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  • A new approach to assess myocardial work by non-invasive left ventricular pressure-strain relations in hypertension and dilated cardiomyopathy

    Author(s)
    Chan, Jonathan
    Edwards, Natalie FA
    Khandheria, Bijoy K
    Shiino, Kenji
    Sabapathy, Surendran
    Anderson, Bonita
    Chamberlain, Robert
    Scalia, Gregory M
    Griffith University Author(s)
    Sabapathy, Surendran
    Edwards, Natalie
    Chan, Jonathan H.
    Shiino, Kenji
    Chamberlain, Rob
    Year published
    2019
    Metadata
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    Abstract
    Aims: Non-invasive left ventricular (LV) pressure–strain loop (PSL) provides a novel method of quantifying myocardial work (MW) with potential advantages over conventional global longitudinal strain (GLS) by incorporating measurements of myocardial deformation and LV pressure. We investigated different patterns of LV PSL and global MW index (GWI) in patients with hypertension (HTN) and dilated cardiomyopathy (CMP). Methods and results: Seventy-four patients underwent transthoracic echocardiography and strain analysis before coronary angiography. Patients were divided into three groups: control, HTN, and CMP. GWI was calculated ...
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    Aims: Non-invasive left ventricular (LV) pressure–strain loop (PSL) provides a novel method of quantifying myocardial work (MW) with potential advantages over conventional global longitudinal strain (GLS) by incorporating measurements of myocardial deformation and LV pressure. We investigated different patterns of LV PSL and global MW index (GWI) in patients with hypertension (HTN) and dilated cardiomyopathy (CMP). Methods and results: Seventy-four patients underwent transthoracic echocardiography and strain analysis before coronary angiography. Patients were divided into three groups: control, HTN, and CMP. GWI was calculated as the area of the LV PSL as a product of strain × systolic blood pressure. MW efficiency (GWE) is derived from the percentage ratio of constructive work (GCW) to sum of constructive work (GCW) and wasted work (GWW). Influences of HTN and LV function on its relationship with MW were evaluated. GLS and LV ejection fraction were preserved in the HTN group with no difference from controls. GWI was significantly higher in moderate to severe HTN patients (P = 0.004) as a compensatory mechanism to preserve LV contractility and function against an increase in afterload. GWE was preserved in HTN patients due to the proportional increase in GCW and GWW. GLS, GWI, and GWE were significantly reduced in CMP (P < 0.05), with a trend in rightward shift and reduction in the LV PSL. Conclusion: GWI is a potential new technique that allows better understanding of the relationship between LV remodelling and increased wall stress under different loading conditions.
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    Journal Title
    European Heart Journal Cardiovascular Imaging
    Volume
    20
    Issue
    1
    DOI
    https://doi.org/10.1093/ehjci/jey131
    Note
    This publication has been entered into Griffith Research Online as an Advanced Online Version.
    Subject
    Cardiology (incl. cardiovascular diseases)
    Publication URI
    http://hdl.handle.net/10072/380751
    Collection
    • Journal articles

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