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Clinical and histopathologic correlation in patients with dilated cardiomyopathy. Value of force-velocity product
H Kurozumi1, Y Yokota, H Fukuzaki
1First Department of Internal Medicine, Kobe University School of Medicine, Japan.
Insights
A new noninvasive cardiac measure, Force-Velocity Product (FVP), accurately reflects myocardial damage and prognosis in dilated cardiomyopathy (DCM) patients, outperforming other echocardiographic and histopathologic metrics.
Area of Science:
- Cardiology
- Biomedical Engineering
Background:
- Dilated cardiomyopathy (DCM) is characterized by impaired cardiac function and myocardial damage.
- Assessing myocardial damage and prognosis in DCM noninvasively remains challenging.
Purpose of the Study:
- To evaluate the relationship between cardiac function and myocardial damage in DCM patients.
- To introduce and validate a novel noninvasive parameter, the Force-Velocity Product (FVP), for assessing myocardial health in DCM.
Main Methods:
- Compared echocardiographic parameters with histopathologic findings in 50 DCM patients.
- Defined and calculated the Force-Velocity Product (FVP) using mean circumferential fiber shortening velocity and noninvasive end-systolic wall stress.
- Assessed the prognostic value of FVP against other echocardiographic and histopathologic parameters.
Main Results:
- FVP demonstrated a significant correlation with percent myocardial fibrosis, a measure of damage not captured by other echocardiographic methods.
- FVP showed the highest prognostic value among all evaluated parameters.
- The novel FVP parameter effectively quantifies myocardial damage and predicts outcomes in DCM.
Conclusions:
- The Force-Velocity Product (FVP) is a highly effective clinical parameter for assessing myocardial damage in DCM.
- FVP offers a significant advantage due to its noninvasive nature.
- This new parameter enhances the noninvasive evaluation of cardiac function and prognosis in DCM patients.
Abstract:
To evaluate the relation between cardiac function and myocardial damage in patients with dilated cardiomyopathy (DCM), we compared echocardiographic parameters and histopathologic findings of the biopsied myocardium in 50 cases with DCM. As wall motion is much influenced by the increased afterload in cases with large ventricles, we generated a new contractile parameter, Force-Velocity Product (FVP). FVP was defined as the result obtained by multiplying mean circumferential fiber shortening velocity by noninvasive end-systolic wall stress. FVP correlated with percent fibrosis in the myocardium, which was reflected by no other echocardiographic parameter. We also evaluated the prognostic values of the echocardiographic and histopathologic parameters. FVP had the highest value among them. We conclude that FVP is a very useful clinical parameter, with the further advantage of being obtained noninvasively.