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Systolic and diastolic myocardial mechanics in patients with cardiac disease and preserved ejection fraction: impact of left ventricular filling pressure.
J Am Soc Echocardiogr 2010; 23(12):1273-80JA

Abstract

BACKGROUND

There are few data on the impact of left ventricular (LV) filling pressure on systolic and diastolic myocardial mechanics in patients with cardiac disease and preserved LV ejection fraction (LVEF) (≥ 50%).

METHODS

Patients referred for cardiac catheterization underwent comprehensive echocardiography within 20 minutes of catheterization. Strain and strain rate in longitudinal, radial, and circumferential directions and torsion were measured in systole and diastole. LV preatrial contraction pressure (pre-A) was measured and averaged over 10 cardiac cycles.

RESULTS

Sixty patients were studied (mean age, 55.3 ± 8.9 years). The 30 patients with LV pre-A ≥ 15 mm Hg had significantly lower longitudinal systolic strain and radial, circumferential, and torsional systolic strain rates than the 30 patients with LV pre-A < 15 mm Hg (P < .05 for all). Similar findings were seen for diastolic variables. There were significant correlations between several systolic and diastolic variables in multiple directions and LV pre-A. On multivariate analysis, the independent predictors of systolic and diastolic speckle-tracking parameters included LVEF and LV pre-A, depending on the specific parameter analyzed.

CONCLUSIONS

In patients with preserved LVEF and cardiac disease, several systolic and diastolic myocardial mechanical parameters significantly correlate with LV filling pressure. These data highlight the notion that patients with preserved LVEF and elevated LV filling pressures have significant abnormalities in systolic function as detected by speckle imaging, findings that may challenge the concept of "isolated diastolic dysfunction." The extent of systolic and diastolic abnormalities in these patients may shed light on the mechanics of heart failure with preserved LVEF.

Authors+Show Affiliations

Department of Medicine, Baylor College of Medicine, Dallas, Texas, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20970305

Citation

Nguyen, John S., et al. "Systolic and Diastolic Myocardial Mechanics in Patients With Cardiac Disease and Preserved Ejection Fraction: Impact of Left Ventricular Filling Pressure." Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography, vol. 23, no. 12, 2010, pp. 1273-80.
Nguyen JS, Lakkis NM, Bobek J, et al. Systolic and diastolic myocardial mechanics in patients with cardiac disease and preserved ejection fraction: impact of left ventricular filling pressure. J Am Soc Echocardiogr. 2010;23(12):1273-80.
Nguyen, J. S., Lakkis, N. M., Bobek, J., Goswami, R., & Dokainish, H. (2010). Systolic and diastolic myocardial mechanics in patients with cardiac disease and preserved ejection fraction: impact of left ventricular filling pressure. Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography, 23(12), pp. 1273-80. doi:10.1016/j.echo.2010.09.008.
Nguyen JS, et al. Systolic and Diastolic Myocardial Mechanics in Patients With Cardiac Disease and Preserved Ejection Fraction: Impact of Left Ventricular Filling Pressure. J Am Soc Echocardiogr. 2010;23(12):1273-80. PubMed PMID: 20970305.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Systolic and diastolic myocardial mechanics in patients with cardiac disease and preserved ejection fraction: impact of left ventricular filling pressure. AU - Nguyen,John S, AU - Lakkis,Nasser M, AU - Bobek,Jaromir, AU - Goswami,Rajiv, AU - Dokainish,Hisham, PY - 2010/01/26/received PY - 2010/10/26/entrez PY - 2010/10/26/pubmed PY - 2011/4/26/medline SP - 1273 EP - 80 JF - Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography JO - J Am Soc Echocardiogr VL - 23 IS - 12 N2 - BACKGROUND: There are few data on the impact of left ventricular (LV) filling pressure on systolic and diastolic myocardial mechanics in patients with cardiac disease and preserved LV ejection fraction (LVEF) (≥ 50%). METHODS: Patients referred for cardiac catheterization underwent comprehensive echocardiography within 20 minutes of catheterization. Strain and strain rate in longitudinal, radial, and circumferential directions and torsion were measured in systole and diastole. LV preatrial contraction pressure (pre-A) was measured and averaged over 10 cardiac cycles. RESULTS: Sixty patients were studied (mean age, 55.3 ± 8.9 years). The 30 patients with LV pre-A ≥ 15 mm Hg had significantly lower longitudinal systolic strain and radial, circumferential, and torsional systolic strain rates than the 30 patients with LV pre-A < 15 mm Hg (P < .05 for all). Similar findings were seen for diastolic variables. There were significant correlations between several systolic and diastolic variables in multiple directions and LV pre-A. On multivariate analysis, the independent predictors of systolic and diastolic speckle-tracking parameters included LVEF and LV pre-A, depending on the specific parameter analyzed. CONCLUSIONS: In patients with preserved LVEF and cardiac disease, several systolic and diastolic myocardial mechanical parameters significantly correlate with LV filling pressure. These data highlight the notion that patients with preserved LVEF and elevated LV filling pressures have significant abnormalities in systolic function as detected by speckle imaging, findings that may challenge the concept of "isolated diastolic dysfunction." The extent of systolic and diastolic abnormalities in these patients may shed light on the mechanics of heart failure with preserved LVEF. SN - 1097-6795 UR - https://www.unboundmedicine.com/medline/citation/20970305/Systolic_and_diastolic_myocardial_mechanics_in_patients_with_cardiac_disease_and_preserved_ejection_fraction:_impact_of_left_ventricular_filling_pressure_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0894-7317(10)00814-X DB - PRIME DP - Unbound Medicine ER -