Global Left Ventricular Myocardial Work Efficiency in Patients With Severe Rheumatic Mitral Stenosis and Preserved Left Ventricular Ejection Fraction
1
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
BACKGROUND: Assessment of left ventricular (LV) function plays a pivotal role in the management of patients with valvular heart disease, including those caused by rheumatic heart disease. Noninvasive LV pressure-strain loop analysis is emerging as a new echocardiographic method to evaluate global LV systolic function, integrating longitudinal strain by speckle-tracking analysis and noninvasively measured blood pressure to estimate myocardial work. The aim of this study was to characterize global LV myocardial work efficiency in patients with severe rheumatic mitral stenosis (MS) with preserved ejection fraction (EF). METHODS: We retrospectively included adult patients with severe rheumatic MS with preserved EF (> 50%) and sinus rhythm. Healthy individuals without structural heart disease were included as a control group. Global LV myocardial work efficiency was estimated with a proprietary algorithm from speckle-tracking strain analyses, as well as noninvasive blood pressure measurements. RESULTS: A total of 45 individuals with isolated severe rheumatic MS with sinus rhythm and 45 healthy individuals were included. In healthy individuals without structural heart disease, the mean global LV myocardial work efficiency was 96% (standard deviation [SD], 2), Compared with healthy individuals, median global LV myocardial work efficiency was significantly worse in MS patients (89%; SD, 4; p < 0.001) although the LVEF was similar. CONCLUSIONS: Individuals with isolated severe rheumatic MS and preserved EF, had global LV myocardial work efficiencies lower than normal controls.
Abstract
BACKGROUND: Assessment of left ventricular (LV) function plays a pivotal role in the management of patients with valvular heart disease, including those caused by rheumatic heart disease. Noninvasive LV pressure-strain loop analysis is emerging as a new echocardiographic method to evaluate global LV systolic function, integrating longitudinal strain by speckle-tracking analysis and noninvasively measured blood pressure to estimate myocardial work. The aim of this study was to characterize global LV myocardial work efficiency in patients with severe rheumatic mitral stenosis (MS) with preserved ejection fraction (EF). METHODS: We retrospectively included adult patients with severe rheumatic MS with preserved EF (> 50%) and sinus rhythm. Healthy individuals without structural heart disease were included as a control group. Global LV myocardial work efficiency was estimated with a proprietary algorithm from speckle-tracking strain analyses, as well as noninvasive blood pressure measurements. RESULTS: A total of 45 individuals with isolated severe rheumatic MS with sinus rhythm and 45 healthy individuals were included. In healthy individuals without structural heart disease, the mean global LV myocardial work efficiency was 96% (standard deviation [SD], 2), Compared with healthy individuals, median global LV myocardial work efficiency was significantly worse in MS patients (89%; SD, 4; p < 0.001) although the LVEF was similar. CONCLUSIONS: Individuals with isolated severe rheumatic MS and preserved EF, had global LV myocardial work efficiencies lower than normal controls.
참고문헌 (35)
- Mutagaywa RK, "Rheumatic heart disease anno 2020 : impacts of gender and migration on epidemiology and management", Eur J Clin Invest, 50, pp.e13374~ (2020)
- GBD 2015 Mortality and Causes of Death Collaborators, "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015", Lancet, 388, pp.1459~1544 (2016)
- Shah B, "Rheumatic heart disease: progress and challenges in India", Indian J Pediatr, 80(Suppl 1), pp.S77~S86 (2013)
- Harding E, "WHO global progress report on tuberculosis elimination", Lancet Respir Med, 8, pp.19~ (2020)
- Kumar RK, "Rheumatic fever & rheumatic heart disease : the last 50 years", Indian J Med Res, 137, pp.643~658 (2013)
- Ambari AM, "Survival analysis of patients with rheumatic MS after PBMV compared with MVS in a low-to-middle-income country", Neth Heart J, 27, pp.559~564 (2019)
- Marwick TH, "Ejection fraction pros and cons : JACC state-of-the-art review", J Am Coll Cardiol, 72, pp.2360~2379 (2018)
- Antoni ML, "Prognostic importance of strain and strain rate after acute myocardial infarction", Eur Heart J, 31, pp.1640~1647 (2010)
- Russell K, "Assessment of wasted myocardial work : a novel method to quantify energy loss due to uncoordinated left ventricular contractions", Am J Physiol Heart Circ Physiol, 305, pp.H996~1003 (2013)
- Russell K, "A novel clinical method for quantification of regional left ventricular pressure-strain loop area : a non-invasive index of myocardial work", Eur Heart J, 33, pp.724~733 (2012)
- Hubert A, "Estimation of myocardial work from pressure-strain loops analysis : an experimental evaluation", Eur Heart J Cardiovasc Imaging, 19, pp.1372~1379 (2018)
- Otto CM, "2020 ACC", AHA guideline for the management of patients with valvular heart disease : a report of the American College of Cardiology, Circulation, pp.2021, 143[DOI]
- Lang RM, "Recommendations for cardiac chamber quantification by echocardiography in adults : an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging", Eur Heart J Cardiovasc Imaging, 16, pp.233~270 (2015)
- Vecera J, "Wasted septal work in left ventricular dyssynchrony : a novel principle to predict response to cardiac resynchronization therapy", Eur Heart J Cardiovasc Imaging, 17, pp.624~632 (2016)
- Boe E, "Non-invasive myocardial work index identifies acute coronary occlusion in patients with non-ST-segment elevation-acute coronary syndrome", Eur Heart J Cardiovasc Imaging, 16, pp.1247~1255 (2015)
- Truong VT, "Normal ranges of global left ventricular myocardial work indices in adults : a meta-analysis", J Am Soc Echocardiogr, 35, pp.369~377 (2022)[DOI]
- Hobbs FD, "Prognosis of all-cause heart failure and borderline left ventricular systolic dysfunction : 5 year mortality follow-up of the Echocardiographic Heart of England Screening Study(ECHOES)", Eur Heart J, 28, pp.1128~1134 (2007)
- Zhao Q, "Prognostic impact of left ventricular ejection fraction in patients with moderate aortic regurgitation : potential implications for treatment decision-making", Front Cardiovasc Med, 8, pp.800961~ (2022)
- Dahl JS, "Effect of left ventricular ejection fraction on postoperative outcome in patients with severe aortic stenosis undergoing aortic valve replacement", Circ Cardiovasc Imaging, 8, pp.e002917~ (2015)
- Teske AJ, "Echocardiographic quantification of myocardial function using tissue deformation imaging, a guide to image acquisition and analysis using tissue Doppler and speckle tracking", Cardiovasc Ultrasound, 5, pp.27~ (2007)
- Suga H, "Instantaneous pressure-volume relationships and their ratio in the excised, supported canine left ventricle", Circ Res, 35, pp.117~126 (1974)
- Foëx P, "Pressure-volume loops : a dynamic approach to the assessment of ventricular function", J Cardiothorac Vasc Anesth, 8, pp.84~96 (1994)
- Heller SJ, "Abnormal left ventricular contraction in patients with mitral stenosis", Circulation, 42, pp.1099~1110 (1970)
- Mohan JC, "Left ventricular intrinsic contractility in pure rheumatic mitral stenosis", Am J Cardiol, 64, pp.240~242 (1989)
- Liu CP, "Reduced left ventricular compliance in human mitral stenosis. Role of reversible internal constraint", Circulation, 85, pp.1447~1456 (1992)
- Klein AJ, "Left ventricular dysfunction and mitral stenosis", Heart Fail Clin, 2, pp.443~452 (2006)
- Ambari AM, "Angiotensin converting enzyme inhibitors(ACEIs)decrease the progression of cardiac fibrosis in rheumatic heart disease through the inhibition of IL-33", sST2, 2020, pp.7, 115~
- Sengupta SP, "Effects of percutaneous balloon mitral valvuloplasty on left ventricular deformation in patients with isolated severe mitral stenosis : a speckle-tracking strain echocardiographic study", J Am Soc Echocardiogr, 27, pp.639~647 (2014)
- Lee R, "Prediction of subclinical left ventricular dysfunction with strain rate imaging in patients with asymptomatic severe mitral regurgitation", Am J Cardiol, 94, pp.1333~1337 (2004)
- Bilen E, "PP-115 : severity of mitral stenosis and left ventricular mechanics : a speckle tracking study", Int J Cardiol, 147, pp.S128~ (2011)
- Ambari AM, "Randomised controlled trial into the role of ramipril in fibrosis reduction in rheumatic heart disease : the RamiRHeD trial protocol", BMJ Open, 11, pp.e048016~ (2021)
- Gash AK, "Left ventricular performance in patients with coexistent mitral stenosis and aortic insufficiency", J Am Coll Cardiol, 3, pp.703~711 (1984)
- Wisenbaugh T, "Excessive vasoconstriction in rheumatic mitral stenosis with modestly reduced ejection fraction", J Am Coll Cardiol, 20, pp.1339~1344 (1992)
- Lustosa RP, "Global left ventricular myocardial work efficiency and long-term prognosis in patients after ST-segment-elevation myocardial infarction", Circ Cardiovasc Imaging, 14, pp.e012072~ (2021)
- Hiemstra YL, "Myocardial work in nonobstructive hypertrophic cardiomyopathy : implications for outcome", J Am Soc Echocardiogr, 33, pp.1201~1208 (2020)