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A new integrated approach to cardiac mechanics: reference values for normal left ventricle

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Abstract

The association between left ventricular (LV) myocardial deformation and hemodynamic forces is still mostly unexplored. The normative values and the effects of demographic and technical factors on hemodynamic forces are not known. The authors studied the association between LV myocardial deformation and hemodynamic forces in a large cohort of healthy volunteers. One-hundred seventy-six consecutive subjects (age range, 16–82; 51% women), with no cardiovascular risk factors or any relevant diseases, were enrolled. All subjects underwent an echo-Doppler examination. Both 2D global myocardial and endocardial longitudinal strain (GLS), circumferential strain (GCS), and the hemodynamic forces were measured with new software that enabled to calculate all these values and parameters from the three apical views. Higher LV mass index and larger LV volumes were found in males compared to females (85 ± 17 vs 74 ± 15 g/m2 and 127 ± 28 vs 85 ± 18 ml, p < 0.0001 respectively) while no differences of the mean values of endocardial and myocardial GLS and of myocardial GCS were found (p = ns) and higher endocardial GCS in women (− 30.6 ± 4.2 vs − 31.8 ± 3.7; p = 0.05). LV longitudinal force, LV systolic longitudinal force and LV impulse were higher in men (16.2 ± 5.3 vs 13.2 ± 3.6; 25.1 ± 7.9 vs 19.4 ± 5.6 and 20.4 ± 7 vs 16.6 ± 5.2, p < 0.0001, respectively). A weak but statistically significant decline with age (p < 0.0001) was also found for these force parameters. This new integrated approach could differentiate normality from pathology by providing average deformation values and hemodynamic forces parameters, differentiated by age and gender.

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Funding

DC and GP received partial support for this study from the Italian Ministry of Education and Research, project PRIN No. 2017A889FP.

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Authors and Affiliations

  1. Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, via Slataper n°9, 34100, Trieste, Italy

    Giorgio Faganello, Stefano Furlotti, Linda Pagura, Michele Zaccari & Andrea Di Lenarda

  2. Department of Engineering and Architecture, University of Trieste, P.le Europa 1, 34127, Trieste, Italy

    Dario Collia & Gianni Pedrizzetti

Authors
  1. Giorgio Faganello
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  2. Dario Collia
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  3. Stefano Furlotti
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  4. Linda Pagura
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  5. Michele Zaccari
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  6. Gianni Pedrizzetti
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  7. Andrea Di Lenarda
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Contributions

GF and GP conceived and designed research; GF, GP and DC interpreted results of experiments; DC prepared figures; DC, and GP analyzed data; SF, LP, MZ, performed experiments; GF, and GP drafted manuscript; ADL edited and revised manuscript; GF, DC, SF, LP, MZ, GP, and ADL approved final version of manuscript.

Corresponding author

Correspondence to Giorgio Faganello.

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Conflict of interest

GP is s senior scientific consultant for Medis Medical Imaging Systems BV (Leiden, The Netherlands). GF, DC, SF, LP, MZ and ADL have no conflict of interest to declare.

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Faganello, G., Collia, D., Furlotti, S. et al. A new integrated approach to cardiac mechanics: reference values for normal left ventricle. Int J Cardiovasc Imaging 36, 2173–2185 (2020). https://doi.org/10.1007/s10554-020-01934-1

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  • DOI: https://doi.org/10.1007/s10554-020-01934-1

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