Longitudinal and Circumferential Strain Rate, Left Ventricular Remodeling, and Prognosis After Myocardial Infarction

Hung, Chung‐Lieh; Verma, Anil; Uno, Hajime; Shin, Sung‐Hee; Bourgoun, Mikhail; Hassanein, Amira; McMurray, John J.V.; Velázquez, Eric J.; Køber, Lars; Pfeffer, Marc A.; Solomon, Scott D.; Investigators, Valiant

doi:10.1016/j.jacc.2010.06.044

Cited by 277 publications

(216 citation statements)

References 41 publications

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“…Thus, echocardiographic longitudinal strain is considered the most sensitive measure of endocardial as well as subendocardial function, which is the myocardial layer of the ventricle considered most susceptible to stressors such as ischemia, mechanical stretch, and afterload resistance. Although previous studies have also demonstrated abnormalities in circumferential and radial strain in the setting of overt and severe ischemic heart disease,4, 38 longitudinal strain may represent a particularly sensitive marker of the cardiac dysfunction that occurs from early and chronic exposure to risk factors that specifically predispose to the future development of CHD. Indeed, we observed no significant relation of strain measured in other planes with incident CHD in our large ambulatory cohort, comprising individuals who were generally healthy without any prevalent CVD at baseline.…”

Section: Discussionmentioning

confidence: 94%

“…Given the need for more‐sensitive measures of LV performance, advances in image analysis have led to noninvasive methods for assessing cardiac mechanical function in multiple planes 2, 3. Numerous studies have now demonstrated that speckle tracking analyses of LV strain (ie, myocardial tissue deformation) applied to routine echocardiography offer significant incremental prognostic information over EF in patients with known cardiovascular disease (CVD) 4, 5, 6, 7, 8, 9. However, there are few studies of LV strain and outcomes in community‐dwelling individuals free of overt CVD 10, 11.…”

Section: Introductionmentioning

confidence: 99%

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Distinct Aspects of Left Ventricular Mechanical Function Are Differentially Associated With Cardiovascular Outcomes and All‐Cause Mortality in the Community

Cheng

McCabe

Larson

et al. 2015

JAHA

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BackgroundThere are few data relating novel measures of left ventricular (LV) mechanical function to cardiovascular disease (CVD) outcomes in the community. Whether distinct components of LV mechanical function provide information regarding risk for different CVD outcomes is unclear.Methods and ResultsWe used speckle tracking echocardiography to quantify distinct components of LV mechanical function (measured as LV strain in multiple planes) in 2831 Framingham Offspring Study participants (mean age, 66 years; 57% women, 97% with LV fractional shortening >0.29). Participants were followed for 6.0±1.2 years for onset of 69 coronary heart disease (CHD), 71 heart failure (HF), and 199 mortality events. Adjusting for CVD risk factors, longitudinal LV strain appeared associated with incident CHD (hazards ratio [HR] per SD increment, 1.29; 95% confidence interval [CI], 1.00–1.67; P=0.05), whereas circumferential and radial strain were not (P>0.37 for both); however, the association of longitudinal strain with CHD was nonsignificant after Bonferroni correction. By contrast, circumferential strain was a significant predictor of incident HF (HR per SD increment, 1.79; 95% CI, 1.35–2.37; P<0.0001). Decrements in circumferential, radial, and longitudinal strain measures were related to all‐cause mortality (P<0.008 for all). Results remained similar in multivariable models adjusting additionally for the conventional echocardiographic measures of LV mass and fractional shortening.ConclusionsIn our large, community‐based sample, distinct components of LV mechanical function were associated with specific CVD outcomes. Additional studies are needed to replicate these findings and investigate the prognostic and therapeutic utility of these novel measures of LV mechanical function.

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Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Distinct Aspects of Left Ventricular Mechanical Function Are Differentially Associated With Cardiovascular Outcomes and All‐Cause Mortality in the Community

Cheng

McCabe

Larson

et al. 2015

JAHA

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“…Clinical and animal studies have shown that increased wall stress induces changes in proteins, contractile element synthesis and gene expression that support the remodeling process 3,4,5 . Increased wall stress has also been shown to be an independent predictor of subsequent LV remodeling 6,7 .…”

Section: Introductionmentioning

confidence: 99%

Reduction in Left Ventricular Wall Stress and Improvement in Function in Failing Hearts using Algisyl-LVR

Lee¹,

Zhang

Hinson³

et al. 2013

JoVE

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Injection of Algisyl-LVR, a treatment under clinical development, is intended to treat patients with dilated cardiomyopathy. This treatment was recently used for the first time in patients who had symptomatic heart failure. In all patients, cardiac function of the left ventricle (LV) improved significantly, as manifested by consistent reduction of the LV volume and wall stress. Here we describe this novel treatment procedure and the methods used to quantify its effects on LV wall stress and function.Algisyl-LVR is a biopolymer gel consisting of Na + -Alginate and Ca 2+ -Alginate. The treatment procedure was carried out by mixing these two components and then combining them into one syringe for intramyocardial injections. This mixture was injected at 10 to 19 locations mid-way between the base and apex of the LV free wall in patients.Magnetic resonance imaging (MRI), together with mathematical modeling, was used to quantify the effects of this treatment in patients before treatment and at various time points during recovery. The epicardial and endocardial surfaces were first digitized from the MR images to reconstruct the LV geometry at end-systole and at end-diastole. Left ventricular cavity volumes were then measured from these reconstructed surfaces.Mathematical models of the LV were created from these MRI-reconstructed surfaces to calculate regional myofiber stress. Each LV model was constructed so that 1) it deforms according to a previously validated stress-strain relationship of the myocardium, and 2) the predicted LV cavity volume from these models matches the corresponding MRI-measured volume at end-diastole and end-systole. Diastolic filling was simulated by loading the LV endocardial surface with a prescribed end-diastolic pressure. Systolic contraction was simulated by concurrently loading the endocardial surface with a prescribed end-systolic pressure and adding active contraction in the myofiber direction. Regional myofiber stress at end-diastole and end-systole was computed from the deformed LV based on the stress-strain relationship.

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“…Understanding ethnic differences and similarities is important for understanding cardiovascular disease experiences among Indigenous populations. Longitudinal strain is a correlate of LV contractility and indicates regional myocardial dysfunction and longitudinal and circumferential strains are prognostic of cardiovascular events and survival [43–45]. Further, elastance and arterial–ventricular coupling provide insight into the interaction between the arterial system and the LV, evaluating stroke work and energetic efficiency and providing indications of atherosclerotic heart disease [46].…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular dynamics of Canadian Indigenous peoples

Foulds

Bredin

2018

International Journal of Circumpolar Health

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Limited understanding of Indigenous adults’ cardiovascular structure and function exists despite high rates of cardiovascular disease. This investigation characterised cardiovascular structure and function among young Indigenous adults and compared to age- and sex-matched European descendants. Echocardiographic assessments included apical two- and four-chamber images, parasternal short-axis images and Doppler. Analyses included cardiac volumes, dimensions, velocities and strains. Cardiovascular structure and function were similar between Indigenous (n=10, 25 ± 3 years, 4 women) and European-descendant (n=10, 24 ± 4 years, 4 women,) adults, though European descendants demonstrated greater systemic vascular resistance (18.19 ± 3.94 mmHg∙min−1∙L−1 vs. 15.36 ± 2.97 mmHg∙min−1∙L−1, p=0.03). Among Indigenous adults, women demonstrated greater arterial elastance (0.80 ± 0.15 mmHg·mL−1·m−2 vs. 0.55 ± 0.17 mmHg·mL−1·m−2, p=0.02) and possibly greater systemic vascular resistance (17.51 ± 2.20 mmHg∙min−1∙L−1 vs. 13.93 ± 2.61 mmHg∙min−1∙L−1, p=0.07). Indigenous men had greater cardiac size, dimensions and output, though body size differences accounted for cardiac size differences. Similar cardiac rotation and strains were observed across sexes. Arterial elastance and cardiac size were different between Indigenous men and women while cardiovascular structure and function may be similar between Indigenous and European descendants.

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Longitudinal and Circumferential Strain Rate, Left Ventricular Remodeling, and Prognosis After Myocardial Infarction

Abstract: Both longitudinal and circumferential SRs were independent predictors of outcomes after MI, whereas only circumferential SRs was predictive of remodeling, suggesting that preserved circumferential function might serve to restrain ventricular enlargement after MI.

Cited by 277 publications

References 41 publications

Distinct Aspects of Left Ventricular Mechanical Function Are Differentially Associated With Cardiovascular Outcomes and All‐Cause Mortality in the Community

Distinct Aspects of Left Ventricular Mechanical Function Are Differentially Associated With Cardiovascular Outcomes and All‐Cause Mortality in the Community

Reduction in Left Ventricular Wall Stress and Improvement in Function in Failing Hearts using Algisyl-LVR

Cardiovascular dynamics of Canadian Indigenous peoples

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