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Longitudinal shortening remains the principal component of left ventricular pumping in patients with chronic myocardial infarction even when the absolute atrioventricular plane displacement is decreased

Asgeirsson, Daniel LU ; Hedström, Erik LU ; Jögi, Jonas LU ; Pahlm, Ulrika LU ; Steding-Ehrenborg, Katarina LU ; Engblom, Henrik LU ; Arheden, Håkan LU and Carlsson, Marcus LU (2017) In BMC Cardiovascular Disorders 17(1).
Abstract

Background: The majority (60%) of left ventricular (LV) stroke volume (SV) is generated by longitudinal shortening causing apical atrioventricular plane displacement (AVPD) in systole. The remaining SV is caused by radial inward motion of the epicardium both in the septal and the lateral wall. We aimed to determine if these longitudinal, septal and lateral contributions to LVSV are changed in patients with chronic myocardial infarction (MI). Methods: Patients with a chronic (>3 months) ST-elevation MI in the left anterior descending (LAD, n = 20) or right coronary artery (RCA, n = 16) and healthy controls (n = 20) were examined with cardiovascular magnetic resonance (CMR). AVPD was quantified in long axis cine CMR images and LV... (More)

Background: The majority (60%) of left ventricular (LV) stroke volume (SV) is generated by longitudinal shortening causing apical atrioventricular plane displacement (AVPD) in systole. The remaining SV is caused by radial inward motion of the epicardium both in the septal and the lateral wall. We aimed to determine if these longitudinal, septal and lateral contributions to LVSV are changed in patients with chronic myocardial infarction (MI). Methods: Patients with a chronic (>3 months) ST-elevation MI in the left anterior descending (LAD, n = 20) or right coronary artery (RCA, n = 16) and healthy controls (n = 20) were examined with cardiovascular magnetic resonance (CMR). AVPD was quantified in long axis cine CMR images and LV volumes and dimensions in short axis cine images. Results: AVPD was decreased both in patients with LAD-MI (11 ± 1 mm, p < 0.001) and RCA-MI (13 ± 1 mm, p < 0.05) compared to controls (15 ± 0 mm). However, the longitudinal contribution to SV was unchanged for both LAD-MI (58 ± 3%, p = 0.08) and RCA-MI (59 ± 3%, p = 0.09) compared to controls (64 ± 2%). The preserved longitudinal contribution despite decreased absolute AVPD was a results of increased epicardial dimensions (p < 0.01 for LAD-MI and p = 0.06 for RCA-MI). In LAD-MI the septal contribution to LVSV was decreased (5 ± 1%) compared to both controls (10 ± 1%, p < 0.01) and patients with RCA-MIs (10 ± 1%, p < 0.01). The lateral contribution was increased in LAD-MI patients (44 ± 3%) compared to both RCA-MI (35 ± 2%, p < 0.05) and controls (29 ± 2%, p < 0.001). Conclusion: Longitudinal shortening remains the principal component of left ventricular pumping in patients with chronic MI even when the absolute AVPD is decreased.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cardiac output, Cardiac pumping, Heart failure, Late gadolinium enhancement, Mitral annular plane systolic excursion, Regional function
in
BMC Cardiovascular Disorders
volume
17
issue
1
publisher
BioMed Central
external identifiers
  • scopus:85026424040
  • wos:000406577300001
ISSN
1471-2261
DOI
10.1186/s12872-017-0641-z
language
English
LU publication?
yes
id
fcd5c1a3-a700-4fd9-8398-a5481948b9fa
date added to LUP
2017-08-24 14:10:14
date last changed
2017-09-18 11:42:57
@article{fcd5c1a3-a700-4fd9-8398-a5481948b9fa,
  abstract     = {<p>Background: The majority (60%) of left ventricular (LV) stroke volume (SV) is generated by longitudinal shortening causing apical atrioventricular plane displacement (AVPD) in systole. The remaining SV is caused by radial inward motion of the epicardium both in the septal and the lateral wall. We aimed to determine if these longitudinal, septal and lateral contributions to LVSV are changed in patients with chronic myocardial infarction (MI). Methods: Patients with a chronic (&gt;3 months) ST-elevation MI in the left anterior descending (LAD, n = 20) or right coronary artery (RCA, n = 16) and healthy controls (n = 20) were examined with cardiovascular magnetic resonance (CMR). AVPD was quantified in long axis cine CMR images and LV volumes and dimensions in short axis cine images. Results: AVPD was decreased both in patients with LAD-MI (11 ± 1 mm, p &lt; 0.001) and RCA-MI (13 ± 1 mm, p &lt; 0.05) compared to controls (15 ± 0 mm). However, the longitudinal contribution to SV was unchanged for both LAD-MI (58 ± 3%, p = 0.08) and RCA-MI (59 ± 3%, p = 0.09) compared to controls (64 ± 2%). The preserved longitudinal contribution despite decreased absolute AVPD was a results of increased epicardial dimensions (p &lt; 0.01 for LAD-MI and p = 0.06 for RCA-MI). In LAD-MI the septal contribution to LVSV was decreased (5 ± 1%) compared to both controls (10 ± 1%, p &lt; 0.01) and patients with RCA-MIs (10 ± 1%, p &lt; 0.01). The lateral contribution was increased in LAD-MI patients (44 ± 3%) compared to both RCA-MI (35 ± 2%, p &lt; 0.05) and controls (29 ± 2%, p &lt; 0.001). Conclusion: Longitudinal shortening remains the principal component of left ventricular pumping in patients with chronic MI even when the absolute AVPD is decreased.</p>},
  articleno    = {208},
  author       = {Asgeirsson, Daniel and Hedström, Erik and Jögi, Jonas and Pahlm, Ulrika and Steding-Ehrenborg, Katarina and Engblom, Henrik and Arheden, Håkan and Carlsson, Marcus},
  issn         = {1471-2261},
  keyword      = {Cardiac output,Cardiac pumping,Heart failure,Late gadolinium enhancement,Mitral annular plane systolic excursion,Regional function},
  language     = {eng},
  month        = {07},
  number       = {1},
  publisher    = {BioMed Central},
  series       = {BMC Cardiovascular Disorders},
  title        = {Longitudinal shortening remains the principal component of left ventricular pumping in patients with chronic myocardial infarction even when the absolute atrioventricular plane displacement is decreased},
  url          = {http://dx.doi.org/10.1186/s12872-017-0641-z},
  volume       = {17},
  year         = {2017},
}