Area of the pressure-strain loop during ejection as non-invasive index of left ventricular performance: a population study
Abstract Background Previous studies highlighted the usefulness of integrating left ventricular (LV) deformation (strain) and hemodynamic parameters to quantify LV performance. In a population sample, we investigated the anthropometric and clinical determinants of a novel non-invasive index of LV sy...
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doaj-6d59844e9e2040768d699d589ce25d892020-11-25T03:34:24ZengBMCCardiovascular Ultrasound1476-71202019-08-0117111110.1186/s12947-019-0166-yArea of the pressure-strain loop during ejection as non-invasive index of left ventricular performance: a population studyNicholas Cauwenberghs0Mahdi Tabassian1Lutgarde Thijs2Wen-Yi Yang3Fang-Fei Wei4Piet Claus5Jan D’hooge6Jan A. Staessen7Tatiana Kuznetsova8Research Unit Hypertension and Cardiovascular Epidemiology KU Leuven Department of Cardiovascular Sciences, University of LeuvenDivision of Cardiovascular Imaging and Dynamics, Department of Cardiovascular Sciences, University of LeuvenResearch Unit Hypertension and Cardiovascular Epidemiology KU Leuven Department of Cardiovascular Sciences, University of LeuvenResearch Unit Hypertension and Cardiovascular Epidemiology KU Leuven Department of Cardiovascular Sciences, University of LeuvenResearch Unit Hypertension and Cardiovascular Epidemiology KU Leuven Department of Cardiovascular Sciences, University of LeuvenDivision of Cardiovascular Imaging and Dynamics, Department of Cardiovascular Sciences, University of LeuvenDivision of Cardiovascular Imaging and Dynamics, Department of Cardiovascular Sciences, University of LeuvenResearch Unit Hypertension and Cardiovascular Epidemiology KU Leuven Department of Cardiovascular Sciences, University of LeuvenResearch Unit Hypertension and Cardiovascular Epidemiology KU Leuven Department of Cardiovascular Sciences, University of LeuvenAbstract Background Previous studies highlighted the usefulness of integrating left ventricular (LV) deformation (strain) and hemodynamic parameters to quantify LV performance. In a population sample, we investigated the anthropometric and clinical determinants of a novel non-invasive index of LV systolic performance derived from simultaneous registration of LV strain and brachial pressure waveforms. Methods Three hundred fifty-six randomly recruited subjects (44.7% women; mean age, 53.9 years; 47.5% hypertensive) underwent echocardiographic and arterial data acquisition. We constructed pressure-strain loops from simultaneously recorded two-dimensional LV strain curves and brachial pressure waveforms obtained by finger applanation tonometry. We defined the area of this pressure-strain loop during ejection as LV ejection work density (EWD). We reported effect sizes as EWD changes associated with a 1-SD increase in covariables. Results In multivariable-adjusted analyses, higher EWD was associated with age, female sex and presence of hypertension (P ≤ 0.0084). In both men and women, EWD increased independently with augmentation pressure (effect size: + 59.1 Pa), central pulse pressure (+ 65.7 Pa) and pulse wave velocity (+ 44.8 Pa; P ≤ 0.0006). In men, EWD decreased with relative wall thickness (− 29.9 Pa) and increased with LV ejection fraction (+ 23.9 Pa; P ≤ 0.040). In women, EWD increased with left atrial (+ 76.2 Pa) and LV end-diastolic (+ 43.8 Pa) volume indexes and with E/e’ ratio (+ 51.1 Pa; P ≤ 0.026). Conclusion Older age, female sex and hypertension were associated with higher EWD. Integration of the LV pressure-strain loop during ejection might be a useful tool to non-invasively evaluate sex-specific and interdependent effects of preload and afterload on LV myocardial performance.http://link.springer.com/article/10.1186/s12947-019-0166-yEchocardiographyHypertensionVentricular-arterial couplingLongitudinal strainEjection work density |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Nicholas Cauwenberghs Mahdi Tabassian Lutgarde Thijs Wen-Yi Yang Fang-Fei Wei Piet Claus Jan D’hooge Jan A. Staessen Tatiana Kuznetsova |
spellingShingle |
Nicholas Cauwenberghs Mahdi Tabassian Lutgarde Thijs Wen-Yi Yang Fang-Fei Wei Piet Claus Jan D’hooge Jan A. Staessen Tatiana Kuznetsova Area of the pressure-strain loop during ejection as non-invasive index of left ventricular performance: a population study Cardiovascular Ultrasound Echocardiography Hypertension Ventricular-arterial coupling Longitudinal strain Ejection work density |
author_facet |
Nicholas Cauwenberghs Mahdi Tabassian Lutgarde Thijs Wen-Yi Yang Fang-Fei Wei Piet Claus Jan D’hooge Jan A. Staessen Tatiana Kuznetsova |
author_sort |
Nicholas Cauwenberghs |
title |
Area of the pressure-strain loop during ejection as non-invasive index of left ventricular performance: a population study |
title_short |
Area of the pressure-strain loop during ejection as non-invasive index of left ventricular performance: a population study |
title_full |
Area of the pressure-strain loop during ejection as non-invasive index of left ventricular performance: a population study |
title_fullStr |
Area of the pressure-strain loop during ejection as non-invasive index of left ventricular performance: a population study |
title_full_unstemmed |
Area of the pressure-strain loop during ejection as non-invasive index of left ventricular performance: a population study |
title_sort |
area of the pressure-strain loop during ejection as non-invasive index of left ventricular performance: a population study |
publisher |
BMC |
series |
Cardiovascular Ultrasound |
issn |
1476-7120 |
publishDate |
2019-08-01 |
description |
Abstract Background Previous studies highlighted the usefulness of integrating left ventricular (LV) deformation (strain) and hemodynamic parameters to quantify LV performance. In a population sample, we investigated the anthropometric and clinical determinants of a novel non-invasive index of LV systolic performance derived from simultaneous registration of LV strain and brachial pressure waveforms. Methods Three hundred fifty-six randomly recruited subjects (44.7% women; mean age, 53.9 years; 47.5% hypertensive) underwent echocardiographic and arterial data acquisition. We constructed pressure-strain loops from simultaneously recorded two-dimensional LV strain curves and brachial pressure waveforms obtained by finger applanation tonometry. We defined the area of this pressure-strain loop during ejection as LV ejection work density (EWD). We reported effect sizes as EWD changes associated with a 1-SD increase in covariables. Results In multivariable-adjusted analyses, higher EWD was associated with age, female sex and presence of hypertension (P ≤ 0.0084). In both men and women, EWD increased independently with augmentation pressure (effect size: + 59.1 Pa), central pulse pressure (+ 65.7 Pa) and pulse wave velocity (+ 44.8 Pa; P ≤ 0.0006). In men, EWD decreased with relative wall thickness (− 29.9 Pa) and increased with LV ejection fraction (+ 23.9 Pa; P ≤ 0.040). In women, EWD increased with left atrial (+ 76.2 Pa) and LV end-diastolic (+ 43.8 Pa) volume indexes and with E/e’ ratio (+ 51.1 Pa; P ≤ 0.026). Conclusion Older age, female sex and hypertension were associated with higher EWD. Integration of the LV pressure-strain loop during ejection might be a useful tool to non-invasively evaluate sex-specific and interdependent effects of preload and afterload on LV myocardial performance. |
topic |
Echocardiography Hypertension Ventricular-arterial coupling Longitudinal strain Ejection work density |
url |
http://link.springer.com/article/10.1186/s12947-019-0166-y |
work_keys_str_mv |
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