PMID- 20190282
OWN - NLM
STAT- MEDLINE
DCOM- 20100617
LR  - 20161125
IS  - 1942-0080 (Electronic)
IS  - 1941-9651 (Linking)
VI  - 3
IP  - 3
DP  - 2010 May
TI  - Impact of loading condition on the 2D speckle tracking-derived left ventricular 
      dyssynchrony index in nonischemic dilated cardiomyopathy.
PG  - 272-81
LID - 10.1161/CIRCIMAGING.109.890848 [doi]
AB  - BACKGROUND: The effects of left ventricular (LV) loading conditions on LV 
      dyssynchrony have not been elucidated. We modified LV loading conditions to 
      reveal their effects on echocardiography-derived LV dyssynchrony index (LVdys) in 
      patients with documented nonischemic dilated cardiomyopathy. METHODS AND RESULTS: 
      Thirty-seven patients were consecutively enrolled. After baseline measurements, 
      pneumatic compression of the lower extremities (Pcom) was used to increase LV 
      afterload. Subsequently, sublingual nitroglycerin (SL-NG) was administered to 
      modify preload. Conventional echocardiographic parameters, LVdys (by 
      speckle-tracking radial strain analysis) and LV end-systolic wall stress 
      (LV-ESWS), were calculated under each condition. LVdys-6 (defined as the maximal 
      difference in time-to-peak radial strain between 6 myocardial segments) and 
      LV-ESWS increased under Pcom (for LVdys-6, 159+/-117 at baseline versus 239+/-140 
      ms under Pcom, P<0.05; for LV-ESWS, 191+/-63 versus 228+/-80 g/m(2), P<0.05) 
      After SL-NG application, both parameters decreased significantly (for LVdys-6, 
      239+/-140 under Pcom versus 147+/-103 ms after SL-NG, P<0.05; for LV-ESWS, 
      228+/-80 under Pcom versus 189+/-67 g/m(2) after SL-NG, P<0.05). When the 
      presence of LV dyssynchrony was defined as the absolute difference in 
      time-to-peak radial strain between the anteroseptal and posterior segments 
      (LVdys-2), the results were unchanged. Using 130 ms as a cutoff value, the 
      proportion of patients with LV dyssynchrony changed significantly (29.7% at 
      baseline, 45.9% under Pcom, and 35.1% after SL-NG). When the presence of LV 
      dyssynchrony was defined as standard deviation of the time to peak radial strain 
      for 6 segments (LVdys-SD), the results were same. LVdys and LV-ESWS showed a 
      modest but significant association with each other (r=0.47, P<0.001 for LVdys-6; 
      r=0.41, P<0.001 for LVdys-2; r=0.46, P<0.001 for LVdys-SD). CONCLUSIONS: To the 
      best of our knowledge, the present study provides the first evidence of a 
      significant association between LVdys and LV loading status, reflective of a 
      dynamic nature of LVdys. Accordingly, LV loading conditions should be taken into 
      account when echocardiographic LVdys is used for clinical decision-making of 
      selecting candidates for cardiac resynchronization therapy or when it is used as 
      a surrogate marker of prognosis.
FAU - Park, Hyo Eun
AU  - Park HE
AD  - Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, 
      Seoul National University Hospital, Seoul, Korea.
FAU - Chang, Sung-A
AU  - Chang SA
FAU - Kim, Hyung-Kwan
AU  - Kim HK
FAU - Shin, Dong-Ho
AU  - Shin DH
FAU - Kim, Ji-Hyun
AU  - Kim JH
FAU - Seo, Myung-Ki
AU  - Seo MK
FAU - Kim, Yong-Jin
AU  - Kim YJ
FAU - Cho, Goo-Yeong
AU  - Cho GY
FAU - Sohn, Dae-Won
AU  - Sohn DW
FAU - Oh, Byung-Hee
AU  - Oh BH
FAU - Park, Young-Bae
AU  - Park YB
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20100227
PL  - United States
TA  - Circ Cardiovasc Imaging
JT  - Circulation. Cardiovascular imaging
JID - 101479935
SB  - IM
MH  - Blood Pressure
MH  - Cardiomyopathy, Dilated/complications/*diagnostic imaging
MH  - Echocardiography, Doppler/methods
MH  - Female
MH  - Heart Rate
MH  - Heart Ventricles/*diagnostic imaging
MH  - Humans
MH  - Intermittent Pneumatic Compression Devices
MH  - Male
MH  - Middle Aged
MH  - Observer Variation
MH  - Ventricular Dysfunction, Left/complications/*diagnostic imaging
EDAT- 2010/03/02 06:00
MHDA- 2010/06/18 06:00
CRDT- 2010/03/02 06:00
PHST- 2010/03/02 06:00 [entrez]
PHST- 2010/03/02 06:00 [pubmed]
PHST- 2010/06/18 06:00 [medline]
AID - CIRCIMAGING.109.890848 [pii]
AID - 10.1161/CIRCIMAGING.109.890848 [doi]
PST - ppublish
SO  - Circ Cardiovasc Imaging. 2010 May;3(3):272-81. doi: 
      10.1161/CIRCIMAGING.109.890848. Epub 2010 Feb 27.