Echocardiography in the assessment of left ventricular longitudinal systolic function: current methodology and clinical applications

Abstract

Quantification of left ventricular (LV) systolic function represents a major aspect of echocardiographic assessment in the spectrum of cardiac diseases. However, because of the high complexity of LV contraction mechanics, the classical approach with assessment of a single measure of systolic function, such as ejection fraction or fractional shortening, has been largely superseded. During the last years, through the considerable technical advances in the field of ultrasonography, a number of different echocardiographic methodologies have become available to perform a detailed assessment of different aspects of LV contraction. In particular, evaluation of LV longitudinal systolic dynamics has progressively gained importance as a key aspect in the assessment of LV systolic function. For most of the techniques currently used to explore LV longitudinal function, the clinical usefulness in both research and daily practice has been validated by consistent evidence and their use is rapidly increasing. Technical considerations and potential clinical applications of the assessment of LV longitudinal systolic function are reviewed.

Echocardiographic assessments of longitudinal left ventricular function in healthy English Springer spaniels

“…Significant, but weak (r 2 <0.15) associations were found between TDI E'lat, S'lat, A'av and body weight ( [8]. The longitudinal parameters we measured were similar to data published for other breeds, suggesting that even when the LV appears rounded with apparently "low" systolic function, as measured with conventional techniques, myocardial performance is normal.…”

“…Commonly used measures of systolic function such as ejection fraction and fractional shortening address global myocardial performance but do not take into account the roles of distinct components of LV contraction or regional wall motion, which may be affected to varying degrees in different cardiac diseases [7]. In humans, reliance upon single measures of global systolic function is being complemented with the addition of more refined assessments, in particular of longitudinal function [8]. These assessments are also gaining attention in veterinary cardiology [9][10][11][12][13][14] although their clinical utility remains unclear.…”

Acute Effects of an Energy Drink on Myocardial Function Assessed by Conventional Echo-Doppler Analysis and by Speckle Tracking Echocardiography on Young Healthy Subjects

“…Left ventricle (LV) systolic function was analyzed by calculating left ventricle ejection fraction (LVEF), measured using Simpson's method, and by obtaining left ventricle longitudinal function parameters, as mitral annular systolic plane systolic excursion (MAPSE) with M-mode and mean peak systolic annular velocity with pulsed tissue-Doppler (mitral S ′) by averaging values measured at septal and lateral mitral annulus [13]. Left ventricle diastolic function was assessed by the ratio between peak early ( E ) and late diastolic ( A ′) LV filling velocities with trans-mitral pulsed Doppler and by mean E ′ and A ′ mitral velocity with pulsed tissue Doppler [14].…”

Assessment of left ventricular function by GPs using pocket-sized ultrasound

“…However, this method requires good image quality for adequate tracing of the endocardial borders. The mitral annular excursion (MAE) is an easily obtainable surrogate measure of LV systolic function 9. Several studies have shown a high correlation between the MAE and LV-EF determined by biplane area–length method 10–12.…”

“…An excursion >10 mm represents a normal LV-EF defined as EF 50%–55% 10,13. A reduction of MAE precedes that in circumferential systolic function in hypertensive cardiomyopathy and correlates with severity of valve disease in aortic stenosis 9. The MAE has been shown to be an independent prognostic variable for survival and has a negative correlation with brain natriuretic peptide (BNP) 14,15…”