The impact of preload reduction with head-up tilt testing on longitudinal and transverse left ventricular mechanics

Echo Research and Practice
Caroline SchneiderDavid Oxborough

Abstract

Left ventricular (LV) function is dependent on load, intrinsic contractility and relaxation with a variable impact on specific mechanics. Strain (ε) imaging allows the assessment of cardiac function however the direct relationship between volume and strain is currently unknown. The aim of this study was to establish the impact of preload reduction through head-up tilt (HUT) testing on simultaneous left ventricular (LV) longitudinal and transverse function and their respective contribution to volume change. A focused transthoracic echocardiogram was performed on 10 healthy male participants (23 ± 3 years,) in the supine position and following 1 min and 5 min of HUT testing. Raw temporal longitudinal ε (Ls) and transverse ε (Ts) values were exported and divided into 5% increments across the cardiac cycle and corresponding LV volumes were traced at each 5% increment. This provided simultaneous LV longitudinal and transverse ε and volume-loops (deformation-volume analysis - DVA). There was a leftward- shift of the ε -volume loop from supine to 1 min and 5 min of HUT, p<0.001). Moreover, longitudinal shortening was reduced (p<0.001) with a concomitant increase in transverse thickening from supine to 1min, which was further augmented...Continue Reading

References

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Jan 25, 2017·The Journal of Physiology·Hugo G HulshofDavid L Oxborough

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Citations

Feb 6, 2020·American Journal of Physiology. Regulatory, Integrative and Comparative Physiology·Hugo G HulshofDick H J Thijssen
Jan 10, 2021·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Frederik Fasth GrundRasmus Mogelvang

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