in patients with aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI). METHODS We performed a complete two-dimensional transthoracic echocardiographic study before and after TAVI in patients with severe AS at high surgical risk. In order to assess LVS, we measured LV end-diastolic pressure (EDP) invasively during TAVI and LV end-diastolic volume (EDV) by means of echocardiography. We defined LVS as the EDV indexed by body surface area at an EDP of 20 mm Hg (EDVI20 ). Our aim was to assess the impact of LVS on one-year all-cause mortality after TAVI. RESULTS One hundred sixty-six patients undergoing TAVI (64% female; mean age 82.7 ± 5.1 years) were enrolled. Seven patients died within the first 30 days after TAVI and 21 within 1 year. Overall follow-up duration was 580 ± 478 days. At multivariate analysis, independent predictors of 1-year all-cause mortality were moderate-to-severe paravalvular leak (PVL; HR 4.7, 95% confidence interval [CI] 1.9-11, P=.0003), female gender (HR 3.5, 95% CI 1.0-12, P=.045), and EDVI20 (HR 0.94, 95% CI 0.90-0.98, P=.015). In particular, patients with higher LVS (EDVI20 ≤48 mL/m2 ) had a 1-year mortality of 26.9% vs 7.4% in patients with lower LVS (EDVI20 >48 mL/m2 ; HR 4.2, 95% CI 1.6-10.6, P=.0007). Patients with higher LVS who developed moderate-to-severe PVL had the worst outcome (incremental chi-square test, P=.014). CONCLUSION In patients with AS, an increased LVS has a negative prognostic impact. Development of significant PVL in patients with higher LVS had an incremental adverse effect.
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Affiliation(s)
- Lorenzo Conte
- Department of Surgical, Medical, Molecular Pathology and Critical Area, Cisanello Hospital, University of Pisa, Pisa, Italy
| | - Iacopo Fabiani
- Department of Surgical, Medical, Molecular Pathology and Critical Area, Cisanello Hospital, University of Pisa, Pisa, Italy
| | - Nicola R Pugliese
- Department of Surgical, Medical, Molecular Pathology and Critical Area, Cisanello Hospital, University of Pisa, Pisa, Italy
| | - Cristina Giannini
- Department of Surgical, Medical, Molecular Pathology and Critical Area, Cisanello Hospital, University of Pisa, Pisa, Italy
| | | | - Marco Angelillis
- Department of Surgical, Medical, Molecular Pathology and Critical Area, Cisanello Hospital, University of Pisa, Pisa, Italy
| | - Paolo Spontoni
- Department of Surgical, Medical, Molecular Pathology and Critical Area, Cisanello Hospital, University of Pisa, Pisa, Italy
| | - Marco De Carlo
- Department of Surgical, Medical, Molecular Pathology and Critical Area, Cisanello Hospital, University of Pisa, Pisa, Italy
| | - Anna Sonia Petronio
- Department of Surgical, Medical, Molecular Pathology and Critical Area, Cisanello Hospital, University of Pisa, Pisa, Italy
| | - Vitantonio Di Bello
- Department of Surgical, Medical, Molecular Pathology and Critical Area, Cisanello Hospital, University of Pisa, Pisa, Italy
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Saito Y, Susukida I, Uzuka Y, Kanai H. Noninvasive early detection of anthracycline-induced cardiotoxicity in patients with hematologic malignancies using the phased tracking method. Cancer Med 2016; 5:2276-85. [PMID: 27484957 PMCID: PMC5055156 DOI: 10.1002/cam4.813] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Revised: 05/24/2016] [Accepted: 06/03/2016] [Indexed: 11/23/2022] Open
Abstract
Anthracyclines are among the most effective and widely used anticancer drugs; however, their use is limited by serious cardiotoxicity. Early detection is necessary to prevent the high mortality rate associated with heart failure (HF). We evaluated cardiac function in 142 patients using conventional echocardiography and the phased tracking method (PTM), which was measured using the minute vibration and the rapid motion components, neither of which is recognized in standard M-mode nor in tissue Doppler imaging. For systolic function comparison, we compared left ventricular ejection fraction (LVEF) in conventional echocardiography with the average velocity of ventricular septum myocytes (Vave ) in the PTM. The Vave of 12 healthy volunteers was 1.5 (m/s)/m or more. At baseline of 99 patients, there was a positive correlation between LVEF and Vave in all patients. There were no significant differences in baseline cardiac function between patients with and without HF. There was a negative correlation between the cumulative anthracycline dose and LVEF or Vave among all patients. We determined that Vave 1.5 (m/s)/m was equivalent to LVEF 60%, 1.25 (m/s)/m to 55%, and 1.0 (m/s)/m to 50%. During the follow-up period, there was a pathological decrease in LVEF (<55%) and Vave (<1.25 m/s/m) in patients with HF; decreases in Vave were detected significantly earlier than those in LVEF (P < 0.001). When Vave declined to 1.5 (m/s)/m or less, careful continuous observation and cardiac examination was required. When Vave further declined to 1.0 (m/s)/m or lower, chemotherapy was postponed or discontinued; thus, serious drug-induced cardiomyopathy was avoided in patients who did not relapse. The PTM was superior to echocardiography for early, noninvasive detection and intermediate-term monitoring of left ventricle systolic function associated with anthracycline chemotherapy, among patients with hematologic malignancies. The PTM was an effective laboratory procedure to avoid the progression to serious cardiomyopathy.
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Affiliation(s)
- Yoshiko Saito
- Department of Food and Nutrition, Miyagigakuin Women's University, Sendai, Japan. ,
- Sendai Blood Disease Center, Sendai, Japan. ,
| | | | | | - Hiroshi Kanai
- Graduate School of Biomedical Engineering and the Graduate School of Engineering, Tohoku University, Sendai, Japan.
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Stöhr EJ, Shave RE, Baggish AL, Weiner RB. Left ventricular twist mechanics in the context of normal physiology and cardiovascular disease: a review of studies using speckle tracking echocardiography. Am J Physiol Heart Circ Physiol 2016; 311:H633-44. [DOI: 10.1152/ajpheart.00104.2016] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 07/03/2016] [Indexed: 11/22/2022]
Abstract
The anatomy of the adult human left ventricle (LV) is the result of its complex interaction with its environment. From the fetal to the neonatal to the adult form, the human LV undergoes an anatomical transformation that finally results in the most complex of the four cardiac chambers. In its adult form, the human LV consists of two muscular helixes that surround the midventricular circumferential layer of muscle fibers. Contraction of these endocardial and epicardial helixes results in a twisting motion that is thought to minimize the transmural stress of the LV muscle. In the healthy myocardium, the LV twist response to stimuli that alter preload, afterload, or contractility has been described and is deemed relatively consistent and predictable. Conversely, the LV twist response in patient populations appears to be a little more variable and less predictable, yet it has revealed important insight into the effect of cardiovascular disease on LV mechanical function. This review discusses important methodological aspects of assessing LV twist and evaluates the LV twist responses to the main physiological and pathophysiological states. It is concluded that correct assessment of LV twist mechanics holds significant potential to advance our understanding of LV function in human health and cardiovascular disease.
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Affiliation(s)
- Eric J. Stöhr
- Discipline of Physiology and Health, Cardiff School of Sport, Cardiff Metropolitan University, Cardiff, United Kingdom; and
| | - Rob E. Shave
- Discipline of Physiology and Health, Cardiff School of Sport, Cardiff Metropolitan University, Cardiff, United Kingdom; and
| | - Aaron L. Baggish
- Cardiovascular Performance Program, Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts
| | - Rory B. Weiner
- Cardiovascular Performance Program, Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts
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Schwarzl M, Ojeda F, Zeller T, Seiffert M, Becher PM, Munzel T, Wild PS, Blettner M, Lackner KJ, Pfeiffer N, Beutel ME, Blankenberg S, Westermann D. Risk factors for heart failure are associated with alterations of the LV end-diastolic pressure–volume relationship in non-heart failure individuals: data from a large-scale, population-based cohort. Eur Heart J 2016; 37:1807-14. [DOI: 10.1093/eurheartj/ehw120] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 03/02/2016] [Indexed: 01/08/2023] Open
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Huang CH, Chang CC, Chang TL, Chang YJ. Dynamic cardiac dyssynchrony is strongly associated with 2-year dialysis adequacy in continuous ambulatory peritoneal dialysis patients. BMC Nephrol 2013; 14:68. [PMID: 23521832 PMCID: PMC3610281 DOI: 10.1186/1471-2369-14-68] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2012] [Accepted: 03/20/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Left ventricular (LV) dyssynchrony is associated with increased risk of all-cause mortality in patients with end-stage renal disease. Our aim was to determine the associations of LV dynamic dyssynchrony with peritoneal solute clearance in continuous ambulatory peritoneal dialysis (CAPD) patients. Our primary objective was to determine the association between dynamic LV dyssynchrony and CAPD clearance at 2 years. Secondary objectives were to identify the factors influencing dynamic dyssynchrony, and to examine the association between dialysis adequacy and echocardiography-assessed LV outcomes. METHODS Fifty CAPD patients and 13 healthy volunteers underwent three-dimensional (3D) dobutamine stress echocardiography (DSE). The main endpoint was systolic dyssynchrony index (SDI). Secondary endpoints, including NT-proBNP, troponin I, Kt/V, and biochemical parameters, were measured before stress echocardiography, and Kt/V was measured again 2 years later. All values are expressed as medians and interquartile ranges (IQR). RESULTS NT-proBNP (3872 [808-11779] vs. 4.99 [4.99-36.83] pg/mL, P < 0.001), and log NT-proBNP (3.587 [2.896-4.071] vs. 0.698 [0.698-1.540], P < 0.001) levels were significantly higher in the CAPD group than in the control group. Real-time 3D DSE showed that the systolic dyssynchrony index was significantly different between the two groups at the peak dobutamine stage (1.11% [0.76-1.64%] vs. 0.66% [0.50-1.02%], P = 0.004), but not at resting (1.30% [0.89-1.74%] vs. 1.22 % [0.72-1.68%], P = 0.358).The subgroup of patients in the CAPD group with greater improvements in dialysis adequacy had lower baseline dynamic SDI and more favorable echocardiographic findings at 2 years. Dialysis adequacy decreased significantly at 2 year in patients with higher, but not in those with lower dynamic SDI at baseline. In multivariate linear regression analysis, log NT-proBNP and SDI at the peak dobutamine dose were significantly associated with Kt/V and weekly creatinine clearance at 2 years, while log NT-proBNP was significant associated with SDI at the peak dobutamine stage. Female CAPD patients group had more pronounced dynamic LV dyssynchrony compared with male patients. CONCLUSIONS Dynamic systolic dyssynchrony was strongly associated with future dialysis adequacy in CAPD patients. Log NT-proBNP was the important predictor of dynamic dyssynchrony. Our study confirmed the concept that cardiac dysfunction has an impact on dialysis adequacy.
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Affiliation(s)
- Ching-Hui Huang
- Division of Nephrology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
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Scali MC, Basso M, Gandolfo A, Bombardini T, Bellotti P, Sicari R. Real time 3D echocardiography (RT3D) for assessment of ventricular and vascular function in hypertensive and heart failure patients. Cardiovasc Ultrasound 2012; 10:27. [PMID: 22742054 PMCID: PMC3439359 DOI: 10.1186/1476-7120-10-27] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Accepted: 06/28/2012] [Indexed: 11/29/2022] Open
Abstract
Background Cardiac and systemic hemodynamics have been historically in the domain of invasive cardiology, but recent advances in real-time 3-Dimensional echocardiography (RT3D echo) provide a reliable measurement of ventricular volumes, allowing to measure a set of hemodynamic parameters previously difficult or impossible to obtain with standard 2D echo. Aim To assess the feasibility of a comprehensive hemodynamic study with RT-3D echo. Methods We enrolled 136 patients referred for routine echocardiography: 44 normal (N), 57 hypertensive (HYP), and 35 systolic heart failure patients (HF). All patients underwent standard 2D echo examination followed by RT3D echo examination, including measurement of left ventricular (LV) end-diastolic and end-systolic volumes and derived assessment of LV elastance (an index of LV contractility), arterial elastance (characterizing the distal impedance of the arterial system downstream of the aortic valve); ventricular-arterial coupling (a central determinant of net cardiovascular performance); systemic vascular resistances. Blood pressure was derived from cuff sphygmomanometer and heart rate from ECG. Results A complete 2D echo was performed in all 136 patients. 3D echo examination was obtained in 130 patients (feasibility = 95 %). Standard 2D echo examination was completed in 14.8 ± 2.2 min. Acquisition of 3D images required an average time of 5 ± 0.9 min (range 3.5-7.5 min) and image analysis was completed in 10.1 ± 2.8 min (range 6–12 min) per patient. Compared to N and HYP, HF patients showed reduced LV elastance (1.7 ± 1.5 mmHg mL-1 m-2, p <0.001 vs N = 3.8 ± 1.3 and HYP = 3.8 ± 1.3) and ventricular-arterial coupling (0.6 ± 0.5, p < 0.01 vs N = 1.4 ± 0.4 and HYP = 1.2 ± 0.4). Systemic vascular resistances were highest in HYP (2736 ± 720, p < .01 vs N = 1980 ± 432 and vs HF = 1855 ± 636 dyne*s/cm5). The LV elastance was related to EF (r = 0.73, p < 0.01) and arterial pressure was moderately related to vascular elastance (r = 0.54, p < 0.01). The ventricular-arterial coupling was unrelated to systemic vascular resistances (r = −0.04, p NS). Conclusion RT-3D echo allows a non invasive, comprehensive assessment of cardiac and systemic hemodynamics, offering insight access to key variables – such as increased systemic vascular resistances in hypertensives and reduced ventricular-arterial coupling in heart failure patients.
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