Correlation between non-invasive myocardial work indices and main parameters of systolic and diastolic function: results from the EACVI NORRE study

Roberta Manganaro, Stella Marchetta, Raluca Dulgheru, Tadafumi Sugimoto, Toshimitsu Tsugu, Federica Ilardi, Marianna Cicenia, Arnaud Ancion, Adriana Postolache, Christophe Martinez, George Kacharava, George D Athanassopoulos, Daniele Barone, Monica Baroni, Nuno Cardim, Andreas Hagendorff, Krasimira Hristova, Teresa Lopez, Gonzalo de la Morena, Bogdan A PopescuMartin Penicka, Tolga Ozyigit, Jose David Rodrigo Carbonero, Nico van de Veire, Ralph Stephan Von Bardeleben, Dragos Vinereanu, Jose Luis Zamorano, Monica Rosca, Andreea Calin, Marie Moonen, Julien Magne, Bernard Cosyns, Elena Galli, Erwan Donal, Scipione Carerj, Concetta Zito, Ciro Santoro, Maurizio Galderisi, Luigi P Badano, Roberto M Lang, Patrizio Lancellotti

Research output: Contribution to journalArticlepeer-review


AIMS: The present study sought to evaluate the correlation between indices of non-invasive myocardial work (MW) and left ventricle (LV) size, traditional and advanced parameters of LV systolic and diastolic function by 2D echocardiography (2DE).

METHODS AND RESULTS: A total of 226 (85 men, mean age: 45 ± 13 years) healthy subjects were enrolled at 22 collaborating institutions of the Normal Reference Ranges for Echocardiography (NORRE) study. Global work index (GWI), global constructive work (GCW), global work waste (GWW), and global work efficiency (GWE) were estimated from LV pressure-strain loops using custom software. Peak LV pressure was estimated non-invasively from brachial artery cuff pressure. LV size, parameters of systolic and diastolic function and ventricular-arterial coupling were measured by echocardiography. As advanced indices of myocardial performance, global longitudinal strain (GLS), global circumferential strain (GCS), and global radial strain (GRS) were obtained. On multivariable analysis, GWI was significantly correlated with GLS (standardized beta-coefficient = -0.23, P < 0.001), ejection fraction (EF) (standardized beta-coefficient = 0.15, P = 0.02), systolic blood pressure (SBP) (standardized beta-coefficient = 0.56, P < 0.001) and GRS (standardized beta-coefficient = 0.19, P = 0.004), while GCW was correlated with GLS (standardized beta-coefficient = -0.55, P < 0.001), SBP (standardized beta-coefficient = 0.71, P < 0.001), GRS (standardized beta-coefficient = 0.11, P = 0.02), and GCS (standardized beta-coefficient = -0.10, P = 0.01). GWE was directly correlated with EF and inversely correlated with Tei index (standardized beta-coefficient = 0.18, P = 0.009 and standardized beta-coefficient = -0.20, P = 0.004, respectively), the opposite occurred for GWW (standardized beta-coefficient =--0.14, P = 0.03 and standardized beta-coefficient = 0.17, P = 0.01, respectively).

CONCLUSION: The non-invasive MW indices show a good correlation with traditional 2DE parameters of myocardial systolic function and myocardial strain.

Original languageEnglish
JournalEuropean Heart Journal Cardiovascular Imaging
Publication statusE-pub ahead of print - Aug 13 2019


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