| 1. |
- Bukachi, Frederick, et al.
(författare)
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Age dependency in the timing of mitral annular motion in relation to ventricular filling in healthy subjects : Umea General Population Heart Study
- 2008
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Ingår i: European Journal of Echocardiography. - : Oxford University Press (OUP). - 1525-2167 .- 1532-2114. ; 9:4, s. 522-529
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: Peak left ventricular (LV) relaxation normally precedes peak filling (E), which supports the hypothesis that LV suction contributes to early-diastolic filling. The significance of similar temporal discordance in late diastole has previously not been studied. We describe the time relationships between mitral annular motion and LV filling in early and late diastole and examine the effect of normal ageing on these time intervals. METHODS AND RESULTS: A total of 128 healthy subjects aged 25-88 years were studied. Transmitral and pulmonary venous flow reversals (Ar) were recorded by Doppler echocardiography. Mitral annular diastolic displacement-early (E(m)) and late (A(m))-were recorded by Doppler tissue imaging. With reference to electrocardiographic R and P-waves, the following measurements were made: R to peak E-wave (R-E) and E(m) (R-E(m)); onset P to peak A-wave (P-pA), A(m) (P-pA(m)), and Ar (P-pAr). The differences between [(R-E) and (R-E(m))] for early-diastolic temporal discordance (EDTD) and [(P-A) and (P-A(m))] for late-diastolic temporal discordance (LDTD) were calculated. Isovolumic relaxation time (IVRT) was also measured. Early-diastolic temporal discordance was approximately 26 ms in all age groups. Late-diastolic temporal discordance, however, was inversely related to age (r = -0.35, P < 0.001) and IVRT (r = -0.34, P < 0.001) and therefore decreased in the elderly vs. young (13 +/- 10 vs. 23 +/- 10 ms; P < 0.001). In multivariate analysis, age failed to predict LDTD in the presence of IVRT. A, A(m), and Ar were simultaneous at onset, and peak A(m) coincided with peak Ar in all age groups (r = 0.97, P < 0.001). No significant differences were noted in the RR intervals. CONCLUSIONS: Sequential prolongation of IVRT with ageing reduces LDTD, thus converging the peaks of A(m), A, and Ar (atrial mechanical alignment)-a potential novel method to identify subjects at increased dependency on atrial contraction for late-diastolic filling.
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| 2. |
- Bukachi, Frederich, et al.
(författare)
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Pulmonary venous flow reversal and its relationship to atrial mechanical function in normal subjects--Umeå General Population Heart Study.
- 2005
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Ingår i: European Journal of Echocardiography. - : Oxford University Press (OUP). - 1525-2167 .- 1532-2114. ; 6:2, s. 107-116
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: Although pulmonary venous flow reversal (Ar) is useful in the evaluation of left ventricular (LV) diastolic function, it is often difficult to study with transthoracic echocardiography (TTE). We determined the relationship between Ar and left atrial (LA) mechanical function and sought to define surrogate measurements for Ar. METHODS AND RESULTS: A total of 130 healthy subjects, mean age 54.3+/-18.3 years, 62 women, were studied and classified into three groups: [young (Y), 25-44 years; n=44], [middle-age (M), 45-64 years; n=43] and [elderly (E), > or =65 years; n=43]. Pulmonary venous flow and LV inflow studies were performed by TTE and LV basal free-wall motion was studied by Doppler tissue imaging (DTI). All images were acquired with a superimposed electrocardiogram. RR interval was similar in all groups while LA dimension and PR interval were increased in Group E vs. Y (P<0.001). LA contraction (A(m)) on DTI, transmitral A-wave (A) and Ar were simultaneous and started 84ms after onset of P wave and this interval increased with age (P=0.02). Similarly, the time intervals from the same landmark to peak A(m), A, and Ar were prolonged with age (all, P<0.001). Despite this prolongation, peak A(m) coincided with peak Ar in every age group (r=0.97, P<0.001) and Ar acceleration and deceleration times were consistently equal. CONCLUSION: The timing of A(m) obtained by DTI can be used to accurately estimate corresponding measurements of Ar recorded by TTE in subjects without cardiac disease.
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| 3. |
- Engvall, Christer, et al.
(författare)
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Can myocardial strain differentiate hypertrophic from infiltrative etiology of a thickened septum?
- 2011
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Ingår i: Echocardiography. - : Wiley. - 0742-2822 .- 1540-8175. ; 28:4, s. 408-415
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Tidskriftsartikel (refereegranskat)abstract
- Septal systolic strain measurements showed reduced longitudinal function but its localized nature failed to demonstrate radial disturbances in patients with pathologically thickened septum. No difference was found in systolic strain between patients according to the etiology of septal thickness. This limitation might be either technical or is explained by the maintained radial function in all patient groups.
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| 4. |
- Gustafsson, Ulf, 1976-, et al.
(författare)
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Assessment of regional rotation patterns improves the understanding of the systolic and diastolic left ventricular function : an echocardiographic speckle-tracking study in healthy individuals
- 2009
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Ingår i: European Journal of Echocardiography. - : Oxford University Press (OUP). - 1525-2167 .- 1532-2114. ; :10, s. 56-61
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Tidskriftsartikel (refereegranskat)abstract
- AIM To elucidate the complexity of left ventricular motion throughout the cardiac cycle, we studied regional rotation in detail. METHODS AND RESULTS: Regional rotation in six subdivisions of the circumference at three levels was studied by using speckle-tracking echocardiography in 40 healthy subjects. At the basal level the inferoseptal segments rotated significantly more clockwise during systole than the opposing anterolateral segments. At the papillary level the inferoseptal segments differed significantly from the anterolateral segments, where the inferoseptal segments rotated clockwise and the anterolateral segments rotated counter-clockwise. The apical level showed significant difference in regional rotation only at aortic valve opening. In early systole, untwist before the main systolic twist was seen at the basal and apical levels; however, the duration of the basal untwist was much longer than that of the apical. The diastolic phases of rotation at the basal and apical levels matched the different filling phases. CONCLUSION: Large regional differences in rotation are present at the basal and papillary levels in healthy subjects. The diastolic untwist matches the phases of both the E-wave and A-wave and seems to be related with intraventricular pressure differences, indicating that untwist plays an important role in the filling of the ventricle.
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| 5. |
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| 6. |
- Henein, Michael, et al.
(författare)
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The normal impact of age and gender on right heart structure and function
- 2014
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Ingår i: Echocardiography. - : Wiley. - 0742-2822 .- 1540-8175. ; 31:1, s. 5-11
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: As the proportion of elderly population increases rapidly, it might be difficult to differentiate physiological changes in cardiac function due to age from the pathophysiological ones. In addition, cardiac function variations with gender are well established. The right ventricular (RV) plays an important role in the overall cardiac function, but reference values varying with age and gender are lacking.MATERIAL AND METHODS: We studied 255 healthy individuals from a general population register, mean age of 58 ± 19 (range 22-89) years, 125 were females. We used 2D and M-mode echocardiography to measure RV inflow tract (RVIT) and RV outflow tract (RVOT) dimensions and fractional shortening (fs). Spectral Doppler echocardiography was also used.RESULTS: We found a modest decrease in RVIT dimensions (P < 0.05), but increase in RVOT dimensions with advancing age (P < 0.05). A small decrease in RVOT fs with age was also found (P < 0.05). Estimated pulmonary pressures and pulmonary vascular resistance increased (P < 0.001) as did RVOT wall thickness (P < 0.001), but RV diastolic function was not altered (P < 0.001) with age. Despite correction for the BSA, males showed larger RVIT dimensions (P < 0.001 for both), but RVOT end-diastolic dimension was larger in females (P < 0.05). RVIT and RVOT fractional shortening were increased in females (P < 0.01 for both).CONCLUSION: In a cohort of normal individuals, age has significant impact on RV structure and function, inlet area falls and outflow tract dimensions increase and fractional shortening also increase in females. In addition, RVOT wall thickness significantly increases and Doppler markers of pulmonary vascular resistance show a consistent rise. The age-related changes should carefully be considered when commenting on normality and when using absolute values.
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| 7. |
- Lindqvist, Per, et al.
(författare)
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New aspects of septal function by using 1-dimensional strain and strain rate imaging.
- 2006
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Ingår i: Journal of the American Society of Echocardiography. - : Elsevier BV. - 0894-7317 .- 1097-6795. ; 19:11, s. 1345-1349
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The interventricular septum is a complex structure, both anatomically and functionally, which limits the use of Doppler tissue imaging in the assessment of radial septal function. In this study we investigated whether strain (epsilon) and epsilon rate (SR) imaging can improve the measurement of the septal function. METHODS: Thirty healthy participants (18 women; age 60 +/- 11 years, range 42-72) were randomly selected from the population. Systolic epsilon and SR measurements were made of the radial motion from right endocardial layer (RE), left endocardial layer (LE), and middle layer of septum. Furthermore, we also compared RE and longitudinal right ventricular free wall and left ventricular longitudinal and LE septal motion. RESULTS: In both the endocardial sampling sites, LE and RE, we found negative radial epsilon (myocardial shortening), -20.1 +/- 11.5% for RE and -25.0 +/- 14.1% for LE during systole. However, in the middle layer we found a positive radial epsilon (myocardial lengthening), +11.5 +/- 13.2%, significantly different from the two endocardial layers (P < .001 for both). SR was negative in the two endocardial layers and significantly higher for LE, (-2.9 +/- 1.8 1/s) than for RE (-1.2 +/- 1.8 1/s, P < .001) and positive for the middle layer (+1.1 +/- 1.0 1/s), significantly different in comparison with the two endocardial layers (P < .001). Finally, there was a higher longitudinal epsilon compared with radial endocardial epsilon for right ventricle (-26.5 +/- 11.5 vs -20.1 +/- 11.5, P < .05) whereas there was significantly higher left ventricular radial epsilon and SR compared with the longitudinal epsilon and SR (-25.0 +/- 14.1 vs -16.8 +/- 9.5, P < .05; and -2.9 +/- 1.8 vs -1.1 +/- 0.4, P < .001). CONCLUSION: Systolic epsilon and SR imaging indicate differences in the radial deformation in different layers of the interventricular septum, which might be explained by the complexity of the septal fiber arrays and function. It might also explain why using Doppler tissue imaging technique is limited in assessing radial myocardial septal velocities. Furthermore, these results suggest that longitudinal shortening dominates in the right ventricle whereas the radial shortening dominates in the left ventricle.
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| 8. |
- Lindqvist, Per, et al.
(författare)
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Regional and global right ventricular function in healthy individuals aged 20-90 years: a pulsed Doppler tissue imaging study: Umeå General Population Heart Study.
- 2005
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Ingår i: Echocardiography. - : Wiley. - 0742-2822 .- 1540-8175. ; 22:4, s. 305-314
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was to describe regional and global right ventricular (RV) function in a wide age range of healthy subjects of both sexes. We studied 255 (125 females) healthy individuals randomly selected from the Umeå General Population Register, age 58 +/- 19 (range 22-89) years. RV function was studied using myocardial tissue Doppler imaging of the RV free wall. Isovolumic contraction (IVCv), systolic (Sv), early (Ev), and late (Av) diastolic velocities were measured. Furthermore, isovolumic periods and ejection time intervals were also measured. Conventional Doppler was used to study RV global filling properties. While systolic myocardial velocities were conserved over age, there was a decrease in myocardial E/A ratio with increasing age (r =-0.67, P < 0.001, for base) taken from the RV free wall. A similar age relation was found in RV global filling velocities with a reduced tricuspid E/A ratio (r =-0.57, P < 0.001). Furthermore, a significant correlation was found between global and regional E/A ratios at the basal (r = 0.58, P
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| 9. |
- Mörner, Stellan, et al.
(författare)
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Right ventricular dysfunction in hypertrophic cardiomyopathy as evidenced by the myocardial performance index
- 2007
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 124:1, s. 57-63
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Left ventricular function in hypertrophic cardiomyopathy (HCM) has been extensively studied, whereas right ventricular function is much less explored. The myocardial performance index (MPI) has been shown to be useful in functional assessment of both ventricles. Furthermore, right ventricular MPI was found to be of predictive value in heart failure due to dilated cardiomyopathy and ischemic heart disease. The aim of this study was, therefore, to evaluate the right ventricular MPI in patients with HCM. METHODS: Fifty patients with HCM and 250 healthy controls were studied by conventional Doppler echocardiography and Doppler tissue imaging. RESULTS: Patients showed increased global, 0.48 (0.15) vs. 0.21 (0.14), and regional, 0.71 (0.23) vs. 0.55 (0.17), right ventricular MPI, as compared to controls, p<0.001. Tricuspid annular plane systolic excursion and peak myocardial systolic velocities were also reduced. Patients with dyspnoea had increased global right ventricular MPI (0.53 vs. 0.36, p<0.05) as compared to those without dyspnoea. CONCLUSION: In the present study, patients with HCM showed evidence of both global and regional right ventricular dysfunction. Previous studies of the right ventricle in HCM have only shown evidence of diastolic dysfunction, contrary to our results, showing impairment of both systolic and diastolic function. This study suggests that HCM should not only be regarded as an isolated disease of the left ventricle, but rather as a biventricular disease. The predictive value of our findings in HCM needs to be assessed in a separate study with special reference to those with and without dyspnoea.
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| 10. |
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