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Abnormal systolic and diastolic LV motion by novel tissue phase mapping accounts for functional capacity in pulmonary hypertension

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However, abnormal ventricular interactions also result in abnormalities of systolic and diastolic LV function... TPM revealed significant abnormalities of systolic and diastolic motion in both the basal and mid LV cavities of patients with PAH (table 1 Figure 1)... Specifically, there was a reduction in systolic twist and diastolic radial and longitudinal expansion... Furthermore, peak LV circumferential untwisting was delayed in PAH (65.1 ± 46 ms after radial e-wave)... Interestingly, LV metrics by TPM did not correlate with PA pressure... However, on univariate analysis, peak LV tangential (r = 0.504, p = 0.033) and radial (r = 0.454, p = 0.044) s-waves, and LV radial e-waves (r = 0.748, p = 0.00023) did correlate with 6-minute walk distance in PAH patients, as did LVEF and LVSV (but not invasive measures)... We have shown using a novel TPM sequence that there are significant abnormalities of LV systolic tangential and diastolic radial and longitudinal velocities in PAH... Furthermore, we have demonstrated that there is temporal distortion of the separate components of early diastolic LV motion... Importantly, we have shown that these abnormal measures correlate with 6-minute walk distances, implying that part of reduced exercise tolerance in PAH is secondary to LV disease... In fact, the only independent predictor of the 6-minute walk test was the radial e-wave, which suggests that LV early diastolic dysfunction may play a pivotal role in the disease symptoms.

No MeSH data available.


Colour-maps displaying radial velocities against time for a mid LV short-axis slice in a healthy volunteer and in a patient with PAH during a single cardiac cycle. Note the abnormal septal motion in PAH, with consequent discordant segmental early diastolic radial LV motion that progresses from the septum towards the lateral LV wall (circled).
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Figure 1: Colour-maps displaying radial velocities against time for a mid LV short-axis slice in a healthy volunteer and in a patient with PAH during a single cardiac cycle. Note the abnormal septal motion in PAH, with consequent discordant segmental early diastolic radial LV motion that progresses from the septum towards the lateral LV wall (circled).

Mentions: The LVEDV was lower in PAH with preserved ejection fraction compared to normal controls. TPM revealed significant abnormalities of systolic and diastolic motion in both the basal and mid LV cavities of patients with PAH (table 1 Figure 1). Specifically, there was a reduction in systolic twist and diastolic radial and longitudinal expansion. Furthermore, peak LV circumferential untwisting was delayed in PAH (65.1 ± 46 ms after radial e-wave). Interestingly, LV metrics by TPM did not correlate with PA pressure. However, on univariate analysis, peak LV tangential (r = 0.504, p = 0.033) and radial (r = 0.454, p = 0.044) s-waves, and LV radial e-waves (r = 0.748, p = 0.00023) did correlate with 6-minute walk distance in PAH patients, as did LVEF and LVSV (but not invasive measures). Nevertheless, on multivariate analysis, only mid-LV peak radial e-wave velocity was an independent predictor of 6-minute walk distance (β = 0.844, p < 0.0006). In addition, peak LV radial e- (r = -0.645, p = 0.004) and a-waves (r = 0.569, p = 0.014) also correlated with NT-proBNP levels in PAH.


Abnormal systolic and diastolic LV motion by novel tissue phase mapping accounts for functional capacity in pulmonary hypertension
Colour-maps displaying radial velocities against time for a mid LV short-axis slice in a healthy volunteer and in a patient with PAH during a single cardiac cycle. Note the abnormal septal motion in PAH, with consequent discordant segmental early diastolic radial LV motion that progresses from the septum towards the lateral LV wall (circled).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4043762&req=5

Figure 1: Colour-maps displaying radial velocities against time for a mid LV short-axis slice in a healthy volunteer and in a patient with PAH during a single cardiac cycle. Note the abnormal septal motion in PAH, with consequent discordant segmental early diastolic radial LV motion that progresses from the septum towards the lateral LV wall (circled).
Mentions: The LVEDV was lower in PAH with preserved ejection fraction compared to normal controls. TPM revealed significant abnormalities of systolic and diastolic motion in both the basal and mid LV cavities of patients with PAH (table 1 Figure 1). Specifically, there was a reduction in systolic twist and diastolic radial and longitudinal expansion. Furthermore, peak LV circumferential untwisting was delayed in PAH (65.1 ± 46 ms after radial e-wave). Interestingly, LV metrics by TPM did not correlate with PA pressure. However, on univariate analysis, peak LV tangential (r = 0.504, p = 0.033) and radial (r = 0.454, p = 0.044) s-waves, and LV radial e-waves (r = 0.748, p = 0.00023) did correlate with 6-minute walk distance in PAH patients, as did LVEF and LVSV (but not invasive measures). Nevertheless, on multivariate analysis, only mid-LV peak radial e-wave velocity was an independent predictor of 6-minute walk distance (β = 0.844, p < 0.0006). In addition, peak LV radial e- (r = -0.645, p = 0.004) and a-waves (r = 0.569, p = 0.014) also correlated with NT-proBNP levels in PAH.

View Article: PubMed Central - HTML

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

However, abnormal ventricular interactions also result in abnormalities of systolic and diastolic LV function... TPM revealed significant abnormalities of systolic and diastolic motion in both the basal and mid LV cavities of patients with PAH (table 1 Figure 1)... Specifically, there was a reduction in systolic twist and diastolic radial and longitudinal expansion... Furthermore, peak LV circumferential untwisting was delayed in PAH (65.1 ± 46 ms after radial e-wave)... Interestingly, LV metrics by TPM did not correlate with PA pressure... However, on univariate analysis, peak LV tangential (r = 0.504, p = 0.033) and radial (r = 0.454, p = 0.044) s-waves, and LV radial e-waves (r = 0.748, p = 0.00023) did correlate with 6-minute walk distance in PAH patients, as did LVEF and LVSV (but not invasive measures)... We have shown using a novel TPM sequence that there are significant abnormalities of LV systolic tangential and diastolic radial and longitudinal velocities in PAH... Furthermore, we have demonstrated that there is temporal distortion of the separate components of early diastolic LV motion... Importantly, we have shown that these abnormal measures correlate with 6-minute walk distances, implying that part of reduced exercise tolerance in PAH is secondary to LV disease... In fact, the only independent predictor of the 6-minute walk test was the radial e-wave, which suggests that LV early diastolic dysfunction may play a pivotal role in the disease symptoms.

No MeSH data available.