Novel techniques for assessment of left ventricular systolic function

Chandra, Sonal; Skali, Hicham; Blankstein, Ron

doi:10.1007/s10741-010-9219-x

Cited by 10 publications

(13 citation statements)

References 96 publications

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“…Nevertheless, we found that global longitudinal strain (GLS), a more sensitive measure of systolic function than ejection fraction 35,36 , was related to worsening dysglycemia and increasing HbA1c for both men and women. The association between HbA1c and GLS appeared to be stronger for women than men.…”

Section: Discussionmentioning

confidence: 89%

Cardiac Structure and Function Across the Glycemic Spectrum in Elderly Men and Women Free of Prevalent Heart Disease

Skali

Shah

Gupta

et al. 2015

Circ: Heart Failure

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Background Individuals with diabetes mellitus and pre-diabetes are at particularly high risk of incident heart failure or death, even after accounting for known confounders. Nevertheless, the extent of impairments in cardiac structure and function in elderly individuals with diabetes and pre-diabetes is not well known. We aimed to assess the relationship between echocardiographic measures of cardiac structure and function and dysglycemia Methods and Results We assessed measures of cardiac structure and function in 4419 participants without prevalent coronary heart disease or heart failure who attended the ARIC Visit 5 examination (2011-2013) and underwent transthoracic echocardiography (age 75±6 years; 61% female, 23% African-American). Subjects were grouped across the dysglycemia spectrum as normal (39%), pre-diabetes (31%), or diabetes (30%) based on medical history, antidiabetic medication use, and HbA1c levels. Glycemic status was related to measures of cardiac structure and function. Worsening dysglycemia was associated with increased LV mass, worse diastolic function, and subtle reduction in left ventricular systolic function (p ≤ 0.01 for all). For every 1% higher HbA1c, LV mass was higher by 3.0 grams (95% CI: 1.5-4.6 grams), E/E’ by 0.5 (95% CI: 0.4-0.7), and global longitudinal strain by 0.3% (95% CI: 0.2-0.4) in multivariable analyses. Conclusions In a large contemporary bi-racial cohort of elderly subjects without prevalent cardiovascular disease or heart failure, dysglycemia was associated with subtle and subclinical alterations of cardiac structure, and left ventricular systolic and diastolic function. It remains unclear whether these are sufficient to explain the heightened risk of heart failure in individuals with diabetes.

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Section: Discussionmentioning

confidence: 89%

Cardiac Structure and Function Across the Glycemic Spectrum in Elderly Men and Women Free of Prevalent Heart Disease

Skali

Shah

Gupta

et al. 2015

Circ: Heart Failure

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“…Diastolic and systolic volumes determine ejection fraction, which remains the cornerstone measurement of LV systolic function. 19 However, there are particular circumstances where LVEDV alone is an important diagnostic and prognostic measure. Ventricular dilation may be an early marker of disease in patients with dilated cardiomyopathy 20 or undergoing follow-up for treatment with cardiotoxic therapy.…”

Section: Discussionmentioning

confidence: 99%

Classification of left ventricular size: diameter or volume with contrast echocardiography?

2014

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BackgroundLeft ventricular (LV) size is an important clinical variable, commonly assessed at echocardiography by measurement of the internal diameter in diastole (IDD). However, this has recognised limitations and volumetric measurement from apical views is considered superior, particularly with the use of echocardiographic contrast. We sought to determine the agreement in classification of LV size by different measures in a large population of patients undergoing echocardiography.Methods and resultsData were analysed retrospectively from consecutive patients (n=2008, 61% male, median 62 years) who received echocardiographic contrast for LV opacification over 3 years in a single institution. Repeat studies were not included. LVIDD was measured, and LV end-diastolic volume (LVEDV) calculated using Simpson's biplane method. Both measures were indexed (i) to body surface area and categorised according to the American Society of Echocardiography (ASE) guidelines as normal, mild, moderate or severely dilated. Of 320 patients with a severely dilated LVEDVi, only 95 (30%) were similarly classified by LVIDD, with 86 patients (27%) measuring in the normal range. LVIDDi agreement was poorer, with only 43 patients (13%) classified as being severely dilated, and 173 (54%) measuring in the normal range.ConclusionsCurrently recommended echocardiographic measures of LV size show limited agreement when classified according to currently recommended cut-offs. LV diameter should have a limited role in the assessment of LV size, particularly where a finding of LV dilation has important diagnostic or therapeutic implications.

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“…Accurate assessment of LVEF is important due to its prognostic value and its ability to direct pharmaceutical and device therapy, particularly in patients with coronary artery disease and in those with heart failure. [1][2][3][4][5][6][7][8] Many patients with chest pain thought to be of cardiac origin undergo left heart catheterization with coronary angiography and ICLV. Witteles et al 8 reported that ICLV was performed in 81.1% of 96,235 patients undergoing coronary angiography.…”

Section: Discussionmentioning

confidence: 99%

“…Left ventricular (LV) ejection fraction (LVEF) is an ejection phase index that is commonly used in the diagnosis and management of cardiovascular disease. [1][2][3][4] In addition, it provides valuable prognostic information for many cardiac disorders. [5][6][7] Multiple diagnostic techniques have been utilized to measure LVEF including invasive contrast left ventriculography (ICLV), two-dimensional echocardiography (2DE), quantitative gated single-photon emission computed tomography (gSPECT), first pass and equilibrium radionuclide left ventriculography, cardiac magnetic resonance imaging, and computed tomographic angiography.…”

Section: Introductionmentioning

confidence: 99%

“…[5][6][7] Multiple diagnostic techniques have been utilized to measure LVEF including invasive contrast left ventriculography (ICLV), two-dimensional echocardiography (2DE), quantitative gated single-photon emission computed tomography (gSPECT), first pass and equilibrium radionuclide left ventriculography, cardiac magnetic resonance imaging, and computed tomographic angiography. 3,[8][9][10][11][12][13][14][15][16][17][18] LVEF is routinely measured in patients with established coronary artery disease and is often obtained during the…”

Section: Introductionmentioning

confidence: 99%

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Comparison of left ventricular ejection fraction values obtained using invasive contrast left ventriculography, two-dimensional echocardiography, and gated single-photon emission computed tomography

et al. 2016

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Objectives:Left ventricular ejection fraction can be measured by a variety of invasive and non-invasive cardiac techniques. This study assesses the relation of three diagnostic modalities to each other in the measurement of left ventricular ejection fraction: invasive contrast left ventriculography, two-dimensional echocardiography, and quantitative gated single-photon emission computed tomography.Methods:Retrospective chart review was conducted on 58 patients hospitalized with chest pain, who underwent left ventricular ejection fraction evaluation using each of the aforementioned modalities within a 3-month period not interrupted by myocardial infarction or revascularization.Results:The mean left ventricular ejection fraction values were as follows: invasive contrast left ventriculography (0.44±0.15), two-dimensional echocardiography (0.46±0.13), and gated single-photon emission computed tomography (0.37±0.10). Correlations coefficients and associated p values were as follows: invasive contrast left ventriculography versus two-dimensional echocardiography (r=0.69, p<0.001), invasive contrast left ventriculography versus gated single-photon emission computed tomography (r=0.80, p<0.0001), and gated single-photon emission computed tomography versus two-dimensional echocardiography (r=0.69, p<0.001).Conclusion:Our results indicate that strong positive correlations exist among the three techniques studied.

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Novel techniques for assessment of left ventricular systolic function

Cited by 10 publications

References 96 publications

Cardiac Structure and Function Across the Glycemic Spectrum in Elderly Men and Women Free of Prevalent Heart Disease

Cardiac Structure and Function Across the Glycemic Spectrum in Elderly Men and Women Free of Prevalent Heart Disease

Classification of left ventricular size: diameter or volume with contrast echocardiography?

Comparison of left ventricular ejection fraction values obtained using invasive contrast left ventriculography, two-dimensional echocardiography, and gated single-photon emission computed tomography

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