Related Experiment Video
Updated: Feb 22, 2026
Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
Correlation between myocardial deformation on three-dimensional speckle tracking echocardiography and cardiopulmonary
1Ultrasound Department, Beijing Haidian Hospital, Peking University Third Hospital Haidian District, Haidian District, Beijing, China.
Insights
Diastolic function, specifically left ventricular untwisting, significantly predicts exercise capacity in heart failure patients. This measure is a better indicator of aerobic capacity than ejection fraction.
Area of Science:
- Cardiology
- Exercise Physiology
Background:
- Heart failure (HF) involves complex systolic and diastolic dysfunction.
- The precise mechanisms linking cardiac function to exercise capacity in HF remain unclear.
Purpose of the Study:
- To investigate the relationship between cardiac function parameters and exercise tolerance in patients with heart failure.
- To identify key determinants of exercise capacity in HF patients.
Main Methods:
- 156 patients with varying cardiac function levels were studied.
- Data collected included 2D and 3D speckle tracking echocardiography and cardiopulmonary exercise testing (CPET).
Main Results:
- Left ventricular untwisting (25%Untwist) and global longitudinal strain (GLS) strongly correlated with peak oxygen uptake (peakVO2).
- Left ventricular ejection fraction (EF) showed a weak correlation with peakVO2.
- Early diastolic function (E/e) and left atrial volume index (LA index) correlated with the carbon dioxide equivalent slope (VE/VCO2).
- A predictive model for peakVO2 included 25%Untwist, GLS, and E/e, with 25%Untwist being a significant independent predictor.
Conclusions:
- Early diastolic function is a key independent predictor of aerobic exercise capacity in heart failure.
- The 25%Untwist measure effectively indicates cardiac diastolic function and exercise capacity.
Purpose:
Heart failure (HF) is a multifactorial entity that combines derangements in both systolic and diastolic function. The relationship between systolic and diastolic function and exercise capacity is not fully understood. We sought to determine the mechanisms linking cardiac function and exercise tolerance in patients with HF.
Methods:
One hundred fifty-six subjects with different cardiac function levels were included in the study. Subjects' 2D echocardiographic, 3D speckle tracking echocardiographic, and cardiopulmonary exercise testing (CPET) data were collected.
Result:
The amount of untwisting at 25% of the untwist duration (25%Untwist) and global longitudinal peak systolic strain (GLS) showed the best positive correlations with peak oxygen uptake (peakVO2 ) (r = .41; P < .001 and r = .32; P < .001, respectively), while the left ventricular ejection fraction (EF) was weakly correlated with peakVO2 . The 25%Untwist value was negatively correlated with the carbon dioxide equivalent slope (VE/VCO2 ) (r = -.49; P < .001). Both E/e and the left atrium volume index (LA index) exhibited good positive correlations with VE/VCO2 (r = .39; P < .01 and r = .32; P < .001). In the multiple regression analysis, the best predictive model for the peakVO2 included the 25%Untwist, GLS, and E/e, explained 64% of the variation in peakVO2 , with 25%Untwist explaining 17.6% of the variation. Including EF in the model explained only 3.1% of the variation in peakVO2 . In a multivariable model for VE/VCO2 , 25%Untwist was the strongest independent predictor, explaining 23% of the variance in VE/VCO2 .
Conclusion:
Left ventricular early diastolic function is a modest independent predictor of aerobic exercise capacity. The 25%Untwist value is a good indicator of cardiac diastolic function.
More Related Videos
11:50High-frequency High-resolution Echocardiography: First Evidence on Non-invasive Repeated Measure of Myocardial Strain, Contractility, and Mitral Regurgitation in the Ischemia-reperfused Murine Heart
Published on: July 9, 2010
06:34Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
Published on: October 28, 2020
Related Concept Videos
01:25Correlation between ECG and Cardiac Cycle
A cardiac action potential originates in the SA node and spreads throughout the atria and the AV node in approximately 0.03 seconds. This results in the P wave in an ECG and triggers atrial contraction. The action potential is then briefly slowed at the AV node, allowing the atria to contract and fill the ventricles with blood before...
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:17Imaging Studies for Cardiovascular System I:Echocardiography
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion,...