Maelys Venet, Jerome Baranger, Aimen Malik, Minh B Nguyen, Seema Mital, Mark K Friedberg, Mathieu Pernot, Clement Papadacci, Sebastien Salles, Rajiv Chaturvedi, Luc Mertens, Olivier Villemain
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引用次数: 0
Abstract
Background: Myocardial work assessment has emerged as a promising tool for left ventricular (LV) performance evaluation. Existing non-invasive methods for assessing it rely on assumptions on LV pressure and geometry. Recently, shear wave elastography allowed to quantify changes in myocardial stiffness throughout the cardiac cycle. Based on Hooke's law, it becomes theoretically possible to calculate myocardial stress and work from myocardial stiffness and strain measurements. The main objective of this study is to demonstrate the feasibility of this comprehensive ultrasound approach and to compare myocardial work values between populations where variations are anticipated.
Methods: Children with hypertrophic cardiomyopathy (HCM), aortic stenosis (AS) and healthy volunteers (HV) were included in this study. Segment dimensions, strain, thickness, and segmental myocardial stiffness were assessed in the basal anteroseptal segment throughout the cardiac cycle. One-beat segmental work, the stress-strain loop area, contributive and dissipative work were compared between groups.
Results: Twenty HV (9.8 ± 5.3 years of age), 20 HCM (10.0 ± 6.1 years of age) and 5 AS (5.3 ± 4.3 years of age) subjects were included. One-beat segmental work was significantly higher in AS (272.0 ± 102.9 µJ/mm) and lower in HCM (38.2 ± 106.9 µJ/mm) compared to HV (131.1 ± 83.3 µJ/mm), p=0.02 and p=0.01 respectively. Desynchronized work was prevailing in HCM with dissipative work during systole measured at 17.3 ± 28.9 µJ/mm and contributive work during diastole measured at 15.3 ± 18.0 µJ/mm. The stress-strain loop area was higher in AS (95.2 ± 31.1 kPa.%) and HV (66.2 ± 35.9 kPa.%) than in HCM (5.8 ± 13.0 kPa.%), p<0.01.
Conclusions: Calculating segmental myocardial work based on myocardial stiffness and strain measurements is technically feasible. This approach overcomes the inherent limitations of current methods by introducing a direct quantitative measure of myocardial stress.
期刊介绍:
European Heart Journal – Cardiovascular Imaging is a monthly international peer reviewed journal dealing with Cardiovascular Imaging. It is an official publication of the European Association of Cardiovascular Imaging, a branch of the European Society of Cardiology.
The journal aims to publish the highest quality material, both scientific and clinical from all areas of cardiovascular imaging including echocardiography, magnetic resonance, computed tomography, nuclear and invasive imaging. A range of article types will be considered, including original research, reviews, editorials, image focus, letters and recommendation papers from relevant groups of the European Society of Cardiology. In addition it provides a forum for the exchange of information on all aspects of cardiovascular imaging.