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Orthostatic effects on echocardiographic measures of ventricular function.

Publication ,  Journal Article
Rowland, T; Unnithan, V; Barker, P; Guerra, M; Roche, D; Lindley, M
Published in: Echocardiography
May 2012

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.

Duke Scholars

Published In

Echocardiography

DOI

EISSN

1540-8175

Publication Date

May 2012

Volume

29

Issue

5

Start / End Page

523 / 527

Location

United States

Related Subject Headings

  • Ventricular Function, Left
  • Stroke Volume
  • Posture
  • Male
  • Humans
  • Heart Ventricles
  • Echocardiography
  • Cardiovascular System & Hematology
  • Adolescent
  • 3201 Cardiovascular medicine and haematology
 

Citation

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Rowland, T., Unnithan, V., Barker, P., Guerra, M., Roche, D., & Lindley, M. (2012). Orthostatic effects on echocardiographic measures of ventricular function. Echocardiography, 29(5), 523–527. https://doi.org/10.1111/j.1540-8175.2011.01634.x
Rowland, Thomas, Viswanath Unnithan, Piers Barker, Miriam Guerra, Denise Roche, and Martin Lindley. “Orthostatic effects on echocardiographic measures of ventricular function.Echocardiography 29, no. 5 (May 2012): 523–27. https://doi.org/10.1111/j.1540-8175.2011.01634.x.
Rowland T, Unnithan V, Barker P, Guerra M, Roche D, Lindley M. Orthostatic effects on echocardiographic measures of ventricular function. Echocardiography. 2012 May;29(5):523–7.
Rowland, Thomas, et al. “Orthostatic effects on echocardiographic measures of ventricular function.Echocardiography, vol. 29, no. 5, May 2012, pp. 523–27. Pubmed, doi:10.1111/j.1540-8175.2011.01634.x.
Rowland T, Unnithan V, Barker P, Guerra M, Roche D, Lindley M. Orthostatic effects on echocardiographic measures of ventricular function. Echocardiography. 2012 May;29(5):523–527.
Journal cover image

Published In

Echocardiography

DOI

EISSN

1540-8175

Publication Date

May 2012

Volume

29

Issue

5

Start / End Page

523 / 527

Location

United States

Related Subject Headings

  • Ventricular Function, Left
  • Stroke Volume
  • Posture
  • Male
  • Humans
  • Heart Ventricles
  • Echocardiography
  • Cardiovascular System & Hematology
  • Adolescent
  • 3201 Cardiovascular medicine and haematology