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Comparison of echocardiographic methods for assessment of left ventricular shortening and wall stress.

Publication ,  Journal Article
Douglas, PS; Reichek, N; Plappert, T; Muhammad, A; St John Sutton, MG
Published in: J Am Coll Cardiol
April 1987

M-mode echocardiographic measurement of left ventricular fractional shortening and meridional wall stress has been used extensively alone and in combination to describe left ventricular systolic function. To determine whether the improved dimensional information afforded by two-dimensional echocardiography might result in shortening and stress calculations yielding a different view of left ventricular function, we compared two-dimensional and M-mode echocardiograms in 69 subjects (19 normal, 13 with aortic stenosis, 22 with aortic regurgitation and 15 with congestive cardiomyopathy). Fractional shortening was greater with M-mode than with two-dimensional echocardiography in all subjects, especially in those with cardiomyopathy (p less than 0.05). In aortic stenosis, two-dimensional shortening, at 24 +/- 5%, was reduced (p less than 0.05 versus normal), but M-mode shortening, at 34 +/- 5%, was not. M-mode estimates of meridional stress were higher than two-dimensional values, again especially in cardiomyopathy. Two-dimensional echocardiography enabled determination of long- and short-axis ratios, circumferential stress and the ratio of circumferential to meridional stresses. Circumferential stress was elevated in aortic stenosis at 302 +/- 65 X 10(3) dynes/cm2, suggesting afterload excess as the cause for the observed reduction in two-dimensional shortening. The more spherical cardiomyopathic hearts had a meridional to circumferential stress ratio closer to 1, such that use of meridional stress alone would overestimate effective afterload. It is concluded that M-mode and two-dimensional echocardiographic analyses of left ventricular shortening and stress produce different results. Two-dimensional echocardiographic methods may enhance the assessment of ventricular function, especially in patients with aortic stenosis and cardiomyopathy.

Duke Scholars

Published In

J Am Coll Cardiol

DOI

ISSN

0735-1097

Publication Date

April 1987

Volume

9

Issue

4

Start / End Page

945 / 951

Location

United States

Related Subject Headings

  • Ventricular Function
  • Myocardial Contraction
  • Middle Aged
  • Male
  • Humans
  • Heart Ventricles
  • Heart Diseases
  • Heart
  • Female
  • Echocardiography
 

Citation

APA
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ICMJE
MLA
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Douglas, P. S., Reichek, N., Plappert, T., Muhammad, A., & St John Sutton, M. G. (1987). Comparison of echocardiographic methods for assessment of left ventricular shortening and wall stress. J Am Coll Cardiol, 9(4), 945–951. https://doi.org/10.1016/s0735-1097(87)80253-x
Douglas, P. S., N. Reichek, T. Plappert, A. Muhammad, and M. G. St John Sutton. “Comparison of echocardiographic methods for assessment of left ventricular shortening and wall stress.J Am Coll Cardiol 9, no. 4 (April 1987): 945–51. https://doi.org/10.1016/s0735-1097(87)80253-x.
Douglas PS, Reichek N, Plappert T, Muhammad A, St John Sutton MG. Comparison of echocardiographic methods for assessment of left ventricular shortening and wall stress. J Am Coll Cardiol. 1987 Apr;9(4):945–51.
Douglas, P. S., et al. “Comparison of echocardiographic methods for assessment of left ventricular shortening and wall stress.J Am Coll Cardiol, vol. 9, no. 4, Apr. 1987, pp. 945–51. Pubmed, doi:10.1016/s0735-1097(87)80253-x.
Douglas PS, Reichek N, Plappert T, Muhammad A, St John Sutton MG. Comparison of echocardiographic methods for assessment of left ventricular shortening and wall stress. J Am Coll Cardiol. 1987 Apr;9(4):945–951.
Journal cover image

Published In

J Am Coll Cardiol

DOI

ISSN

0735-1097

Publication Date

April 1987

Volume

9

Issue

4

Start / End Page

945 / 951

Location

United States

Related Subject Headings

  • Ventricular Function
  • Myocardial Contraction
  • Middle Aged
  • Male
  • Humans
  • Heart Ventricles
  • Heart Diseases
  • Heart
  • Female
  • Echocardiography