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Short-axis epicardial volume change is a measure of cardiac left ventricular short-axis function which is independent of myocardial wall thickness.

Ugander, Martin LU ; Carlsson, Marcus LU and Arheden, Håkan LU (2010) In American Journal of Physiology: Heart and Circulatory Physiology 298(2). p.530-535
Abstract
BACKGROUND: Fractional shortening (FS) by echocardiography is considered to represent the short-axis contribution to the stroke volume (SV), also called short-axis function. However, FS is mathematically coupled to the amount of myocardium, since it rearranges during atrioventricular plane displacement (AVPD). The SV is the sum of the volumes generated by 1) reduction in outer volume of the heart, and 2) inner AVPD. The long-axis contribution to the SV is generated by AVPD, and thus the short-axis contribution is the remaining outer volume change of the heart, which should be unrelated to myocardial wall thickness. We hypothesized that both endocardial and midwall shortening indexed to SV are dependent on myocardial wall thickness, whereas... (More)
BACKGROUND: Fractional shortening (FS) by echocardiography is considered to represent the short-axis contribution to the stroke volume (SV), also called short-axis function. However, FS is mathematically coupled to the amount of myocardium, since it rearranges during atrioventricular plane displacement (AVPD). The SV is the sum of the volumes generated by 1) reduction in outer volume of the heart, and 2) inner AVPD. The long-axis contribution to the SV is generated by AVPD, and thus the short-axis contribution is the remaining outer volume change of the heart, which should be unrelated to myocardial wall thickness. We hypothesized that both endocardial and midwall shortening indexed to SV are dependent on myocardial wall thickness, whereas epicardial volume change (EVC) indexed to SV is not. METHOD: Twelve normals, 12 athletes and 12 patients with dilated cardiomyopathy (ejection fraction<30%) underwent cine cardiac magnetic resonance imaging. Left ventricular long-axis function was measured as the portion of the stroke volume, in ml, generated by AVPD. EVC was defined as SV minus long-axis function. Endocardial and midwall shortening were measured in a midventricular short-axis slice. RESULTS: Endocardial shortening/SV and midwall shortening/SV both varied in relation to end-diastolic myocardial wall thickness (R(2)=0.16, p=0.008 and R(2)=0.14, p=0.012, respectively) whereas EVC/SV did not (R(2)=0.00, p=0.37). CONCLUSIONS: FS is dependent on myocardial wall thickness while EVC is not and therefore represents true short-axis function. This is not surprising considering that FS is mainly caused by rearrangement of myocardium secondary to long-axis function. FS is therefore not synonymous with short-axis function. Key words: cardiac short-axis function, fractional shortening, left ventricle, echocardiography. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
left ventricle, fractional shortening, cardiac short-axis function, echocardiography
in
American Journal of Physiology: Heart and Circulatory Physiology
volume
298
issue
2
pages
530 - 535
publisher
American Physiological Society
external identifiers
  • wos:000273780400029
  • pmid:19933422
  • scopus:74949136191
ISSN
1522-1539
DOI
10.1152/ajpheart.00153.2009
language
English
LU publication?
yes
id
e103989e-cff0-4de0-8e55-146ec11f8711 (old id 1511626)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/19933422?dopt=Abstract
date added to LUP
2009-12-07 11:06:53
date last changed
2018-05-29 09:47:17
@article{e103989e-cff0-4de0-8e55-146ec11f8711,
  abstract     = {BACKGROUND: Fractional shortening (FS) by echocardiography is considered to represent the short-axis contribution to the stroke volume (SV), also called short-axis function. However, FS is mathematically coupled to the amount of myocardium, since it rearranges during atrioventricular plane displacement (AVPD). The SV is the sum of the volumes generated by 1) reduction in outer volume of the heart, and 2) inner AVPD. The long-axis contribution to the SV is generated by AVPD, and thus the short-axis contribution is the remaining outer volume change of the heart, which should be unrelated to myocardial wall thickness. We hypothesized that both endocardial and midwall shortening indexed to SV are dependent on myocardial wall thickness, whereas epicardial volume change (EVC) indexed to SV is not. METHOD: Twelve normals, 12 athletes and 12 patients with dilated cardiomyopathy (ejection fraction&lt;30%) underwent cine cardiac magnetic resonance imaging. Left ventricular long-axis function was measured as the portion of the stroke volume, in ml, generated by AVPD. EVC was defined as SV minus long-axis function. Endocardial and midwall shortening were measured in a midventricular short-axis slice. RESULTS: Endocardial shortening/SV and midwall shortening/SV both varied in relation to end-diastolic myocardial wall thickness (R(2)=0.16, p=0.008 and R(2)=0.14, p=0.012, respectively) whereas EVC/SV did not (R(2)=0.00, p=0.37). CONCLUSIONS: FS is dependent on myocardial wall thickness while EVC is not and therefore represents true short-axis function. This is not surprising considering that FS is mainly caused by rearrangement of myocardium secondary to long-axis function. FS is therefore not synonymous with short-axis function. Key words: cardiac short-axis function, fractional shortening, left ventricle, echocardiography.},
  author       = {Ugander, Martin and Carlsson, Marcus and Arheden, Håkan},
  issn         = {1522-1539},
  keyword      = {left ventricle,fractional shortening,cardiac short-axis function,echocardiography},
  language     = {eng},
  number       = {2},
  pages        = {530--535},
  publisher    = {American Physiological Society},
  series       = {American Journal of Physiology: Heart and Circulatory Physiology},
  title        = {Short-axis epicardial volume change is a measure of cardiac left ventricular short-axis function which is independent of myocardial wall thickness.},
  url          = {http://dx.doi.org/10.1152/ajpheart.00153.2009},
  volume       = {298},
  year         = {2010},
}