Assessment of left ventricular myocardial work in Turner syndrome patients: insights from the novel non-invasive pressure-strain loop analysis method

Feng²,

et al. 2021

Preprint

Background: This study aimed to determine the left ventricular (LV) systolic function in patients on maintenance hemodialysis (MHD) using the myocardial work (MW) technique and investigate the clinical value of the MW technique for the quantitative analysis of left ventricular (LV) systolic function in MHD patients with left ventricular hypertrophy (LVH).Methods: A total of 68 MHD patients and 35 controls were registered in this study. The MHD patients were divided into the non-left ventricular hypertrophy (NLVH) group (n=35) and the LVH group (n=33) according to the LV mass index (LVMI). MW was used to generate the LV global longitudinal strain (GLS), global work index (GWI), global constructive work (GCW), and global wasted work (GWW), global work efficiency (GWE). GLS and the MW parameters (GWI, GCW, GWW, GWE) were compared between groups and the correlations between these parameters and the LV ejection fraction (LVEF) in the LVH group were examined. The receiver operating characteristic (ROC) curve was used to evaluate the efficacy of MW parameters and GLS for the assessment of LV systolic dysfunction in MHD with LVH patients.Results: The LVH group had significantly lower GWE, GWI, GCW, and GLS but higher GWW than the control and NLVH groups. Compared with the control group, the NLVH group had significantly lower GWE and GLS and higher GWW, but no significant differences in GWI, GCW were observed between these two groups. The LVEF was negatively correlated with GWW in MHD patients, but positively correlated with GWI, GWE, and GCW in the LVH group. Receiver operating characteristic curve (ROC) analysis revealed that GWE, GWW, GWI, and GCW had appreciable area under the curve (AUC), sensitivity, and specificity for evaluating LV function in LVH patients on MHD. Conclusion: The MW parameters can quantitatively represent the LV myocardial work in MHD patients. Thus, the technique provides a new method for the quantitative evaluation of LV systolic function in MHD with LVH patients.

Section: Discussionmentioning

confidence: 93%

Value of quantitative analysis of left ventricular systolic function in patients on maintenance hemodialysis based on myocardial work technique

Feng²,

et al. 2021

Preprint

“…This also suggests that the LV myocardium was not signi cantly impaired in NLVH patients and that LVEF was maintained at a normal level by enhanced myocardial contractility. However, if the high GWI persists and exceeds the compensatory capacity of the myocardium, LV remodeling and dysfunction will occur [39]. In addition, the NLVH group had higher GWW but lower GWE than the normal group, with no signi cant difference in the LV PSD between the groups.…”

Section: Discussionmentioning

confidence: 93%

Value of Quantitative Analysis of Left Ventricular Systolic Function in Patients on Maintenance Hemodialysis Based on Myocardial Work Technique

Feng²,

et al. 2020

Preprint

Abstract Background: This study investigated the clinical value of the myocardial work technique for the quantitative analysis of left ventricular (LV) systolic function in maintenance hemodialysis (MHD) patients with or without left ventricular hypertrophy (LVH).Methods: A total of 58 MHD patients and 29 normal subjects were registered in this study. The MHD patients were divided into the non-left ventricular hypertrophy (NLVH) group (n=32) and the LVH group (n=26) according to the LV myocardial index (LVMI). Automated function imaging was used to analyze the dynamic images of the LV myocardium obtained in two-, three-, and four-chamber views. The blood pressure was inputted to generated the LV global longitudinal strain (GLS), myocardial global work index (GWI), global constructive work (GCW), global wasted work (GWW), global work efficiency (GWE), and peak strain dispersion (PSD). GLS, PSD, and the MW parameters (GWI, GCW, GWW, GWE) were compared between groups and the correlations between these parameters and the LV ejection fraction (LVEF) were examined. The receiver operating characteristic (ROC) curve was used to evaluate the efficacy of MW parameters and GLS for the assessment of LV systolic dysfunction in MHD patients with LVH.Results: The LVH group had significantly lower GWE, GWI, GCW, and GLS but higher GWW and PSD than the control and NLVH groups. Compared with the control group, the NLVH group had significantly lower GWE and GLS and higher GWW, but no significant differences in GWI, GCW, and PSD were observed between these two groups. The LVEF was negatively correlated with GWW in MHD patients, but positively correlated with GWI, GWE, and GCW. Area under the curve (AUC) analysis revealed that in the LVH group, GWE, GWW, GWI, and GCW had appreciable AUC, sensitivity, and specificity for evaluating LV function in LVH patients. Conclusion: MW parameters can be effectively used to evaluate the LV systolic function in MHD patients with or without LVH.

“…This also suggests that the LV myocardium was not signi cantly impaired in NLVH patients and that LVEF was maintained at a normal level by enhanced myocardial contractility. However, if the high GWI persists and exceeds the compensatory capacity of the myocardium, LV remodeling and dysfunction will occur [37]. In addition, the NLVH group had higher GWW but lower GWE than the normal group, with no signi cant difference in the LV PSD between the groups.…”

Section: Discussionmentioning

confidence: 93%

Value of quantitative analysis of left ventricular systolic function in patients on maintenance hemodialysis based on myocardial work technique

Feng²,

et al. 2020

Preprint

Background: To detect the left ventricular (LV) systolic function in maintenance hemodialysis (MHD) patients by using myocardial work (MW) technique. And investigated the clinical value of the MW technique for the quantitative analysis of left ventricular (LV) systolic function in MHD patients with left ventricular hypertrophy (LVH).Methods: A total of 58 MHD patients and 29 normal subjects were registered in this study. The MHD patients were divided into the non-left ventricular hypertrophy (NLVH) group (n=32) and the LVH group (n=26) according to the LV myocardial index (LVMI). MW was used to generated the LV global longitudinal strain (GLS), global work index (GWI), global constructive work (GCW), global wasted work (GWW), global work efficiency (GWE. GLS and the MW parameters (GWI, GCW, GWW, GWE) were compared between groups and the correlations between these parameters and the LV ejection fraction (LVEF) in the LVH group were examined. The receiver operating characteristic (ROC) curve was used to evaluate the efficacy of MW parameters and GLS for the assessment of LV systolic dysfunction in MHD patients with LVH.Results: The LVH group had significantly lower GWE, GWI, GCW, and GLS but higher GWW than the control and NLVH groups. Compared with the control group, the NLVH group had significantly lower GWE and GLS and higher GWW, but no significant differences in GWI, GCW were observed between these two groups. The LVEF was negatively correlated with GWW in MHD patients, but positively correlated with GWI, GWE, and GCW in the LVH group. Receiver operating characteristic curve (ROC) analysis revealed that GWE, GWW, GWI, and GCW had appreciable area under the curve (AUC), sensitivity, and specificity for evaluating LV function in LVH patients. Conclusion: MW parameters can be effectively used to evaluate the LV systolic function in MHD patients with or without LVH.