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Minczykowski A, Guzik P, Sajkowska A, Pałasz-Borkowska A, Wykrętowicz A. Interrelationships between Peak Strain Dispersion, Myocardial Work Indices, Isovolumetric Relaxation and Systolic-Diastolic Coupling in Middle-Aged Healthy Subjects. J Clin Med 2023; 12:5623. [PMID: 37685690 PMCID: PMC10488442 DOI: 10.3390/jcm12175623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 08/11/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
In echocardiography, peak strain dispersion (PSD) is the standard deviation of the time to peak longitudinal strain for each left ventricular (LV) segment during systole. It assesses the coordination and synchrony of LV segment contractility. Global work efficiency (GWE) and global wasted work (GWW) quantify LV myocardial work and, if impaired, the coupling between LV systolic contraction and early relaxation. Isovolumetric relaxation (IVRT) measures the duration of initial LV relaxation, while the ratio of early diastolic recoil to systolic excursion (E'VTI/S'VTI) describes systolic-diastolic coupling. We evaluated these parameters in 69 healthy subjects and found that PSD correlated negatively with GWE (r = -0.49, p < 0.0001) and E'VTI/S'VTI (r = -0.44, p = 0.0002), but positively with GWW (r = 0.4, p = 0.0007) and IVRT (r = 0.53, p < 0.0001). GWE correlated negatively with GWW (r = -0.94, p < 0.0001) and IVRT (r = -0.30, p = 0.0127), but positively with E'VTI/S'VTI (r = 0.3, p = 0.0132). In addition, E'VTI/S'VTI was negatively correlated with GWW (r = -0.35, p = 0.0032) and IVRT (r = -0.36, p = 0.0024). These associations remained significant after adjustment for sex, age and LV mass index of the subjects. In conclusion, there is an interaction between measures of LV asynchrony, myocardial work, diastolic function and its systolic-diastolic coupling in middle-aged healthy subjects. The clinical value of these interactions requires further investigation.
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Affiliation(s)
- Andrzej Minczykowski
- Department of Cardiology-Intensive Therapy, Poznań University of Medical Sciences, 49 Przybyszewskiego, 60-355 Poznań, Poland; (P.G.); (A.S.); (A.P.-B.); (A.W.)
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Alvandi M, Shaghaghi Z, Aryafar V, Fariba F, Sanaei Z. The evaluation of left ventricular dyssynchrony in hypertensive patients with a preserved systolic function undergoing gated SPECT myocardial perfusion imaging. Ann Nucl Med 2019; 33:899-906. [DOI: 10.1007/s12149-019-01402-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 09/17/2019] [Indexed: 01/25/2023]
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Truong V, Mazur W, Magier A, Broderick J, Safdar K, Volz B, Bartone C, Kereiakes DJ, Chung ES. Changes in mechanical dyssynchrony in severe aortic stenosis patients undergoing transcatheter aortic valve replacement. Echocardiography 2019; 36:243-248. [PMID: 30623480 DOI: 10.1111/echo.14237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 11/27/2018] [Accepted: 11/27/2018] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Aortic stenosis (AS) imposes a significant afterload on the left ventricle, but regional manifestations of the overall load may not be uniform, leading to mechanical dyssynchrony. Accordingly, we evaluated the prevalence of dyssynchrony in patients with severe AS at baseline as well as changes after transfemoral aortic valve replacement (TAVR). METHODS This study is a retrospective analysis of 225 patients in sinus rhythm who underwent TAVR for severe AS, in whom inter-ventricular and intra-ventricular dyssynchrony were measured at baseline, discharge, 1 month, and 1 year. Inter-ventricular dyssynchrony was defined as the difference between left and right ventricular pre-ejection intervals; intra-ventricular dyssynchrony was defined as the difference between time to peak systolic velocity of the basal septal and lateral segments. Patients were further stratified into those with QRS <120 ms or >120 ms. RESULTS At baseline, a quarter of patients met the criterion for significant inter-ventricular dyssynchrony, and a third had evidence of intra-ventricular dyssynchrony. Both decreased after TAVR although only the intra-ventricular dyssynchrony reached statistical significance. The interplay between QRS duration and changes in inter- and intra-ventricular dyssynchrony are also explored. CONCLUSIONS In patients with severe AS, there was evidence of mechanical dyssynchrony that is improved post-TAVR. Whether dyssynchrony is clinically and prognostically significant, and if it represents a potential target for additional therapy remains to be studied.
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Affiliation(s)
- Vien Truong
- The Christ Hospital Heart and Vascular Center, Cincinnati, Ohio.,The Lindner Center for Research and Education, Cincinnati, Ohio.,The Christ Hospital, Cincinnati, Ohio
| | - Wojciech Mazur
- The Christ Hospital Heart and Vascular Center, Cincinnati, Ohio.,The Lindner Center for Research and Education, Cincinnati, Ohio.,The Christ Hospital, Cincinnati, Ohio
| | - Adam Magier
- The Christ Hospital Heart and Vascular Center, Cincinnati, Ohio.,The Lindner Center for Research and Education, Cincinnati, Ohio.,The Christ Hospital, Cincinnati, Ohio
| | - John Broderick
- The Christ Hospital Heart and Vascular Center, Cincinnati, Ohio.,The Lindner Center for Research and Education, Cincinnati, Ohio.,The Christ Hospital, Cincinnati, Ohio
| | - Komal Safdar
- The Christ Hospital Heart and Vascular Center, Cincinnati, Ohio.,The Lindner Center for Research and Education, Cincinnati, Ohio.,The Christ Hospital, Cincinnati, Ohio
| | - Brian Volz
- The Christ Hospital Heart and Vascular Center, Cincinnati, Ohio.,The Lindner Center for Research and Education, Cincinnati, Ohio.,The Christ Hospital, Cincinnati, Ohio
| | - Cheryl Bartone
- The Christ Hospital Heart and Vascular Center, Cincinnati, Ohio.,The Lindner Center for Research and Education, Cincinnati, Ohio.,The Christ Hospital, Cincinnati, Ohio
| | - Dean J Kereiakes
- The Christ Hospital Heart and Vascular Center, Cincinnati, Ohio.,The Lindner Center for Research and Education, Cincinnati, Ohio.,The Christ Hospital, Cincinnati, Ohio
| | - Eugene S Chung
- The Christ Hospital Heart and Vascular Center, Cincinnati, Ohio.,The Lindner Center for Research and Education, Cincinnati, Ohio.,The Christ Hospital, Cincinnati, Ohio
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Ojala T, Mathur S, Vatanen A, Sinha MD, Jahnukainen K, Simpson J. Repeatability and Agreement of Real Time Three-dimensional Echocardiography Measurements of Left Ventricular Mass and Synchrony in Young Patients. Echocardiography 2014; 32:522-7. [DOI: 10.1111/echo.12672] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Affiliation(s)
- Tiina Ojala
- Department of Pediatric Cardiology; Children's Hospital; University of Helsinki and Helsinki University Central Hospital; Helsinki Finland
| | - Sujeev Mathur
- Department of Congenital Heart Disease; Evelina London Children′s Hospital; Guy's and St. Thomas NHS Trust; London United Kingdom
| | - Anu Vatanen
- Division of Pediatric Hematology-Oncology; Children's Hospital; University of Helsinki and Helsinki University Central Hospital; Helsinki Finland
| | - Manish D. Sinha
- Department of Paediatric Nephrology; Evelina London Children′s Hospital; Guy's and St. Thomas NHS Trust; London United Kingdom
| | - Kirsi Jahnukainen
- Division of Pediatric Hematology-Oncology; Children's Hospital; University of Helsinki and Helsinki University Central Hospital; Helsinki Finland
| | - John Simpson
- Department of Congenital Heart Disease; Evelina London Children′s Hospital; Guy's and St. Thomas NHS Trust; London United Kingdom
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Chung WJ. Is Dynamic Left Ventricular Dyssynchrony a Novel Surrogate Marker in the Patient with Hypertension? J Cardiovasc Ultrasound 2012; 20:172-3. [PMID: 23346285 PMCID: PMC3542509 DOI: 10.4250/jcu.2012.20.4.172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 12/16/2012] [Accepted: 12/17/2012] [Indexed: 11/22/2022] Open
Affiliation(s)
- Wook-Jin Chung
- Cardiology Division, Heart Center, Gachon University Gil Hospital, Incheon, Korea
- Gachon Cardiovascular Research Institute, Gachon University Gil Hospital, Incheon, Korea
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