Related Experiment Video
Updated: Jun 3, 2026
Echocardiographic Assessment of Cardiac Anatomy and Function in Adult Rats
Published on: December 13, 2019
Early left ventricular longitudinal systolic dysfunction and cardiovascular risk factors in 1,371 asymptomatic
Giovanni Di Salvo1, Vitantonio Di Bello, Alessandro Salustri
1Second University of Naples, Naples, Italy Cardiac Thoracic and Vascular Department, University of Pisa, Pisa, Italy. giodisal@yahoo.it
Insights
Tissue Doppler imaging (TDI) detects early left ventricular (LV) systolic dysfunction in asymptomatic individuals with cardiovascular risk factors. This dysfunction worsens with more risk factors, aiding early treatment identification.
Area of Science:
- Cardiology
- Echocardiography
- Cardiovascular Imaging
Background:
- Early diagnosis of left ventricular (LV) dysfunction is crucial in asymptomatic individuals with cardiovascular (CV) risk factors.
- Tissue Doppler imaging (TDI) is an emerging tool for assessing cardiac function.
Purpose of the Study:
- To assess TDI's capability in detecting early longitudinal LV dysfunction.
- To correlate TDI findings with the number of CV risk factors in subjects with preserved LV ejection fraction and normal diastolic function.
Main Methods:
- A study population of 1,371 subjects was categorized into controls and groups based on the number of CV risk factors (0, 1, 2, or ≥3).
- All participants underwent standard echocardiography and a pulsed-wave TDI (PW-TDI) assessment.
Main Results:
- Diastolic parameters differentiated the number of CV risk factors.
- LV global longitudinal systolic function (Sm) was the sole systolic parameter that significantly decreased with an increasing number of CV risk factors (P < 0.0001).
- Multivariate analysis confirmed Sm as the only functional parameter predicting an increased number of CV risk factors (P < 0.001).
Conclusions:
- TDI can identify early longitudinal LV systolic abnormalities, even with normal systolic and diastolic function.
- These abnormalities show a progressive decline with an increasing burden of CV risk factors.
- Findings support TDI's clinical utility in identifying high-risk asymptomatic individuals for tailored preventive strategies.
Background:
Nowadays early diagnosis of left ventricular (LV) dysfunction represents a major challenge in asymptomatic subjects with cardiovascular (CV) risk factors. Tissue Doppler imaging (TDI) recently emerged as an important tool with clinical relevance in several cardiac diseases.
Aim:
To evaluate the ability of TDI in detecting early longitudinal ventricular dysfunction in asymptomatic subjects, with LV ejection fraction >55%, normal diastolic function, and its relationship with CV risk factors.
Methods:
A total of 1,371 subjects (median age 60 years, 595 males) formed our study population: Controls, 265 healthy subjects; Group I, 434 subjects with one CV risk factor; Group II, 401 subjects with two CV risk factors; Group III, 271 subjects with ≥ 3 CV risk factors. All subjects underwent a comprehensive standard echo Doppler evaluation, including PW-TDI study.
Results:
Diastolic parameters such as (E\A, A-wave, Em\Am; E\Em) were able to discriminate the number of CV risk factors. The only systolic parameter that progressively reduced by increasing the number of CV risk factors was LV global longitudinal systolic function (Sm), (P < 0.0001). At multivariate analysis, the only functional parameter able to predict the increasing number of CV risk factors was Sm (P < 0.001).
Conclusions:
TDI is able to identify early longitudinal LV systolic abnormalities in presence of apparently normal systolic and diastolic function and progressively impairs with increasing CV risk factors. These findings could be clinically relevant in identifying asymptomatic subjects who need a early tailored preventive treatment.
