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. 2022 Sep 9:10:1000556.
doi: 10.3389/fped.2022.1000556. eCollection 2022.

Normal ranges of non-invasive left ventricular myocardial work indices in healthy young people

Xiuxia Luo  1 , Quanrong Ge  1 , Jin Su  1 , Ning Zhou  1 , Ping Li  1 , Xu Xiao  1 , Yan Chen  1 , Dong Wang  1 , Yujing Ma  1 , Li Ma  1 , Yongsheng Zhu  1
Affiliations

Normal ranges of non-invasive left ventricular myocardial work indices in healthy young people

Xiuxia Luo et al. Front Pediatr. .

Abstract

Objectives: Echocardiographic global myocardial work (GMW) indices recently emerged to non-invasively evaluate left ventricular (LV) myocardial performance with less load-dependence than LV ejection fraction (LVEF) or global longitudinal strain (GLS). Yet, few data exist on the descriptions of LV GMW indices in young people. We therefore aimed to provide normal reference values of LV GMW in a healthy young cohort, and simultaneously to investigate factors associated with non-invasive GMW indices.

Materials and methods: A total of 155 healthy young people (age 10-24 years, 59% male) underwent transthoracic echocardiography were recruited and further stratified for age groups and divided by gender. Two-dimensional speckle-tracking echocardiography (2D-STE) were performed to determine LV GLS, peak strain dispersion (PSD) and GMW indices, which include global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE). LV peak systolic pressure was assumed to be equal to the systolic brachial artery cuff blood pressure.

Results: Age and gender specific normal ranges for LV GMW indices were presented. On multivariable analysis, GWI and GCW correlated more closely with systolic blood pressure (SBP) than LV GLS, while both GWW and GWE independently correlated with PSD (P < 0.05 for all). There were no associations between any of the GMW indices with age, sex, body mass index, heart rate, left ventricular mass index as well as LV sizes or LVEF. Of noted, LV GMW indices had good intra-observer and inter-observer reproducibility.

Conclusion: We reported echocardiographic reference ranges for non-invasive LV GMW indices in a large group of healthy young subjects, which are reproducible and reliable, and thus can be further used when assessing subclinical dysfunction in young people with myocardial diseases.

Keywords: echocardiography; myocardial strain; myocardial work; peak strain dispersion; two-dimensional speckle tracking imaging; young people.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Non-invasive determination of left ventricular (LV) myocardial work from echocardiography. Using automated function imaging (AFI) software, images of the apical long–axis (A), apical four– (B) and two–chamber (C) views were analyzed to determine LV global longitudinal strain (GLS) (D) and peak strain dispersion (PSD) (E). After adjusting the event timing of aortic and mitral valve closure and opening in the apical long-axis view and inputting the blood pressure (BP) value (F), the Bull’s-eye images of 17 LV segments for myocardial work index or myocardial work efficiency were presented with global myocardial work values (G), including global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE).
FIGURE 2
FIGURE 2
Relationship between left ventricular (LV) myocardial work indices and systolic blood pressure (SBP). Scatter plot presented the significantly positive correlation between LV global work index (GWI) (A) and global constructive work (GCW) (B) with SBP.
FIGURE 3
FIGURE 3
Relationship between left ventricular (LV) myocardial work indices and LV global longitudinal strain (GLS). Scatter plot presented the significantly negative correlation between LV global work index (GWI) (A) and global constructive work (GCW) (B) with LV GLS.
FIGURE 4
FIGURE 4
Relationship between left ventricular (LV) myocardial work indices and LV peak strain dispersion (PSD). Scatter plot showed that PSD was positively correlated to LV global wasted work (GWW) (A) while negatively correlated to global work efficiency (GWE) (B).
See this image and copyright information in PMC

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