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  • Novel non-invasive left ventricular pressure-strain loop imaging demonstrates reduced myocardial work in cardiomyopathy with significant regional variation in non-ischemic cases

    Author(s)
    Edwards, NFA
    Chan, J
    Sabapathy, S
    Anderson, B
    Chamberlain, R
    Scalia, G
    Griffith University Author(s)
    Sabapathy, Surendran
    Chamberlain, Rob
    Edwards, Natalie
    Year published
    2018
    Metadata
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    Abstract
    Background: Non-invasive left ventricular (LV) pressure-strain loop imaging is a novel method of calculating myocardial work (MW). The total area within the pressure-strain loop represents global MW (Figure1A). Myocardial shortening during systole and lengthening during isovolumic relaxation is classified as constructive work (CW) while myocardial lengthening during systole and shortening during isovolumic relaxation is classified as wasted work (WW). Purpose: Non-ischemic (CMPN-ISC) and ischemic cardiomyopathy (CMPISC) heart disease etiology influences management, prognosis as well as electromechanical correlates in heart ...
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    Background: Non-invasive left ventricular (LV) pressure-strain loop imaging is a novel method of calculating myocardial work (MW). The total area within the pressure-strain loop represents global MW (Figure1A). Myocardial shortening during systole and lengthening during isovolumic relaxation is classified as constructive work (CW) while myocardial lengthening during systole and shortening during isovolumic relaxation is classified as wasted work (WW). Purpose: Non-ischemic (CMPN-ISC) and ischemic cardiomyopathy (CMPISC) heart disease etiology influences management, prognosis as well as electromechanical correlates in heart failure. Differences in global MW and regional MW in patients with CMPN-ISC and CMPISC were assessed. Methods: Strain analysis was performed in 34 patients divided into: 1) Controls (n=10); 2) CMPN-ISC (n=10) (EF<40%; no evidence of significant coronary artery disease); 3) CMPISC (n=14) (EF<40%; coronary artery stenosis) immediately prior to coronary angiography. Dedicated MW software normalized standard LV pressure curves to brachial systolic cuff pressure and isovolumic and ejection duration. MW efficiency (GWE) was derived from the percentage ratio of: CW/(CW+WW). Segmental wasted work between septal and lateral segments were compared between CMPN-ISC and CMPISC. Results: Significantly higher global MW and GWE (p<0.05) was observed in controls. CMPISC demonstrated the lowest global MW (780mmHg%) but was not significantly different to CMPN-ISC (1054mmHg%). CMPN-ISC WW was significantly higher (p<0.05) compared to CMPISC (259 vs 185 mmHg%). Regional septal WW was significantly higher (p<0.05) in CMPN-ISC (459mmHg%) vs lateral WW (174mmHg%) (Figure1C). There was no significant difference between septal (198mmHg%) and lateral (161mmHg%) WW in CMPISC.
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    Conference Title
    European Heart Journal
    Volume
    39
    Issue
    suppl_1
    DOI
    https://doi.org/10.1093/eurheartj/ehy566.4922
    Subject
    Cardiorespiratory Medicine and Haematology
    Clinical Sciences
    Science & Technology
    Life Sciences & Biomedicine
    Cardiac & Cardiovascular Systems
    Cardiovascular System & Cardiology
    Publication URI
    http://hdl.handle.net/10072/402341
    Collection
    • Conference outputs

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