3D-wall motion tracking: a new tool for myocardial contractility analysis.
BACKGROUND: Left-ventricular ejection fraction (LVEF), the most frequently used parameter to evaluate left ventricular (LV) systolic function, depends not only on LV contractility, but also on different variables such as pre-load and after-load. Three-dimensional wall motion tracking echocardiography (3D-WMT) is a new technique that provides information regarding different new parameters of LV systolic function. Our aim was to evaluate whether the new 3D-WMT-derived LV systolic function parameters are less dependent on load conditions than LVEF. METHODS: In order to modify the load conditions to study the dependence of the different LV systolic function parameters on them, a group of renal failure patients under chronic hemodialysis treatment was selected. The echocardiographic studies, including the 3D-WMT analysis, were performed immediately before and immediately after the hemodialysis session. RESULTS: Thirty-one consecutive patients were enrolled (mean age 65.5 ± 17.0 years; 74.2% men). There was a statistically significant change in predialysis and postdialysis, pre-load and after-load conditions (E/È ratio and systolic blood pressure) and in the LV end-diastolic volume and LVEF. Nevertheless, the findings did not show any significant change before and after dialysis in the 3D-WMT-derived parameters. CONCLUSIONS: LV 3D-wall motion tracking-derived systolic function parameters are less dependent on load conditions than LVEF. They might measure myocardial contractility in a more direct way than LVEF. Thus, hypothetically, they might be useful to detect early and subtle contractility impairments in a wide number of cardiac patients and they could help to optimize the clinical management of such patients.
Hospital Clínico San Carlos, Madrid, Spain.
Leopoldo
L
Perez de Isla
Cesar
C
Montes
Tania
T
Monzón
José
J
Herrero
Adriana
A
Saltijeral
David Vivas
DV
Balcones
Alberto
A
de Agustin
Ivan
I
Nuñez-Gil
Covadonga
C
Fernández-Golfín
Carlos
C
Almería
José Luis
JL
Rodrigo
Pedro
P
Marcos-Alberca
Carlos
C
Macaya
Jose
J
Zamorano