Orthostatic effects on echocardiographic measures of ventricular function.

Published

Journal Article

Orthostatic-induced alterations in Doppler echocardiographic measures of ventricular function have not been well-defined. Identifying such changes may provide useful insights regarding the responses of these measures to variations in ventricular loading conditions. Standard assessment of mitral inflow velocity and tissue Doppler imaging (TDI) of left ventricular longitudinal myocardial velocities was performed on 14 young males (mean age 17.9 ± 0.7 years) in the supine position and then 5 minutes after assuming a sitting position with legs dependent. Upon sitting, average values of stroke volume and cardiac output fell by 28% and 18%, respectively, while heart rate increased from 64 ± 10 to 73 ± 12 beats/min (+14%) and calculated systemic vascular resistance rose from 12.9 ± 2.2 to 16.4 ± 3.1 units (+27%). Mitral E peak velocity declined from 87 ± 16 to 64 ± 16 cm/sec, and average TDI-E' and TDI-S both decreased (by -44% and -20%, respectively). When adjusted for orthostatic decreases in left ventricular end-diastolic volume, the mean decrease in TDI-E' was reduced to -29 (P < 0.01), but no significant decline was observed in adjusted TDI-S. Average E/E' rose with sitting by 40% (P = 0.02). These findings suggest that (a) decreases in TDI measures when assuming the upright position reflect the reduction of left ventricular size; (b) orthostatic fall in TDI-E' is also related to smaller ventricular size but, in addition, to a nonspecified reduction in ventricular relaxation; and (c) values of E/E' do not reflect alterations in ventricular preload, which occur during an orthostatic challenge.

Full Text

Duke Authors

Cited Authors

  • Rowland, T; Unnithan, V; Barker, P; Guerra, M; Roche, D; Lindley, M

Published Date

  • May 2012

Published In

Volume / Issue

  • 29 / 5

Start / End Page

  • 523 - 527

PubMed ID

  • 22329868

Pubmed Central ID

  • 22329868

Electronic International Standard Serial Number (EISSN)

  • 1540-8175

International Standard Serial Number (ISSN)

  • 0742-2822

Digital Object Identifier (DOI)

  • 10.1111/j.1540-8175.2011.01634.x

Language

  • eng