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Herkert C, Migeotte PF, Hossein A, Spee RF, Kemps HMC. The kinocardiograph for assessment of changes in haemodynamic load in patients with chronic heart failure with reduced ejection fraction. ESC Heart Fail 2021; 8:4925-4932. [PMID: 34687162 PMCID: PMC8712789 DOI: 10.1002/ehf2.13522] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 06/14/2021] [Accepted: 07/05/2021] [Indexed: 01/15/2023] Open
Abstract
Aims The kinocardiograph (KCG) is an unobtrusive device, consisting of a chest sensor, which records local thoracic vibrations produced in result of cardiac contraction and ejection of blood into the great vessels [seismocardiography (SCG)], and a lower back sensor, which records micromovements of the body in reaction to blood flowing through the vasculature [ballistocardiography (BCG)]. SCG and BCG signals are translated to the integral of cardiac kinetic energy (iK) and cardiac maximum power (Pmax), which might be promising metrics for future telemonitoring purposes in heart failure (HF). As a first step of validation, this study aimed to determine whether iK and Pmax are responsive to exercise‐induced changes in the haemodynamic load of the heart in HF patients. Methods and results Fifteen patients with stable HF with reduced ejection fraction performed a submaximal exercise protocol. KCG and cardiac ultrasound measurements were obtained both at rest and at submaximal exercise. BCG iK over the cardiac cycle (CC) increased significantly (0.0026 ± 0.0017 to 0.0052 ± 0.0061 mJ.s.; P = 0.01) during exercise, in contrast to a non‐significant increase in SCG iK CC. BCG Pmax CC increased significantly (0.92 ± 0.89 to 2.03 ± 1.95 mJ/s; P = 0.02), in contrast to a non‐significant increase in SCG Pmax CC. When analysing the systolic phase of the CC, similar patterns were found. Cardiac output (CO) ratio (i.e. CO exercise/CO rest) showed a moderate, significant correlation with BCG Pmax CC ratio (r = +0.65; P = 0.008) and with SCG Pmax CC ratio (r = +0.54; P = 0.04). Conclusions iK and Pmax measured with the KCG, preferentially using BCG, are responsive to changes in the haemodynamic load of the heart in HF patients. The combination of the BCG and SCG sensor might be of added value to fully understand changes in haemodynamics and to discriminate between an HF patient and a healthy individual.
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Affiliation(s)
- Cyrille Herkert
- Department of Cardiology, Máxima Medical Centre, Dominee Theodor Fliednerstraat 1, Eindhoven, 5631 BM, The Netherlands
| | | | - Amin Hossein
- LPHYS, Université Libre de Bruxelles, Brussels, Belgium
| | - Rudolph Ferdinand Spee
- Department of Cardiology, Máxima Medical Centre, Dominee Theodor Fliednerstraat 1, Eindhoven, 5631 BM, The Netherlands
| | - Hareld Marijn Clemens Kemps
- Department of Cardiology, Máxima Medical Centre, Dominee Theodor Fliednerstraat 1, Eindhoven, 5631 BM, The Netherlands.,Department of Industrial Design, Eindhoven University of Technology, Eindhoven, The Netherlands
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2
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Characterisation of LV myocardial exercise function by 2-D strain deformation imaging in elite adolescent footballers. Eur J Appl Physiol 2020; 121:239-250. [PMID: 33030575 PMCID: PMC7815563 DOI: 10.1007/s00421-020-04510-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 09/19/2020] [Indexed: 12/15/2022]
Abstract
Purpose Few data exist on the descriptions of LV myocardial mechanics and reserve during dynamic exercise of adolescent athletes. The aim of this study was to describe the LV myocardial and cardiopulmonary changes during exercise using 2-D strain deformation imaging. Methods Elite adolescent male football players (n = 42) completed simultaneous cardiopulmonary exercise testing (CPET) and exercise echocardiography measurement of LV myocardial deformation by 2-D strain imaging. LV longitudinal and circumferential 2-D strain and strain rates were analyzed at each stage during incremental exercise to a work rate of 150 W. Additionally, exercise LV myocardial deformation and its relation to metabolic exercise parameters were evaluated at each exercise stage and in recovery using repeated measures ANOVA, linear regression and paired t tests. Results LV peak systolic baseline 2-D strain (longitudinal: − 15.4 ± 2.5%, circumferential: − 22.5 ± 3.1%) increased with each exercise stage, but longitudinal strain plateaued at 50 W (mean strain reserve − 7.8 ± 3.0) and did not significantly increase compared to subsequent exercise stages (P > 0.05), whilst circumferential strain (mean strain reserve − 11.6 ± 3.3) significantly increased (P < 0.05) throughout exercise up to 150 W as the dominant mechanism of exercise LV contractility increase. Regression analyses showed LV myocardial strain increased linearly relative to HR, VO2 and O2 pulse (P < 0.05) for circumferential deformation, but showed attenuation for longitudinal deformation. Conclusion This study describes LV myocardial deformation dynamics by 2-D strain and provides reference values for LV myocardial strain and strain rate during exercise in adolescent footballers. It found important differences between LV longitudinal and circumferential myocardial mechanics during exercise and introduces a methodology that can be used to quantify LV function and cardiac reserve during exercise in adolescent athletes.
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Gülan U, Saguner AM, Akdis D, Gotschy A, Tanner FC, Kozerke S, Manka R, Brunckhorst C, Holzner M, Duru F. Hemodynamic Changes in the Right Ventricle Induced by Variations of Cardiac Output: A Possible Mechanism for Arrhythmia Occurrence in the Outflow Tract. Sci Rep 2019; 9:100. [PMID: 30643204 PMCID: PMC6331649 DOI: 10.1038/s41598-018-36614-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 11/23/2018] [Indexed: 01/07/2023] Open
Abstract
The rationale of this paper is to investigate right ventricular (RV) hemodynamics in relation to changes in cardiac output, and in particular to study exercise-induced stresses at the RV outflow tract (RVOT), which is a common site of ventricular arrhythmias in the athlete’s heart. We hypothesize that the thin-walled RVOT is exposed to high wall shear stresses (WSS) during physiological states associated with high cardiac output such as exercise, and therefore, may be particularly prone to substrate formation leading to ventricular tachyarrhythmias. 3D Particle Tracking Velocimetry (3D-PTV), an optical imaging method, has been performed in a novel anatomically accurate compliant silicone right heart model derived from a high resolution MRI heart scan of a healthy male proband. RV and RVOT flow patterns at resting conditions were obtained from two healthy athletic male proband’s hearts and two patients with arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) via phase contrast magnetic resonance imaging (PC-MRI). The healthy case was used as a reference for validating the in vitro flow patterns of the silicone model, while the diseased cases were used to generalize our findings and investigate possible changes in hemodynamic stresses with RV morphological remodelling. Our results showed that both healthy and diseased geometries consistently displayed an increased WSS in the RVOT relative to the rest of the RV. We found that increases in cardiac output may lead to increases of mean kinetic energy (MKE), laminar viscous dissipation and WSS at the RVOT. Furthermore, higher peak WSS magnitudes were found for the diseased cases. The identified high WSS regions may correlate with the common site of RVOT ventricular tachycardia in athletes and patients with ARVC/D. Our results imply that exercise, as well as anatomical and functional remodeling might alter RV wall shear stress both in magnitude and spatial distribution, leading to increased hemodynamic stresses in the RVOT.
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Affiliation(s)
- Utku Gülan
- ETH Zurich, Institute of Environmental Engineering, Zurich, 8093, Switzerland.
| | | | - Deniz Akdis
- University Heart Center, Department of Cardiology, Zurich, 8091, Switzerland
| | - Alexander Gotschy
- University Heart Center, Department of Cardiology, Zurich, 8091, Switzerland.,Institute for Biomedical Engineering, University and ETH Zurich, Zurich, 8092, Switzerland
| | - Felix C Tanner
- University Heart Center, Department of Cardiology, Zurich, 8091, Switzerland
| | - Sebastian Kozerke
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, 8092, Switzerland
| | - Robert Manka
- University Heart Center, Department of Cardiology, Zurich, 8091, Switzerland.,Institute of Diagnostic and Interventional Radiology, University and ETH Zurich, Zurich, 8092, Switzerland
| | - Corinna Brunckhorst
- University Heart Center, Department of Cardiology, Zurich, 8091, Switzerland
| | - Markus Holzner
- ETH Zurich, Institute of Environmental Engineering, Zurich, 8093, Switzerland
| | - Firat Duru
- University Heart Center, Department of Cardiology, Zurich, 8091, Switzerland.,Center for Integrative Human Physiology, University of Zurich, Zurich, 8091, Switzerland
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Khalid A, Lim E, Chan BT, Abdul Aziz YF, Chee KH, Yap HJ, Liew YM. Assessing regional left ventricular thickening dysfunction and dyssynchrony via personalized modeling and 3D wall thickness measurements for acute myocardial infarction. J Magn Reson Imaging 2018; 49:1006-1019. [PMID: 30211445 DOI: 10.1002/jmri.26302] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 07/31/2018] [Accepted: 07/31/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Existing clinical diagnostic and assessment methods could be improved to facilitate early detection and treatment of cardiac dysfunction associated with acute myocardial infarction (AMI) to reduce morbidity and mortality. PURPOSE To develop 3D personalized left ventricular (LV) models and thickening assessment framework for assessing regional wall thickening dysfunction and dyssynchrony in AMI patients. STUDY TYPE Retrospective study, diagnostic accuracy. SUBJECTS Forty-four subjects consisting of 15 healthy subjects and 29 AMI patients. FIELD STRENGTH/SEQUENCE 1.5T/steady-state free precession cine MRI scans; LGE MRI scans. ASSESSMENT Quantitative thickening measurements across all cardiac phases were correlated and validated against clinical evaluation of infarct transmurality by an experienced cardiac radiologist based on the American Heart Association (AHA) 17-segment model. STATISTICAL TEST Nonparametric 2-k related sample-based Kruskal-Wallis test; Mann-Whitney U-test; Pearson's correlation coefficient. RESULTS Healthy LV wall segments undergo significant wall thickening (P < 0.05) during ejection and have on average a thicker wall (8.73 ± 1.01 mm) compared with infarcted wall segments (2.86 ± 1.11 mm). Myocardium with thick infarct (ie, >50% transmurality) underwent remarkable wall thinning during contraction (thickening index [TI] = 1.46 ± 0.26 mm) as opposed to healthy myocardium (TI = 4.01 ± 1.04 mm). For AMI patients, LV that showed signs of thinning were found to be associated with a significantly higher percentage of dyssynchrony as compared with healthy subjects (dyssynchrony index [DI] = 15.0 ± 5.0% vs. 7.5 ± 2.0%, P < 0.01). Also, a strong correlation was found between our TI and left ventricular ejection fraction (LVEF) (r = 0.892, P < 0.01), and moderate correlation between DI and LVEF (r = 0.494, P < 0.01). DATA CONCLUSION The extracted regional wall thickening and DIs are shown to be strongly correlated with infarct severity, therefore suggestive of possible practical clinical utility. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2019;49:1006-1019.
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Affiliation(s)
- Amirah Khalid
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
| | - Einly Lim
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
| | - Bee Ting Chan
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
| | - Yang Faridah Abdul Aziz
- University Malaya Research Imaging Centre, Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Kok Han Chee
- Department of Medicine, Faculty of Medicine Building, University of Malaya, Kuala Lumpur, Malaysia
| | - Hwa Jen Yap
- Department of Mechanical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
| | - Yih Miin Liew
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
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Cheng JL, Au JS, Guzman JC, Morillo CA, MacDonald MJ. Cardiovascular testing in patients with postural tachycardia syndrome and Ehlers-Danlos type III: authors' response. Clin Auton Res 2017; 27:119-120. [DOI: 10.1007/s10286-017-0402-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 01/25/2017] [Indexed: 11/24/2022]
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Au JS, Ditor DS, MacDonald MJ, Stöhr EJ. Carotid artery longitudinal wall motion is associated with local blood velocity and left ventricular rotational, but not longitudinal, mechanics. Physiol Rep 2016; 4:4/14/e12872. [PMID: 27440745 PMCID: PMC4962076 DOI: 10.14814/phy2.12872] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2016] [Accepted: 06/28/2016] [Indexed: 11/24/2022] Open
Abstract
Recent studies have identified a predictable movement pattern of the common carotid artery wall in the longitudinal direction. While there is evidence that the magnitude of this carotid artery longitudinal wall motion (CALM) is sensitive to cardiovascular health status, little is known about the determinants of CALM. The purpose of this integrative study was to evaluate the contribution of left ventricular (LV) cardiac motion and local blood velocity to CALM. Simultaneous ultrasound measurements of CALM, common carotid artery mean blood velocity (MBV), and left ventricular motion were performed in ten young, healthy individuals (6 males; 22 ± 1 years). Peak anterograde CALM occurred at a similar time as peak MBV (18.57 ± 3.98% vs. 18.53 ± 2.81% cardiac cycle; t‐test: P = 0.94; ICC: 0.79, P < 0.01). The timing of maximum retrograde CALM displacement was different, but related, to both peak apical (41.00 ± 7.81% vs. 35.33 ± 5.79% cardiac cycle; t‐test: P < 0.01; ICC: 0.79, P < 0.01) and basal rotation (41.80 ± 6.12% vs. 37.30 ± 5.66% cardiac cycle; t‐test: P < 0.01; ICC: 0.74, P < 0.01) with peak cardiac displacements preceding peak CALM displacements in both cases. The association between basal rotation and retrograde CALM was further supported by strong correlations between their peak magnitudes (r = −0.70, P = 0.02), whereas the magnitude of septal longitudinal displacement was not associated with peak CALM (r = 0.11, P = 0.77). These results suggest that the rotational mechanical movement of the LV base may be closely associated with longitudinal mechanics in the carotid artery. This finding may have important implications for interpreting the complex relationship between ventricular and vascular function.
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Affiliation(s)
- Jason S Au
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - David S Ditor
- Department of Kinesiology, Brock University, St. Catharines, Ontario, Canada
| | | | - Eric J Stöhr
- Discipline of Physiology & Health, Cardiff School of Sport, Cardiff Metropolitan University, Cardiff, Wales, UK
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Armstrong C, Samuel J, Yarlett A, Cooper SM, Stembridge M, Stöhr EJ. The Effects of Exercise Intensity vs. Metabolic State on the Variability and Magnitude of Left Ventricular Twist Mechanics during Exercise. PLoS One 2016; 11:e0154065. [PMID: 27100099 PMCID: PMC4839594 DOI: 10.1371/journal.pone.0154065] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 04/07/2016] [Indexed: 11/18/2022] Open
Abstract
Increased left ventricular (LV) twist and untwisting rate (LV twist mechanics) are essential responses of the heart to exercise. However, previously a large variability in LV twist mechanics during exercise has been observed, which complicates the interpretation of results. This study aimed to determine some of the physiological sources of variability in LV twist mechanics during exercise. Sixteen healthy males (age: 22 ± 4 years, V˙O2peak: 45.5 ± 6.9 ml∙kg-1∙min-1, range of individual anaerobic threshold (IAT): 32–69% of V˙O2peak) were assessed at rest and during exercise at: i) the same relative exercise intensity, 40%peak, ii) at 2% above IAT, and, iii) at 40%peak with hypoxia (40%peak+HYP). LV volumes were not significantly different between exercise conditions (P > 0.05). However, the mean margin of error of LV twist was significantly lower (F2,47 = 2.08, P < 0.05) during 40%peak compared with IAT (3.0 vs. 4.1 degrees). Despite the same workload and similar LV volumes, hypoxia increased LV twist and untwisting rate (P < 0.05), but the mean margin of error remained similar to that during 40%peak (3.2 degrees, P > 0.05). Overall, LV twist mechanics were linearly related to rate pressure product. During exercise, the intra-individual variability of LV twist mechanics is smaller at the same relative exercise intensity compared with IAT. However, the absolute magnitude (degrees) of LV twist mechanics appears to be associated with the prevailing rate pressure product. Exercise tests that evaluate LV twist mechanics should be standardised by relative exercise intensity and rate pressure product be taken into account when interpreting results.
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Affiliation(s)
- Craig Armstrong
- Discipline of Physiology & Health, Cardiff Metropolitan University, Cardiff, Wales, United Kingdom
| | - Jake Samuel
- Discipline of Physiology & Health, Cardiff Metropolitan University, Cardiff, Wales, United Kingdom
| | - Andrew Yarlett
- Discipline of Physiology & Health, Cardiff Metropolitan University, Cardiff, Wales, United Kingdom
| | - Stephen-Mark Cooper
- Discipline of Physiology & Health, Cardiff Metropolitan University, Cardiff, Wales, United Kingdom
| | - Mike Stembridge
- Discipline of Physiology & Health, Cardiff Metropolitan University, Cardiff, Wales, United Kingdom
| | - Eric J. Stöhr
- Discipline of Physiology & Health, Cardiff Metropolitan University, Cardiff, Wales, United Kingdom
- * E-mail:
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8
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van Mil ACCM, Pearson J, Drane AL, Cockcroft JR, McDonnell BJ, Stöhr EJ. Interaction between left ventricular twist mechanics and arterial haemodynamics during localised, non-metabolic hyperaemia with and without blood flow restriction. Exp Physiol 2016; 101:509-20. [DOI: 10.1113/ep085623] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 01/21/2016] [Indexed: 12/17/2022]
Affiliation(s)
| | - James Pearson
- Cardiff Metropolitan University; Cardiff UK
- University of Colorado; Colorado Springs CO USA
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9
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Steding-Ehrenborg K, Arvidsson PM, Töger J, Rydberg M, Heiberg E, Carlsson M, Arheden H. Determinants of kinetic energy of blood flow in the four-chambered heart in athletes and sedentary controls. Am J Physiol Heart Circ Physiol 2016; 310:H113-22. [DOI: 10.1152/ajpheart.00544.2015] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Accepted: 10/19/2015] [Indexed: 11/22/2022]
Abstract
The kinetic energy (KE) of intracardiac blood may play an important role in cardiac function. The aims of the present study were to 1) quantify and investigate the determinants of KE, 2) compare the KE expenditure of intracardiac blood between athletes and control subjects, and 3) quantify the amount of KE inside and outside the diastolic vortex. Fourteen athletes and fourteen volunteers underwent cardiac MRI, including four-dimensional phase-contrast sequences. KE was quantified in four chambers, and energy expenditure was calculated by determining the mean KE/cardiac index. Left ventricular (LV) mass was an independent predictor of diastolic LVKE ( R2= 0.66, P < 0.001), whereas right ventricular (RV) end-diastolic volume was important for diastolic RVKE ( R2= 0.76, P < 0.001). The mean KE/cardiac index did not differ between groups (control subjects: 0.53 ± 0.14 mJ·l−1·min·m2and athletes: 0.56 ± 0.21 mJ·l−1·min·m2, P = 0.98). Mean LV diastolic vortex KE made up 70 ± 1% and 73 ± 2% of total LV diastolic KE in athletes and control subjects ( P = 0.18). In conclusion, the characteristics of the LV as a pressure pump and the RV as a volume pump are demonstrated as an association between LVKE and LV mass and between RVKE and end-diastolic volume. This also suggests different filling mechanisms where the LV is dependent on diastolic suction, whereas the RV fills with a basal movement of the atrioventricular plane over “stationary” blood. Both groups had similar energy expenditure for intracardiac blood flow, indicating similar pumping efficiency, likely explained by the lower heart rate that cancels the higher KE per heart beat in athletes. The majority of LVKE is found within the LV diastolic vortex, in contrast to earlier findings.
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Affiliation(s)
- K. Steding-Ehrenborg
- Department of Clinical Physiology, Lund University, Lund University Hospital Lund, Lund, Sweden
| | - P. M. Arvidsson
- Department of Clinical Physiology, Lund University, Lund University Hospital Lund, Lund, Sweden
| | - J. Töger
- Department of Clinical Physiology, Lund University, Lund University Hospital Lund, Lund, Sweden
| | - M. Rydberg
- Department of Clinical Physiology, Lund University, Lund University Hospital Lund, Lund, Sweden
| | - E. Heiberg
- Department of Clinical Physiology, Lund University, Lund University Hospital Lund, Lund, Sweden
| | - M. Carlsson
- Department of Clinical Physiology, Lund University, Lund University Hospital Lund, Lund, Sweden
| | - H. Arheden
- Department of Clinical Physiology, Lund University, Lund University Hospital Lund, Lund, Sweden
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10
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Hioki A, Masuda K, Asanuma T, Goto Y, Nakatani S. Application of three-dimensional speckle tracking echocardiography to assess left ventricular regional work using wall tension-regional area loop. Am J Physiol Heart Circ Physiol 2015; 308:H1258-64. [DOI: 10.1152/ajpheart.00932.2014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Accepted: 03/12/2015] [Indexed: 11/22/2022]
Abstract
Three-dimensional (3-D) speckle tracking echocardiography allows us to track a change in regional endocardial surface area. The change of regional area during a cardiac cycle should be useful for assessing left ventricular regional work. We investigated the feasibility of assessing regional work, calculated as the area within the wall tension-regional area (T-A) loop using 3-D echocardiography. Three-dimensional full-volume images were acquired using 3-D echocardiography (Artida, Toshiba) at baseline and during brief occlusion of the left circumflex coronary artery in eight dogs. Wall tension was calculated according to Laplace's law for a spherical model. Area change ratio (in %) determined by area tracking was transformed into a change of regional area (in cm2) by a custom software. We calculated the area within the T-A loop (TAA) in the area under transient ischemia (risk area) and the remote area as regional work and validated the T-A loop method by comparing the global integral of TAA with the total work assessed by the pressure-volume loop. During coronary occlusion, regional work for the risk area significantly decreased (baseline vs. occlusion, 26.8 ± 10.7 vs. 18.4 ± 7.8 mmHg·cm3; P < 0.05), whereas that for the remote area did not change. The global integral of TAA closely correlated with the total work assessed by the pressure-volume loop ( r = 0.91, P < 0.0001). The wall T-A loop reflected regional dysfunction caused by myocardial ischemia. This analysis using 3-D speckle tracking echocardiography might be useful to quantify left ventricular regional work.
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Affiliation(s)
- Ayana Hioki
- Division of Functional Diagnostics, Department of Health Sciences, Osaka University Graduate School of Medicine, Suita, Osaka, Japan; and
| | - Kasumi Masuda
- Division of Functional Diagnostics, Department of Health Sciences, Osaka University Graduate School of Medicine, Suita, Osaka, Japan; and
| | - Toshihiko Asanuma
- Division of Functional Diagnostics, Department of Health Sciences, Osaka University Graduate School of Medicine, Suita, Osaka, Japan; and
| | - Yoichi Goto
- Cardiology Division of Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Satoshi Nakatani
- Division of Functional Diagnostics, Department of Health Sciences, Osaka University Graduate School of Medicine, Suita, Osaka, Japan; and
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Stöhr EJ, Stembridge M, Esformes JI. In vivohuman cardiac shortening and lengthening velocity is region dependent and not coupled with heart rate: ‘longitudinal’ strain rate markedly underestimates apical contribution. Exp Physiol 2015; 100:507-18. [DOI: 10.1113/ep085081] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2015] [Accepted: 03/04/2015] [Indexed: 11/08/2022]
Affiliation(s)
- Eric J. Stöhr
- Cardiff School of Sport; , Cardiff Metropolitan University; Cardiff UK
| | - Mike Stembridge
- Cardiff School of Sport; , Cardiff Metropolitan University; Cardiff UK
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