Echocardiographic reference ranges for noninvasive left ventricular 18-segment myocardial work index and work efficiency in a healthy Asian population

Wu, Jian; Huang, Xinyi; Huang, Kunhui; Tang, Yiruo; Gao, Qiumei; Chen, Xu; Jing, Bo; Wang, Xinyu; Lin, Biqin; Su, Maolong

doi:10.1186/s12947-023-00299-4

Cited by 3 publications

(1 citation statement)

References 32 publications

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“…85 Four parameters are calculated (Table 6): Global Work Index (GWI), Global Constructive Work (GCW), Global Wasted Work (GWW), and Global Work Efficiency (GWE). 86 Based on large studies, [86][87][88][89] the average of LLN of GWI is 1442 mmHg%.…”

Section: Myocardial Workmentioning

confidence: 99%

Myocardial strain of the left ventricle by speckle tracking echocardiography: From physics to clinical practice

Gherbesi,

Gianstefani,

Angeli

et al. 2024

Echocardiography

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Speckle tracking echocardiography (STE) is a reliable imaging technique of recognized clinical value in several settings. This method uses the motion of ultrasound backscatter speckles within echocardiographic images to derive myocardial velocities and deformation parameters, providing crucial insights on several cardiac pathological and physiological processes. Its feasibility, reproducibility, and accuracy have been widely demonstrated, being myocardial strain of the various chambers inserted in diagnostic algorithms and guidelines for various pathologies. The most important parameters are Global longitudinal strain (GLS), Left atrium (LA) reservoir strain, and Global Work Index (GWI): based on large studies the average of the lower limit of normality are −16%, 23%, and 1442 mmHg%, respectively. For GWI, it should be pointed out that myocardial work relies primarily on non‐invasive measurements of blood pressure and segmental strain, both of which exhibit high variability, and thus, this variability constitutes a significant limitation of this parameter. In this review, we describe the principal aspects of the theory behind the use of myocardial strain, from cardiac mechanics to image acquisition techniques, outlining its limitation, and its principal clinical applications: in particular, GLS have a role in determine subclinical myocardial dysfunction (in cardiomyopathies, cardiotoxicity, target organ damage in ambulatory patients with arterial hypertension) and LA strain in determine the risk of AF, specifically in ambulatory patients with arterial hypertension.

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Section: Myocardial Workmentioning

confidence: 99%

Myocardial strain of the left ventricle by speckle tracking echocardiography: From physics to clinical practice

Gherbesi,

Gianstefani,

Angeli

et al. 2024

Echocardiography

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Global and regional myocardial function assessment in symptomatic patients with chronic coronary syndrome using longitudinal strain and noninvasive myocardial work

Lv,

Jiang,

Tan

et al. 2023

Int J Cardiovasc Imaging

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Myocardial Work Indices in Patients Recently Recovered from Mild-to-Moderate COVID-19

Dankowski,

Sacharczuk,

Fedorowicz

et al. 2024

JCM

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Background/Objectives: Persistent cardiovascular issues are common in COVID-19 survivors, making the detection of subtle myocardial injuries critical. This study evaluates myocardial work (MW) indices in patients recently recovering from mild-to-moderate COVID-19. Methods: A total of 105 recently recovered COVID-19 patients (who had a mean age of 52 years) underwent comprehensive laboratory testing and advanced echocardiographic assessments. The median time since their COVID-19 infections was 56 days (IQR: 42–71). The cohort was stratified based on high-sensitive troponin I (hs-TnI) levels: undetectable versus detectable. The echocardiographic analysis utilized pressure-strain loops to evaluate MW indices. Results: Detectable hs-TnI levels were observed in 42% of patients. The median values of MW indices for the entire group were slightly below normal values: global work index (GWI)—1834 mmHg% (IQR 1168–2054 mmHg%), global constructive work (GCW)—2130 mmHg% (IQR 2010–2398 mmHg%), global wasted work (GWW)—119 mmHg% (IQR 78–175 mmHg%), and global work efficiency (GWE)—94% (IQR 92–96%). Patients with detectable hs-TnI had higher GWW (168 vs. 97 mmHg%, p < 0.005) and lower GWE (93% vs. 95%, p < 0.005). In multiple regression analysis, strain dispersion (PSD) was the sole predictor for GWW (β = 0.67, p < 0.001), while for GWE, PSD (β = −0.67, p < 0.001) and LVEF (β = 0.16, p = 0.05) were significant predictors. Conclusions: Among patients recently recovering from mild-to-moderate COVID-19, elevated hs-TnI levels are linked with a reduction in GWE and an increase in GWW. PSD is an important predictor of myocardial inefficiency and wasted work. In this group, disruptions in the timing and coordination of cardiac muscle contractions may play a key pathophysiological role in reducing the efficiency of the heart’s performance.

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Echocardiographic reference ranges for noninvasive left ventricular 18-segment myocardial work index and work efficiency in a healthy Asian population

Cited by 3 publications

References 32 publications

Myocardial strain of the left ventricle by speckle tracking echocardiography: From physics to clinical practice

Myocardial strain of the left ventricle by speckle tracking echocardiography: From physics to clinical practice

Global and regional myocardial function assessment in symptomatic patients with chronic coronary syndrome using longitudinal strain and noninvasive myocardial work

Myocardial Work Indices in Patients Recently Recovered from Mild-to-Moderate COVID-19

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