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...

Full description

Bibliographic Details
Main Authors: Nicholas Cauwenberghs, Mahdi Tabassian, Lutgarde Thijs, Wen-Yi Yang, Fang-Fei Wei, Piet Claus, Jan D’hooge, Jan A. Staessen, Tatiana Kuznetsova
Format: Article
Language:English
Published: BMC 2019-08-01
Series:Cardiovascular Ultrasound
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12947-019-0166-y
id doaj-6d59844e9e2040768d699d589ce25d89
record_format Article
spelling 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 AT nicholascauwenberghs areaofthepressurestrainloopduringejectionasnoninvasiveindexofleftventricularperformanceapopulationstudy
AT mahditabassian areaofthepressurestrainloopduringejectionasnoninvasiveindexofleftventricularperformanceapopulationstudy
AT lutgardethijs areaofthepressurestrainloopduringejectionasnoninvasiveindexofleftventricularperformanceapopulationstudy
AT wenyiyang areaofthepressurestrainloopduringejectionasnoninvasiveindexofleftventricularperformanceapopulationstudy
AT fangfeiwei areaofthepressurestrainloopduringejectionasnoninvasiveindexofleftventricularperformanceapopulationstudy
AT pietclaus areaofthepressurestrainloopduringejectionasnoninvasiveindexofleftventricularperformanceapopulationstudy
AT jandhooge areaofthepressurestrainloopduringejectionasnoninvasiveindexofleftventricularperformanceapopulationstudy
AT janastaessen areaofthepressurestrainloopduringejectionasnoninvasiveindexofleftventricularperformanceapopulationstudy
AT tatianakuznetsova areaofthepressurestrainloopduringejectionasnoninvasiveindexofleftventricularperformanceapopulationstudy
_version_ 1724558980736352256