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Early Assessment of Left Ventricular Function by Layer-Specific Strain and Its Relationship to Pulsatile Arterial

Jing Shi1, Yumeng Xing1, Juying Qian2

  • 1Department of Echocardiography, Zhongshan Hospital of Fudan University, Shanghai Institute of Medical Imaging, Shanghai Institute of Cardiovascular Diseases.

International Heart Journal
|April 26, 2019
PubMed

Insights

Patients with coronary slow flow (CSF) exhibit impaired left ventricular (LV) systolic function, particularly in the endocardium and mid-myocardium layers. Increased arterial load, indicated by lower arterial compliance, is linked to this reduced LV contractility in CSF patients.

Area of Science:

  • Cardiology
  • Cardiovascular Physiology
  • Medical Imaging

Background:

  • Controversy exists regarding left ventricular (LV) function impairment in patients with coronary slow flow (CSF).
  • Increased arterial load may negatively impact coronary anatomy and LV function.
  • Layer-specific strain analysis offers a novel approach to assess LV contractility.

Purpose of the Study:

  • To investigate LV systolic function using layer-specific strain technology in patients with CSF.
  • To assess the association between pulsatile arterial load and LV contractility in CSF.
  • To explore the relationship between layer-specific strain and coronary microvascular function markers.

Main Methods:

  • Utilized two-dimensional speckle tracking imaging (2D-STI) to assess layer-specific global longitudinal strain (GLS) (endocardium, mid-myocardium, epicardium).
  • Measured indexed arterial compliance (ACI) to estimate pulsatile arterial load.
  • Included 70 patients with CSF and 50 controls; correlated strain parameters with coronary artery disease severity (number of affected arteries, thrombolysis in myocardial infarction frame count).

Main Results:

  • Layer-specific GLS was significantly reduced in the endocardium and mid-myocardium of CSF patients compared to controls.
  • Layer-specific longitudinal strain correlated with the number of affected coronary arteries and thrombolysis in myocardial infarction frame count.
  • Patients with CSF had lower indexed arterial compliance (ACI), which negatively correlated with layer-specific GLS.

Conclusions:

  • Layer-specific LV evaluation reveals impaired longitudinal function in CSF patients, particularly in inner myocardial layers.
  • Increased pulsatile arterial load, indicated by lower ACI, is associated with worse LV longitudinal function in CSF.
  • This study highlights the utility of layer-specific strain analysis in understanding LV pathophysiology in coronary slow flow.

Keywords:
Arterial complianceMyocardial ischemiaSpeckle-trackingTwo-dimensional

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