Journal of the American Society of Echocardiography
The Functional Role of Longitudinal, Circumferential, and Radial Myocardial Deformation for Regulating the Early Impairment of Left Ventricular Contraction and Relaxation in Patients With Cardiovascular Risk Factors: A Study With Two-Dimensional Strain Imaging
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Study Population
The study population included 2 groups: 1) patients with cardiovascular risk factors but no overt cardiac disease, and 2) age-matched subjects with no risk factors, who served as controls. A total of 70 patients with risk factors were selected because they had adequate acoustic windows and 1 or more of the following criteria: 1) current smoker; 2) body mass index ≥ 25 kg/m2; 3) hypertension with systolic or diastolic blood pressure > 140 mm Hg or 90 mm Hg, respectively; 4) hyperlipidemia with
Clinical Characteristics
There were no significant differences in all clinical parameters but low-density lipoprotein cholesterol between the control and E/A ≥ 1 groups (Table 1). There were no significant differences in body mass index, heart rate, blood pressure, or hemoglobin A1c between the E/A ≥ 1 and E/A < 1 groups.
In the 2 patient groups, risk factors were observed as follows: >20 cigarettes for 10 or more years in 4 patients of the E/A ≥ 1 group and 10 patients of the E/A < 1 group, body mass index ≥ 25 kg/m2
Discussion
The present study indicates that LV myocardial contraction and relaxation were first impaired in the longitudinal direction in subclinical patients with cardiovascular risk factors. However, LV pump function and LV filling were compensated by circumferential shortening at ventricular systole and 3 directional lengthening at atrial systole, respectively.
The 3-dimensional dynamic geometry and myofiber architecture of the LV should be considered to accurately understand LV deformation.3, 4, 5 The
Conclusions
Both longitudinal LV diastolic and systolic function were first impaired in subclinical patients with cardiovascular risk factors and preserved LV pump function. In systole, radial thickening was preserved, with an increase in circumferential shortening accompanying the decrease in longitudinal shortening, resulting in maintenance of LV ejection fraction. In diastole, the early diastolic strain rate decreased in longitudinal and radial directions, particularly in the former direction. However,
References (43)
- et al.
Left ventricular form and function revisited: applied translational science to cardiovascular ultrasound imaging
J Am Soc Echocardiogr
(2007) - et al.
Two-dimensional strain–a novel software for real-time quantitative echocardiographic assessment of myocardial function
J Am Soc Echocardiogr
(2004) - et al.
Doppler tissue imaging: a non-invasive technique for evaluation of left ventricular relaxation and estimation of filling pressures
J Am Coll Cardial
(1997) - et al.
Incidence and characteristics of segmental postsystolic longitudinal shortening in normal, acutely ischemic, and scarred myocardium
J Am Soc Echocardiogr
(2003) - et al.
Left ventricular structure and functionBasic science for cardiac imaging
J Am Coll Cardiol
(2006) - et al.
Transmural dispersion of myofiber mechanicsImplications for electrical heterogeneity in vivo
J Am Coll Cardiol
(2007) - et al.
Influence of aging on systolic left ventricular wall motion velocities along the long and short axes in clinically normal patients determined by pulsed tissue Doppler imaging
J Am Soc Echocardiogr
(1999) - et al.
Detection of early abnormalities of left ventricular function by hemodynamic, echo-tissue Doppler imaging, and mitral Doppler flow techniques in patients with coronary artery disease and normal ejection fraction
J Am Soc Echocardiogr
(2001) - et al.
Augmentation of atrial contribution to left ventricular inflow with aging as assessed by intracardiac Doppler flowmetry
Am J Cardiol
(1984) - et al.
Plasma triglyceride level is an independent predictor of altered left ventricular relaxation
J Am Soc Echocardiogr
(2005)