Evaluation of myocardial work in normal adults of varying ages by left ventricular pressure-strain loop

doi:10.3877/cma.j.issn.1672-6448.2023.04.003

Abstract

Abstract:

Objective

To quantitatively evaluate myocardial work by left ventricular pressure-strain loop (LV-PSL) in normal adults of different ages and explore the relationship between myocardial work and age.

Methods

A total of 30 young volunteers (18-45 years old), 30 middle-aged volunteers (46-64 years old), and 30 elderly volunteers (≥65 years old) who underwent physical examination at the Second Affiliated Hospital of Anhui Medical University from July 2021 to September 2021 were selected. Routine ultrasonic parameters were collected. LV-PSL was used to evaluate left ventricular myocardial work parameters, including left ventricular global longitudinal strain (GLS), global work index (GWI), global constructive work (GCW), global work waste (GWW), and global work efficiency (GWE). The differences in these parameters among the age groups were compared.

Results

There was no significant difference in GLS, GWI, or GCW among normal adults of different age groups (P＞0.05 for all). However, GWW increased with increasing age, and it was significantly higher in the elderly group than in the young and middle-aged groups (P＜0.05 for both), while GWE decreased with increasing age, and GWE in the elderly group was significantly lower than that in the young and middle-aged groups (P＜0.05 for both). GWI was positively correlated with systolic blood pressure, GLS, and left ventricular ejection fraction (LVEF) (r=0.326, 0.608, and 0.315, respectively, P＜0.05 for all). GCW was also positively correlated with systolic blood pressure, GLS, and LVEF (r=0.308, 0.488, and 0.219, respectively, P＜0.05 for all). GWW was positively associated with systolic blood pressure, age, and late diastolic peak velocity (A) (r=0.265, 0.544, and 0.348, respectively, P＜0.05 for all) and negatively associated with early diastolic peak velocity (E), E/A, and early diastolic mitral annular motion velocity (e′) (r=-0.256, -0.452, and -0.324, respectively, P＜0.05 for all). GWE was positively correlated with GLS, E, E/A, and e′ (r=0.222, 0.322, 0.508, and 0.338, respectively, P＜0.05 for all) and negatively correlated with age and A (r=-0.595 and -0.350, respectively, P＜0.05 for both).

Conclusions

The non-invasive myocardial work parameters show a significant correlation with traditional left ventricular systolic and diastolic function parameters. With the increase in age, GWW has an upward and GWE has a downward trend. The influence of age should be contemplated in the evaluation of myocardial work parameters measured by LV-PSL.

Key words: Left ventricular pressure-strain loop, Myocardial work, Echocardiography, Ventricular function, Age

Ping Hu, Xiang Xie, Tingting Wu, Fan Jiang. Evaluation of myocardial work in normal adults of varying ages by left ventricular pressure-strain loop[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(04): 391-397.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2023.04.003

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Figures/Tables 7

组别	例数	身高（cm， $x ¯$ ±s）	体重（kg， $x ¯$ ±s）	体质量指数［kg/m²，M（Q_R）］	收缩压［mmHg，M（Q_R）］	舒张压［mmHg，M（Q_R）］	心率［次/min，M（Q_R）］
青年组	30	168.67±6.10	69.67±14.66	22.75（5.80）	120.50（22.50）	79.00（12.00）	74.50（20.00）
中年组	30	162.70±7.17^a	64.73±11.08	24.50（3.45）	125.00（12.50）	78.50（15.25）	71.50（12.50）
老年组	30	160.60±7.13^a	59.40±9.02^a	22.80（3.25）	128.50（20.75）	71.50（15.75）^b	69.00（9.50）^a
统计值		F=11.303	H=8.589	H=3.033	H=4.774	H=7.407	H=6.870
Ｐ值		＜0.001	0.014	0.219	0.092	0.025	0.032

组别	例数	身高（cm， $x ¯$ ±s）	体重（kg， $x ¯$ ±s）	体质量指数［kg/m²，M（Q_R）］	收缩压［mmHg，M（Q_R）］	舒张压［mmHg，M（Q_R）］	心率［次/min，M（Q_R）］
青年组	30	168.67±6.10	69.67±14.66	22.75（5.80）	120.50（22.50）	79.00（12.00）	74.50（20.00）
中年组	30	162.70±7.17^a	64.73±11.08	24.50（3.45）	125.00（12.50）	78.50（15.25）	71.50（12.50）
老年组	30	160.60±7.13^a	59.40±9.02^a	22.80（3.25）	128.50（20.75）	71.50（15.75）^b	69.00（9.50）^a
统计值		F=11.303	H=8.589	H=3.033	H=4.774	H=7.407	H=6.870
Ｐ值		＜0.001	0.014	0.219	0.092	0.025	0.032

组别	例数	LVEDD （cm， $x ¯$ ±s）	LVESV （ml， $x ¯$ ±s）	LVEDV ［ml，M（Q_R）］	LVEF （%， $x ¯$ ±s）	E（cm/s， $x ¯$ ±s）	A［cm/s，M（Q_R）］	e′［cm/s，M（Q_R）］	E/A ［M（Q_R）］	E/e′ ［M（Q_R）］
青年组	30	45.43±4.75	32.97±8.65	87.00（27.00）	62.63±3.93	89.2±21.41	63（23.25）	9（3.00）	1.39（0.45）	9.10（4.40）
中年组	30	43.93±3.90	26.43±9.20^a	66.00（27.25）^a	64.33±5.24	78.7±21.50^a	74（24.00）^a	7（3.25）^a	0.98（0.40）^a	10.70（4.43）
老年组	30	44.10±4.29	26.40±5.40^a	68.00（17.25）^a	61.87±4.36	63.9±15.91^ab	89（32.25）^a	7（2.25）^a	0.72（0.23）^ab	10.25（4.45）
统计值		F=1.081	H=11.514	H=13.208	F=2.317	F=12.387	H=15.158	H=26.1	H=42.869	H=3.237
P值		0.344	0.003	0.001	0.105	＜0.001	0.001	＜0.001	＜0.001	0.198

组别	例数	LVEDD （cm， $x ¯$ ±s）	LVESV （ml， $x ¯$ ±s）	LVEDV ［ml，M（Q_R）］	LVEF （%， $x ¯$ ±s）	E（cm/s， $x ¯$ ±s）	A［cm/s，M（Q_R）］	e′［cm/s，M（Q_R）］	E/A ［M（Q_R）］	E/e′ ［M（Q_R）］
青年组	30	45.43±4.75	32.97±8.65	87.00（27.00）	62.63±3.93	89.2±21.41	63（23.25）	9（3.00）	1.39（0.45）	9.10（4.40）
中年组	30	43.93±3.90	26.43±9.20^a	66.00（27.25）^a	64.33±5.24	78.7±21.50^a	74（24.00）^a	7（3.25）^a	0.98（0.40）^a	10.70（4.43）
老年组	30	44.10±4.29	26.40±5.40^a	68.00（17.25）^a	61.87±4.36	63.9±15.91^ab	89（32.25）^a	7（2.25）^a	0.72（0.23）^ab	10.25（4.45）
统计值		F=1.081	H=11.514	H=13.208	F=2.317	F=12.387	H=15.158	H=26.1	H=42.869	H=3.237
P值		0.344	0.003	0.001	0.105	＜0.001	0.001	＜0.001	＜0.001	0.198

组别	例数	GLS ［-%，M（Q_R）］	GWI （mmHg%， $x ¯$ ±s）	GCW （mmHg%， $x ¯$ ±s）	GWW ［mmHg%，M（Q_R）］	GWE ［%，M（Q_R）］
青年组	30	20.00（3.25）	2006.67±161.87	2276.73±114.53	99.50（42.00）	96.00（1.00）
中年组	30	21.00（3.00）	2074.73±244.79	2328.03±264.88	103.00（56.75）	95.00（2.00）
老年组	30	19.00（5.00）	1980.37±275.28	2376.13±235.74	158.00（112.5）^ab	93.00（3.50）^ab
统计值		H=1.878	H=2.456	H=2.724	H=28.434	H=31.797
P值		0.391	0.293	0.256	＜0.001	＜0.001

组别	例数	GLS ［-%，M（Q_R）］	GWI （mmHg%， $x ¯$ ±s）	GCW （mmHg%， $x ¯$ ±s）	GWW ［mmHg%，M（Q_R）］	GWE ［%，M（Q_R）］
青年组	30	20.00（3.25）	2006.67±161.87	2276.73±114.53	99.50（42.00）	96.00（1.00）
中年组	30	21.00（3.00）	2074.73±244.79	2328.03±264.88	103.00（56.75）	95.00（2.00）
老年组	30	19.00（5.00）	1980.37±275.28	2376.13±235.74	158.00（112.5）^ab	93.00（3.50）^ab
统计值		H=1.878	H=2.456	H=2.724	H=28.434	H=31.797
P值		0.391	0.293	0.256	＜0.001	＜0.001

参数	观察者内		观察者间
参数	ICC	95%CI	ICC	95%CI
GWI	0.939	0.776~0.985	0.907	0.671~0.976
GCW	0.932	0.752~0.983	0.896	0.639~0.973
GWW	0.887	0.612~0.971	0.843	0.490~0.959
GWE	0.866	0.552~0.965	0.830	0.457~0.955

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