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3D-wall motion tracking: a new tool for myocardial contractility analysis.

Perez de Isla, Leopoldo; Montes, Cesar; Monzón, Tania; Herrero, José; Saltijeral, Adriana; Balcones, David Vivas; de Agustin, Alberto; Nuñez-Gil, Ivan; Fernández-Golfín, Covadonga; Almería, Carlos; Rodrigo, José Luis; Marcos-Alberca, Pedro; Macaya, Carlos; Zamorano, Jose
Journal of Cardiovascular Medicine: Post Author Corrections: October 16, 2010
doi: 10.2459/JCM.0b013e3283405b9b
Original article: PDF Only

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/E 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.

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