Related Experiment Video
Updated: Jan 2, 2026
06:34
Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
Published on: October 28, 2020
4.5K
Risk stratifying asymptomatic left ventricular systolic dysfunction in the community: beyond left ventricular
Simone Burocchi1,2, Mauro Gori1, Giovanni Cioffi3
1CardioVascular Department, ASST Papa Giovanni XXIII Hospital, Piazza OMS, 1, Bergamo, Italy.
European Heart Journal. Cardiovascular Imaging
|December 7, 2019
Summary
Midwall fractional shortening (MWFS) is a reliable echocardiographic measure for predicting heart failure (HF) and death in high-risk patients. Lower MWFS independently identifies individuals at increased risk, improving risk stratification beyond other parameters.
Area of Science:
- Cardiology
- Echocardiography
- Preventive Medicine
Background:
- Left ventricular (LV) systolic function is crucial for heart health.
- Left ventricular ejection fraction (LVEF) can be less reliable with specific LV geometries.
- Midwall fractional shortening (MWFS) offers a potentially more robust measure of LV systolic function.
Purpose of the Study:
- To investigate the predictive value of MWFS for heart failure (HF) and death in asymptomatic, high-risk individuals.
- To determine if MWFS improves risk stratification beyond established clinical and echocardiographic parameters.
Main Methods:
- Prospective enrollment of 623 asymptomatic outpatients (aged 55-80) at increased HF risk.
- Baseline assessments included clinical data, ECG, NT-proBNP, and echocardiography (measuring LVEF and MWFS).
- Cox analysis was used to assess the association between MWFS and HF/death events over a median follow-up of 5.7 years.
Main Results:
- Lower MWFS was the sole echocardiographic parameter significantly associated with increased risk of HF/death (HR 0.89, P<0.001).
- Inclusion of MWFS in risk models significantly improved reclassification of HF/death risk compared to baseline models and conventional echocardiography.
- Subjects with combined LVEF and MWFS systolic dysfunction showed the highest risk (P=0.001).
Conclusions:
- MWFS is a simple, reliable echocardiographic parameter for risk stratification in high-risk HF populations.
- Routine assessment of MWFS in clinical practice is suggested to enhance prediction of HF and death.
- MWFS provides incremental prognostic information beyond LVEF and other echocardiographic measures.
Related Concept Videos
01:30Heart Failure IV: Classification and Diagnostic Evaluation
261
Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
261
01:29Cardiomyopathy III: Hypertrophic Cardiomyopathy
325
Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
325
01:23Mitral Stenosis II: Clinical features and Diagnostic Tests
175
Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
175
01:17Pathophysiology of Heart Failure
2.6K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
2.6K
01:20Mitral Regurgitation I: Introduction
322
Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
322
01:22Aortic Regurgitation II: Clinical Features and Diagnostic Tests
337
Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
337