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 language | English |
|---|---|
| Pages (from-to) | 319-325 |
| Number of pages | 7 |
| Journal | International Heart Journal |
| Volume | 55 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 2014 Jan 1 |
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Keywords
- Heart failure
- Myocardial strain
- Strain rate imaging
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Patterns of decrease in multidirectional myocardial deformations in patients with fluctuating left ventricular ejection fraction. / Kim, Yong Hyun; Choi, Jungsoon; Kim, Seong Hwan; Kim, Dong Hyeok; Ahn, Jeong Cheon; Song, Woohyuk.
In: International Heart Journal, Vol. 55, No. 4, 01.01.2014, p. 319-325.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Patterns of decrease in multidirectional myocardial deformations in patients with fluctuating left ventricular ejection fraction
AU - Kim, Yong Hyun
AU - Choi, Jungsoon
AU - Kim, Seong Hwan
AU - Kim, Dong Hyeok
AU - Ahn, Jeong Cheon
AU - Song, Woohyuk
PY - 2014/1/1
Y1 - 2014/1/1
N2 - 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.
AB - 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.
KW - Heart failure
KW - Myocardial strain
KW - Strain rate imaging
UR - http://www.scopus.com/inward/record.url?scp=84904104810&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84904104810&partnerID=8YFLogxK
U2 - 10.1536/ihj.13-350
DO - 10.1536/ihj.13-350
M3 - Article
VL - 55
SP - 319
EP - 325
JO - International Heart Journal
JF - International Heart Journal
SN - 1349-2365
IS - 4
ER -