Key result
Non-invasive cardiac imaging extends direct assessment of myocardial work and contractility beyond invasive PV loops.
Why the study?
Invasive pressure-volume loop analysis has been the gold standard for characterizing left ventricular function, but its clinical utility is limited by invasiveness, prompting non-invasive assessment via advanced cardiac imaging.
Recent advances in non-invasive cardiac imaging allow for the direct assessment of fundamental myocardial physiological parameters that previously required invasive pressure-volume loop analysis.
Answers are grounded in this paper and cite their sources.
May enable non-invasive myocardial assessment clinically; leaves open prospective validation against invasive PV loops.
Recent advances in cardiac imaging have revitalized the assessment of fundamental physiological concepts. In the field of cardiac physiology, invasive measurements with pressure-volume (PV) loops have served as the gold standard methodology for the characterization of left ventricular (LV) function. From PV loop data, fundamental aspects of LV chamber function are derived such as work, efficiency, stiffness and contractility. However, the parametrization of these aspects is limited because of the need for invasive procedures. Through the utilization of recent advances in echocardiography, magnetic resonance imaging and positron emission tomography, it has become increasingly feasible to quantify these fundamental aspects of LV function non-invasively. Importantly, state-of-the-art imaging technology enables direct assessment of myocardial performance, thereby extending functional assessment from the net function of the LV chamber, as is done with PV loops, to the myocardium itself. With a strong coupling to underlying myocardial physiology, imaging measurements of myocardial work, efficiency, stiffness and contractility could represent the next generation of functional parameters. The purpose of this review is to discuss how the new imaging parameters of myocardial work, efficiency, stiffness and contractility can bring cardiac physiologists, researchers and clinicians alike one step closer to underlying myocardial physiology.
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Harbo et al. (2022) conducted a review in Left ventricular function. Non-invasive cardiac imaging (echocardiography, MRI, PET) vs. Invasive pressure-volume (PV) loops was evaluated. State-of-the-art non-invasive cardiac imaging enables direct assessment of myocardial work, efficiency, stiffness, and contractility, extending functional assessment beyond invasive PV loops.
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