Patterns of decrease in multidirectional myocardial deformations in patients with fluctuating left ventricular ejection fraction

Yong Hyun Kim, Jungsoon Choi, Seong Hwan Kim, Dong Hyeok Kim, Jeong Cheon Ahn, Woohyuk Song

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Few studies have examined the variations in longitudinal/circumferential/radial strain (LS/CS/RS) and strain rate (LSr/CSr/RSr) in individual hearts when the left ventricular ejection fraction (LVEF) has changed. We hypothesized the relationships of strain/strain rate and LVEF are not linear, but vary with multiple inflection points (IPs) in individual hearts. Twenty-five patients with fluctuating LVEF (ΔLVEF > 10%) who had 2-D speckle tracking echocardiography available for analysis were enrolled. After models of best fit were obtained from the 'collective' plots to determine inflection points, the decrements of slopes above inflection points (IP) were compared with those below IPs in the 'individual hearts' plots. In the 'collective' plots, both LS and LSr linearly decreased in proportion to LVEF when LVEF ≥ 40% but remained constant regardless of LVEF when LVEF < 40% (IPs when LVEF = 40%, P < 0.0001). The RS-LVEF relationship was sigmoid with two IPs when LVEF = 30% and 50% (P < 0.0001). However, in the 'individual hearts' plots, the decrements of slopes above and below IPs were not different for LS-LVEF and LSr-LVEF, and marginally different for RS-LVEF (P = 0.049, across IP when LVEF = 50%). Collectively, the relationship of LS/LSr/RS and LVEF seemed to be not linear, but inflective, however, we could not prove the inflective relationship in individual hearts with fluctuating LVEF. Further study with more patients is needed to prove our hypothesis.

Original languageEnglish
Pages (from-to)319-325
Number of pages7
JournalInternational Heart Journal
Volume55
Issue number4
DOIs
Publication statusPublished - 2014 Jan 1

Keywords

  • Heart failure
  • Myocardial strain
  • Strain rate imaging

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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