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Published in: Cardiovascular Ultrasound 1/2013

Open Access 01-12-2013 | Research

Speckle tracking echocardiography-determined measures of global and regional left ventricular function correlate with functional capacity in patients with and without preserved ejection fraction

Authors: John W Petersen, Talha F Nazir, Licheng Lee, Cynthia S Garvan, Ashkan Karimi

Published in: Cardiovascular Ultrasound | Issue 1/2013

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Abstract

Background

Standard measures of left ventricular systolic and diastolic function often fail to identify left ventricular dysfunction in patients with heart failure and do not correlate with measures of functional capacity.

Aim

To determine if speckle tracking echocardiography (STE)–determined measures of global and regional myocardial contractility have a linear association with functional capacity in patients with and without preserved ejection fraction.

Methods

In 68 adult patients, functional status was estimated with the Duke Activity Status Index (DASI), left ventricular ejection fraction was determined with Simpson’s biplane method, and QLAB advanced quantification software (Philips, The Netherlands) was used to determine peak measures of strain.

Results

Global and regional measures of longitudinal, circumferential, and radial strain had a strong linear association with the DASI score. Longitudinal strain in the inferolateral segments had the strongest correlation with DASI (r = −0.72, P < 0.001). In patients with an ejection fraction ≥45%, ejection fraction and E/e’ had no correlation with DASI, whereas longitudinal strain in the inferolateral segments had significant correlation with DASI (r = −0.53, P = 0.03, n = 16).

Conclusions

STE–determined measures of global and regional left ventricular function have a strong linear association with estimates of functional capacity in patients with and without preserved ejection fraction. STE–determined measures of strain, especially longitudinal strain, are likely to be important targets for therapy and should be considered in future studies aimed at improving our diagnosis of left ventricular inadequacy in patients with heart failure, especially those with preserved ejection fraction.
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Literature
1.
go back to reference Solomon SD, Anavekar N, Skali H, McMurray JJ, Swedberg K, Yusuf S, Granger CB, Michelson EL, Wang D, Pocock S, et al.: Influence of ejection fraction on cardiovascular outcomes in a broad spectrum of heart failure patients. Circulation. 2005, 112 (24): 3738-3744. 10.1161/CIRCULATIONAHA.105.561423.CrossRefPubMed Solomon SD, Anavekar N, Skali H, McMurray JJ, Swedberg K, Yusuf S, Granger CB, Michelson EL, Wang D, Pocock S, et al.: Influence of ejection fraction on cardiovascular outcomes in a broad spectrum of heart failure patients. Circulation. 2005, 112 (24): 3738-3744. 10.1161/CIRCULATIONAHA.105.561423.CrossRefPubMed
2.
go back to reference Bhatia RS, Tu JV, Lee DS, Austin PC, Fang J, Haouzi A, Gong Y, Liu PP: Outcome of heart failure with preserved ejection fraction in a population-based study. New Engl J Med. 2006, 355: 260-269. 10.1056/NEJMoa051530.CrossRefPubMed Bhatia RS, Tu JV, Lee DS, Austin PC, Fang J, Haouzi A, Gong Y, Liu PP: Outcome of heart failure with preserved ejection fraction in a population-based study. New Engl J Med. 2006, 355: 260-269. 10.1056/NEJMoa051530.CrossRefPubMed
3.
go back to reference Franciosa JA, Park M, Levine TB: Lack of correlation between exercise capacity and indexes of resting left ventricular performance in heart failure. Am J Cardiol. 1981, 47 (1): 33-39. 10.1016/0002-9149(81)90286-1.CrossRefPubMed Franciosa JA, Park M, Levine TB: Lack of correlation between exercise capacity and indexes of resting left ventricular performance in heart failure. Am J Cardiol. 1981, 47 (1): 33-39. 10.1016/0002-9149(81)90286-1.CrossRefPubMed
4.
go back to reference Carell ES, Murali S, Schulman DS, Estrada-Quintero T, Uretsky BF: Maximal exercise tolerance in chronic congestive heart failure. Relationship to resting left ventricular function. Chest. 1994, 106 (6): 1746-1752. 10.1378/chest.106.6.1746.CrossRefPubMed Carell ES, Murali S, Schulman DS, Estrada-Quintero T, Uretsky BF: Maximal exercise tolerance in chronic congestive heart failure. Relationship to resting left ventricular function. Chest. 1994, 106 (6): 1746-1752. 10.1378/chest.106.6.1746.CrossRefPubMed
5.
go back to reference Persson H, Lonn E, Edner M, Baruch L, Lang CC, Morton JJ, Ostergren J, McKelvie RS: Diastolic dysfunction in heart failure with preserved systolic function: need for objective evidence:results from the CHARM Echocardiographic Substudy-CHARMES. J Am Coll Cardiol. 2007, 49 (6): 687-694. 10.1016/j.jacc.2006.08.062.CrossRefPubMed Persson H, Lonn E, Edner M, Baruch L, Lang CC, Morton JJ, Ostergren J, McKelvie RS: Diastolic dysfunction in heart failure with preserved systolic function: need for objective evidence:results from the CHARM Echocardiographic Substudy-CHARMES. J Am Coll Cardiol. 2007, 49 (6): 687-694. 10.1016/j.jacc.2006.08.062.CrossRefPubMed
6.
go back to reference Geyer H, Caracciolo G, Abe H, Wilansky S, Carerj S, Gentile F, Nesser H-J, Khandheria B, Narula J, Sengupta PP: Assessment of myocardial mechanics using speckle tracking echocardiography: fundamentals and clinical applications. J Am Soc Echocardiogr. 2010, 2010 (23): 351-369.CrossRef Geyer H, Caracciolo G, Abe H, Wilansky S, Carerj S, Gentile F, Nesser H-J, Khandheria B, Narula J, Sengupta PP: Assessment of myocardial mechanics using speckle tracking echocardiography: fundamentals and clinical applications. J Am Soc Echocardiogr. 2010, 2010 (23): 351-369.CrossRef
7.
go back to reference Petersen JW, Forder JR, Thomas JD, Moyé LA, Lawson M, Loghin C, Traverse JH, Baraniuk S, Silva G, Pepine CJ, et al.: Quantification of myocardial segmental function in acute and chronic ischemic heart disease and implications for cardiovascular cell therapy trials: a review from the NHLBI-Cardiovascular Cell Therapy Research Network. JACC Cardiovasc Imaging. 2011, 4 (6): 671-679. 10.1016/j.jcmg.2011.02.015.CrossRefPubMedPubMedCentral Petersen JW, Forder JR, Thomas JD, Moyé LA, Lawson M, Loghin C, Traverse JH, Baraniuk S, Silva G, Pepine CJ, et al.: Quantification of myocardial segmental function in acute and chronic ischemic heart disease and implications for cardiovascular cell therapy trials: a review from the NHLBI-Cardiovascular Cell Therapy Research Network. JACC Cardiovasc Imaging. 2011, 4 (6): 671-679. 10.1016/j.jcmg.2011.02.015.CrossRefPubMedPubMedCentral
8.
go back to reference Tan YT, Wenzelburger F, Lee E, Heatlie G, Leyva F, Patel K, Frenneaux M, Sanderson JE: The pathophysiology of heart failure with normal ejection fraction. J Am Coll Cardiol. 2009, 54: 36-46. 10.1016/j.jacc.2009.03.037.CrossRefPubMed Tan YT, Wenzelburger F, Lee E, Heatlie G, Leyva F, Patel K, Frenneaux M, Sanderson JE: The pathophysiology of heart failure with normal ejection fraction. J Am Coll Cardiol. 2009, 54: 36-46. 10.1016/j.jacc.2009.03.037.CrossRefPubMed
9.
go back to reference Hlatky MA, Boineau RE, Higginbotham MB, Lee KL, Mark DB, Califf RM, Cobb FR, Pryor DB: A brief self-administered questionnaire to determine functional capacity (the Duke Activity Status Index). Am J Cardiol. 1989, 64 (10): 651-654. 10.1016/0002-9149(89)90496-7.CrossRefPubMed Hlatky MA, Boineau RE, Higginbotham MB, Lee KL, Mark DB, Califf RM, Cobb FR, Pryor DB: A brief self-administered questionnaire to determine functional capacity (the Duke Activity Status Index). Am J Cardiol. 1989, 64 (10): 651-654. 10.1016/0002-9149(89)90496-7.CrossRefPubMed
10.
go back to reference Nagueh SF, Appleton CP, Gillebert TC, Marino PN, Oh JK, Smiseth OA, Waggoner AD, Flachskampf FA, Pellikka PA, Evangelista A: Recommendations for the evaluation of left ventricular diastolic function by echocardiography. J Am Soc Echocardiogr. 2009, 22 (2): 107-133. 10.1016/j.echo.2008.11.023.CrossRefPubMed Nagueh SF, Appleton CP, Gillebert TC, Marino PN, Oh JK, Smiseth OA, Waggoner AD, Flachskampf FA, Pellikka PA, Evangelista A: Recommendations for the evaluation of left ventricular diastolic function by echocardiography. J Am Soc Echocardiogr. 2009, 22 (2): 107-133. 10.1016/j.echo.2008.11.023.CrossRefPubMed
11.
go back to reference van Dalen BM, Vletter WB, Soliman OI, ten Cate FJ, Geleijnse ML: Importance of transducer position in the assessment of apical rotation by speckle tracking echocardiography. J Am Soc Echocardiogr. 2008, 21 (8): 895-898. 10.1016/j.echo.2008.02.001.CrossRefPubMed van Dalen BM, Vletter WB, Soliman OI, ten Cate FJ, Geleijnse ML: Importance of transducer position in the assessment of apical rotation by speckle tracking echocardiography. J Am Soc Echocardiogr. 2008, 21 (8): 895-898. 10.1016/j.echo.2008.02.001.CrossRefPubMed
12.
go back to reference Meng X-I, Rosenthal R, Rubin DB: Comparing correlated correlation coefficients. Psychol Bull. 1992, 111 (1): 172-175.CrossRef Meng X-I, Rosenthal R, Rubin DB: Comparing correlated correlation coefficients. Psychol Bull. 1992, 111 (1): 172-175.CrossRef
13.
go back to reference Marwick TH, Leano RL, Brown J, Sun JP, Hoffmann R, Lysyansky P, Becker M, Thomas JD: Myocardial strain measurement with 2-dimensional speckle-tracking echocardiography: definition of normal range. JACC Cardiovasc Imagining. 2009, 2 (1): 80-84. 10.1016/j.jcmg.2007.12.007.CrossRef Marwick TH, Leano RL, Brown J, Sun JP, Hoffmann R, Lysyansky P, Becker M, Thomas JD: Myocardial strain measurement with 2-dimensional speckle-tracking echocardiography: definition of normal range. JACC Cardiovasc Imagining. 2009, 2 (1): 80-84. 10.1016/j.jcmg.2007.12.007.CrossRef
14.
go back to reference Wang J, Khoury DS, Yue Y, Torre-Amione G, Nagueh SF: Preserved left ventricular twist and circumferential deformation, but depressed longitudinal and radial deformation in patients with diastolic heart failure. Eur Heart J. 2008, 29 (10): 1283-1289.CrossRefPubMed Wang J, Khoury DS, Yue Y, Torre-Amione G, Nagueh SF: Preserved left ventricular twist and circumferential deformation, but depressed longitudinal and radial deformation in patients with diastolic heart failure. Eur Heart J. 2008, 29 (10): 1283-1289.CrossRefPubMed
15.
go back to reference Jones CJ, Raposo L, Gibson DG: Functional importance of the long axis dynamics of the human left ventricle. Br Heart J. 1990, 63 (4): 215-220. 10.1136/hrt.63.4.215.CrossRefPubMedPubMedCentral Jones CJ, Raposo L, Gibson DG: Functional importance of the long axis dynamics of the human left ventricle. Br Heart J. 1990, 63 (4): 215-220. 10.1136/hrt.63.4.215.CrossRefPubMedPubMedCentral
16.
go back to reference Gjesdal O, Vartdal T, Hopp E, Lunde K, Brunvand H, Smith HJ, Edvardsen T: Left ventricle longitudinal deformation assessment by mitral annulus displacement or global longitudinal strain in chronic ischemic heart disease: are they interchangeable?. J Am Soc Echocardiogr. 2009, 22 (7): 823-830. 10.1016/j.echo.2009.04.023.CrossRefPubMed Gjesdal O, Vartdal T, Hopp E, Lunde K, Brunvand H, Smith HJ, Edvardsen T: Left ventricle longitudinal deformation assessment by mitral annulus displacement or global longitudinal strain in chronic ischemic heart disease: are they interchangeable?. J Am Soc Echocardiogr. 2009, 22 (7): 823-830. 10.1016/j.echo.2009.04.023.CrossRefPubMed
17.
go back to reference Hong GR, Pedrizzetti G, Tonti G, Li P, Wei Z, Kim JK, Baweja A, Liu S, Chung N, Houle H, et al.: Characterization and quantification of vortex flow in the human left ventricle by contrast echocardiography using vector particle image velocimetry. JACC Cardiovasc Imaging. 2008, 1 (6): 705-717. 10.1016/j.jcmg.2008.06.008.CrossRefPubMedPubMedCentral Hong GR, Pedrizzetti G, Tonti G, Li P, Wei Z, Kim JK, Baweja A, Liu S, Chung N, Houle H, et al.: Characterization and quantification of vortex flow in the human left ventricle by contrast echocardiography using vector particle image velocimetry. JACC Cardiovasc Imaging. 2008, 1 (6): 705-717. 10.1016/j.jcmg.2008.06.008.CrossRefPubMedPubMedCentral
18.
go back to reference Sengupta PP, Pedrizzetti G, Kilner PJ, Kheradvar A, Ebbers T, Tonti G, Fraser AG, Narula J: Emerging trends in CV flow visualization. JACC Cardiovasc Imaging. 2012, 5 (3): 305-316. 10.1016/j.jcmg.2012.01.003.CrossRefPubMed Sengupta PP, Pedrizzetti G, Kilner PJ, Kheradvar A, Ebbers T, Tonti G, Fraser AG, Narula J: Emerging trends in CV flow visualization. JACC Cardiovasc Imaging. 2012, 5 (3): 305-316. 10.1016/j.jcmg.2012.01.003.CrossRefPubMed
19.
go back to reference Spruit MA, Maeder MT, Knackstedt C, Ammann P, Jeker U, Uszko-Lencer NH, Kiencke S, Pfisterer ME, Rickli H, Brunner-La Rocca HP: Prognostic value of self-reported versus objectively measured functional capacity in patients with heart failure: results from the TIME-CHF (Trial of Intensified Versus Standard Medical Therapy in Elderly Patients with Congestive Heart Failure). J Am Coll Cardiol. 2012, 60 (20): 2125-2126. 10.1016/j.jacc.2012.08.968.CrossRefPubMed Spruit MA, Maeder MT, Knackstedt C, Ammann P, Jeker U, Uszko-Lencer NH, Kiencke S, Pfisterer ME, Rickli H, Brunner-La Rocca HP: Prognostic value of self-reported versus objectively measured functional capacity in patients with heart failure: results from the TIME-CHF (Trial of Intensified Versus Standard Medical Therapy in Elderly Patients with Congestive Heart Failure). J Am Coll Cardiol. 2012, 60 (20): 2125-2126. 10.1016/j.jacc.2012.08.968.CrossRefPubMed
Metadata
Title
Speckle tracking echocardiography-determined measures of global and regional left ventricular function correlate with functional capacity in patients with and without preserved ejection fraction
Authors
John W Petersen
Talha F Nazir
Licheng Lee
Cynthia S Garvan
Ashkan Karimi
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Cardiovascular Ultrasound / Issue 1/2013
Electronic ISSN: 1476-7120
DOI
https://doi.org/10.1186/1476-7120-11-20

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