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Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
09:05

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The relative impact of circumferential and longitudinal shortening on left ventricular ejection fraction and stroke

David H Maciver1

  • 1Department of Cardiology, Taunton & Somerset Hospital, Musgrove Park, Taunton, United Kingdom.

Experimental and Clinical Cardiology
|December 4, 2012
PubMed

Insights

Circumferential myocardial shortening contributes more to left ventricular stroke volume (two-thirds) than longitudinal shortening (one-third). This finding impacts assessing cardiac function and left ventricular hypertrophy.

Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Computational Biology

Background:

  • In vivo studies offer inconclusive data on the impact of myocardial shortening on stroke volume.
  • Understanding the distinct roles of longitudinal and circumferential shortening is crucial for accurate left ventricular function assessment.

Purpose of the Study:

  • To quantify the relative contributions of longitudinal and circumferential myocardial shortening to stroke volume and ejection fraction.
  • To evaluate the influence of left ventricular hypertrophy on these contributions.

Main Methods:

  • Utilized a two-shell, three-dimensional mathematical model to simulate myocardial shortening.
  • Assessed the impact of isolated reductions in longitudinal and circumferential strain on cardiac output parameters.

Main Results:

  • Reducing circumferential strain by 15% decreased stroke volume by 43%, while a similar reduction in longitudinal strain decreased it by 19%.
  • Circumferential shortening accounted for 67% of stroke volume contribution, versus 33% for longitudinal shortening.
  • These proportions remained consistent regardless of left ventricular wall thickness.

Conclusions:

  • Circumferential myocardial shortening plays a more significant role in determining stroke volume and ejection fraction than longitudinal shortening.
  • Findings challenge previous assumptions and have implications for clinical assessment of left ventricular function, particularly in conditions involving hypertrophy.

Keywords:
Ejection fractionMathematical modellingMyocardial mechanicsMyocardial strainStroke volume

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