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Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
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Two-dimensional speckle tracking to image ventricular-arterial coupling in uremia
Fu-Yong Ye1, Yin-Ting Liang1, Xiao-Chun Lin1
1Department of Ultrasound, The People's Hospital of Gaozhou City, Gaozhou, Guangdong, China.
Echocardiography (Mount Kisco, N.Y.)
|November 10, 2018
Summary
In uremic patients, ventricular-arterial coupling (VAC) worsens as left ventricular (LV) systolic function declines. LV myocardial longitudinal strain (LS), especially at the apex (LSAP), is a key predictor of VAC in these patients.
Area of Science:
- Cardiovascular Physiology
- Nephrology
- Medical Imaging
Background:
- Uremia significantly impacts cardiovascular health, affecting the intricate relationship between the left ventricle and the arterial system.
- Ventricular-arterial coupling (VAC) is crucial for cardiovascular efficiency, and its assessment in uremic patients is vital for understanding disease progression.
Purpose of the Study:
- To investigate ventricular-arterial coupling (VAC) in patients with uremia using two-dimensional speckle tracing imaging (2DSTI).
- To correlate left ventricular (LV) myocardial strain parameters with VAC and identify independent predictors of VAC in uremia.
Main Methods:
- One hundred uremic patients were stratified by left ventricular ejection fraction (LVEF) into two groups (LVEF ≥ 55% and LVEF < 55%).
- Forty healthy subjects served as controls. Conventional echocardiography and 2DSTI were employed to assess VAC components and myocardial performance.
- Longitudinal strain (LS) was measured in 17 LV segments, with mean base (LSBA), papillary muscle (LSPM), and apex (LSAP) values calculated.
Main Results:
- Patients with lower LVEF (group 2) showed reduced LV volumes, LV mass index, and VAC compared to controls and group 1 (P < 0.05).
- End-systolic elastance (Ees), EF, and FS were significantly higher in group 2 (P < 0.05).
- LSBA, LSPM, and LSAP correlated positively with Ees, EF, and FS, but negatively with arterial elastance (Ea), VAC, SVRI, and RPP (all P < 0.05). Relative wall thickness, LVMI, LSAP, and stroke works were independent predictors of VAC.
Conclusions:
- In uremic patients, LV myocardial longitudinal strain (LS) decreases progressively with worsening LV systolic dysfunction.
- VAC demonstrates a negative correlation with LV myocardial LS, highlighting the compromised ventricular-arterial interaction.
- Apical longitudinal strain (LSAP) emerges as an independent predictor of VAC in the uremic population.
Keywords:
arterial elastanceend-systolic elastanceleft ventricular functionspeckle tracking imaginguremiaventricular-arterial couplingMore Related Videos
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