Abstract
BackgroundThe physiological factors which affect left ventricular (LV) long-axis function are not fully defined. We investigated the relationships of resting heart rate and body size with the peak velocities and amplitudes of LV systolic and early diastolic long axis motion, and also with long-axis contraction duration.MethodsTwo groups of adults free of cardiac disease underwent pulsed-wave tissue Doppler imaging at the septal and lateral mitral annular borders. Group 1 (n = 77) were healthy subjects <50 years of age and Group 2 (n = 65) were subjects between 40–80 years of age referred for stress echocardiography. Systolic excursion (SExc), duration (SDur) and peak velocity (s') and early diastolic excursion (EDExc) and peak velocity (e') were measured.ResultsSExc was not correlated with heart rate, height or body surface area (BSA) for either LV wall in either group, but SDur was inversely correlated with heart rate for both walls and both groups, and after adjustment for heart rate, males in both groups had a shorter septal SDur. Septal and lateral s` were independently and positively correlated with SExc, heart rate and height in both groups, independent of sex and age. There were no correlations of heart rate, height or BSA with either e` or EDExc for either wall in either group.ConclusionHeart rate and height independently modify the relationship between s` and SExc, but neither are related to EDExc or e`. These findings suggest that s` and SExc cannot be used interchangeably for the assessment of LV long-axis contraction.
Highlights
The longitudinally oriented myocardial fibres of the left ventricle provide substantial contributions to both left ventricular (LV) ejection and filling [1,2,3], and echocardiographic measurements which reflect the action of these fibres on mitral annular motion have proven to be clinically useful [4]
Systolic excursion (SExc) was not correlated with heart rate, height or body surface area (BSA) for either LV wall in either group, but SDur was inversely correlated with heart rate for both walls and both groups, and after adjustment for heart rate, males in both groups had a shorter septal SDur
There were no correlations of heart rate, height or BSA with either e‘ or early diastolic excursion (EDExc) for either wall in either group
Summary
The longitudinally oriented myocardial fibres of the left ventricle provide substantial contributions to both left ventricular (LV) ejection and filling [1,2,3], and echocardiographic measurements which reflect the action of these fibres on mitral annular motion have proven to be clinically useful [4] Both mitral annular plane systolic excursion and the peak velocity of systolic mitral annular motion (s‘) can be used as predictors of a low ejection fraction [5,6,7,8,9,10,11], both have been utilised to demonstrate impairment of long axis systolic function in patients with heart failure and a preserved ejection fraction [12,13,14,15,16], and s‘ provides prognostic information in heart failure with reduced ejection fraction [17]. Whether the interpretation of measures of LV long axis function should involve consideration of factors other than age has received little attention
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