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.
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.
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.
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
Received 8 April, 2010
Revised 26 August, 2010
Accepted 5 September, 2010
Correspondence to Leopoldo Pérez de Isla, Unidad de Imagen Cardiovascular, Hospital Clínico San Carlos, Plaza Cristo Rey, 28040-Madrid, Spain Tel: +34 913303290; fax: +34 913303290; e-mail: email@example.com