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August 7, 2009European Journal of Echocardiography182 citationsOpen Access

Influence of afterload on left ventricular radial and longitudinal systolic functions: a two-dimensional strain imaging study

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EDErwan DonalCBCyrille BergerotHTHélène Thibault

Key Result

Graded increases in left ventricular afterload early impaired longitudinal function while radial function remained preserved, with 2D strain correlating with sonomicrometry (r=0.63, P<0.001).

Structured PICO

Does graded aortic banding alter radial and longitudinal left ventricular systolic regional functions in an experimental pig model?

P
Population
6 open-chest pigs in an experimental model of aortic banding
I
Intervention
Graded aortic banding (subsequent increase in LV pressure of 10, 20, and 40 mmHg)
C
Comparator
Baseline loading conditions
O
Outcome
Systolic myocardial function (radial and longitudinal) assessed by two-dimensional strain (2D-S) and sonomicrometry (SS)surrogate

Longitudinal LV function is impaired earlier than radial function in response to increased afterload, suggesting combined assessment may better characterize myocardial dysfunction in pressure-overload.

Main Result

Effect estimate: r = 0.63 and r = 0.65

p-value: p=<0.001 and <0.01

Abstract

AIMS: This study aimed to assess the influence of afterload alteration on radial (R) and longitudinal (L) left ventricular (LV) systolic regional functions. METHODS AND RESULTS: We analysed systolic myocardial function by two-dimensional strain (2D-S) and sonomicrometry (SS) in an experimental pig model of aortic banding. Both radial and longitudinal functions were analysed in six open-chest pigs under various loading conditions: baseline and graded aortic banding (subsequent increase in LV pressure of 10, 20, and 40 mmHg). Both systolic 2D-S(long) and 2D-S(rad) were significantly correlated with SS(long) and SS(rad) (r = 0.63, P < 0.001 and r = 0.65, P < 0.01, respectively). At a low increase in LV afterload, 2D-S(rad) was still preserved whereas 2D-S(long) significantly decreased. When LV afterload was subsequently increased, both 2D-S(rad) and 2D-S(long) significantly decreased. Difference in dependence to wall stress might explain these different behaviours. CONCLUSION: 2D-S shows a different response in longitudinal and radial functions to increased afterload. Longitudinal function is early impaired, whereas radial function remains preserved. This finding justifies the combined assessment of both radial and longitudinal regional myocardial functions to characterize myocardial dysfunction and might help to better identify the transition to heart failure in pressure-overload cardiomyopathy.

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Cite This Study

Donal et al. (2009) studied Aortic banding (experimental pig model) (n=6). Graded aortic banding vs. Baseline was evaluated on Radial and longitudinal left ventricular systolic regional functions (r = 0.63 and r = 0.65, p=<0.001 and <0.01). Graded increases in left ventricular afterload early impaired longitudinal function while radial function remained preserved, with 2D strain correlating with sonomicrometry (r=0.63, P<0.001).

synapsesocial.com/papers/6a0a5e55c0fb98abde3786b9https://doi.org/10.1093/ejechocard/jep095
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