Copyright © 2005, The European Society of Cardiology
Relations of longitudinal left ventricular systolic function to left ventricular mass, load, and Doppler stroke volume*
aDepartment of Clinical and Experimental Medicine, Federico II University School of Medicine, 80131 Naples, Italy
b"CTO" Hospital, ASL Napoli 1, Italy
Received 14 February 2005; received in revised form 12 July 2005; accepted after revision 27 July 2005.
* Corresponding author. Department of Internal Medicine, Federico II University School of Medicine, via Pansini 5, Edifico 1/A, Room 421, 80131 Naples, Italy. Tel.: +39 81 7464323; fax: +39 81 5466152. vpalmier{at}med.cornell.edu
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Abstract |
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Aims To evaluate whether the peak systolic velocities of the displacement of the lateral mitral anulus (Sa) and of the mid-portion of the interventricular septal wall (Sm) correlate with measures of left ventricular load, left ventricular mass, and Doppler stroke volume in normotensive and hypertensive subjects without clinically overt cardiovascular disease.
Methods and results Tissue Doppler imaging was used to evaluate Sa and Sm in apical 4-chamber view; standard echocardiographic procedures were used to assess left ventricular structure and traditional parameters of systolic function (ejection fraction, stress-corrected midwall shortening, meridional and circumferential end-systolic stress); pulsed Doppler was employed to evaluate stroke volume. In 87 subjects meeting inclusion criteria, Sa and Sm were not significantly correlated either with left ventricular end-diastolic volume and end-systolic stress, or with stroke volume; in contrast, endocardial and midwall fractional shortening were lower with higher afterload, as expected. Fractional shortening at endocardium and midwall, and Sm were lower with higher left ventricular mass. Mean Sa and Sm values were lower in subjects with low vs. those with normal stress-corrected midwall shortening, but low Sa was not associated with lower stress-corrected midwall shortening in our study sample.
Conclusions While Sa and Sm might be indices of longitudinal left ventricular systolic mechanics, they should not be considered as measures of left ventricular contractility alternative to well-established parameters of systolic function, such as stress-corrected midwall shortening, in subjects at rest without overt heart disease.
Keywords: Left ventricular; Systole; Function; Tissue Doppler imaging; Echocardiography
Supported in part by Educational Grant, PhD. Program 2000–2004 "XVI Ciclo", Department of Clinical and Experimental Medicine, Federico II University School of Medicine, Recipient Dr. Vittorio Palmieri; Educational Grant, GE Medical Systems Ultrasound, Italy, Recipient Dr. Aldo Celentano.
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