Regional left ventricular systolic function in relation to the cavity geometry in patients with chronic right ventricular pressure overload: A three-dimensional tagged magnetic resonance imaging study

S. J. Dong, A. P. Crawley, J. H. MacGregor, Y. F. Petrank, D. W. Bergman, I. Belenkie, E. R. Smith, J. V. Tyberg, R. Beyar

Research output: Contribution to journalArticle

Abstract

Background: Distortion of the left ventricular (LV) cavity in patients with right ventricular pressure overload (RVPO) is well known. However, no direct measurements of regional myocardial function in terms of myocardial shortening and wall thickening are available; therefore, exactly how RVPO disturbs LV regional performance remains unclear. By using three-dimensional (3D) tagged magnetic resonance imaging, we were able to measure regional systolic function directly. Our objective was to study the relation between the distortion of the LV circular shape and regional LV function. Methods and Results: In nine patients with RVPO and six healthy volunteers, four parallel short-axis images (with 12 radial tags) and two mutually orthogonal long- axis images (with four parallel tags) were generated, and endocardial and epicardial borders were manually traced. By integration of the short- and long-axis images, 3D reconstruction of the LV tracking points from end diastole to end systole was obtained. Data from the midventricular two short- axis image slices were analyzed. These were then divided into anterior, lateral, posterior, and septal regions. Circumferential and longitudinal shortening were then calculated from the endocardial and epicardial tag intersection points. Wall thickness and thickening were calculated by the 3D volume-element approach. An eccentricity index (EI), the ratio of septum-to- free-wall to anteroposterior diameters, was used to describe the shape of the LV cavity. The regional curvature was also measured. The RVPO group was characterized by flattening of the septum and LV lateral wall, decreased EI reflecting the distorted LV shape, altered distribution of endocardial circumferential shortening, and preserved ejection fraction. Changes in EI closely correlated with the septal curvature. The EI was smaller at end systole, reflecting further shape distortion relative to end diastole. Reduced myocardial performance, as measured by wall thickening and circumferential and longitudinal shortening fractions, was observed for the septum. A reduction in endocardial circumferential shortening of the septal and lateral walls was directly related to the end-systolic EI. In addition, whereas for healthy subjects a linear relation between area ejection fraction and endocardial circumferential shortening was observed, in RVPO patients a curvilinear (quadratic) relation was observed. Conclusions: In patients with RVPO, compared with healthy subjects, the septal function was reduced, as evidenced by reduced thickening and shortening fractions. The distortion in LV cavity at end systole due to the flattening of the septum contributes to preserved systolic ventricular function and nonuniform distribution in endocardial circumferential shortening.

Original languageEnglish (US)
Pages (from-to)2359-2370
Number of pages12
JournalCirculation
Volume91
Issue number9
StatePublished - 1995
Externally publishedYes

Fingerprint

Ventricular Pressure
Left Ventricular Function
Magnetic Resonance Imaging
Systole
Patient Rights
Healthy Volunteers
Diastole
Septum of Brain
Ventricular Septum
Computer-Assisted Image Processing
Ventricular Function

Keywords

  • magnetic resonance imaging
  • pressure
  • systole
  • ventricles

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Regional left ventricular systolic function in relation to the cavity geometry in patients with chronic right ventricular pressure overload : A three-dimensional tagged magnetic resonance imaging study. / Dong, S. J.; Crawley, A. P.; MacGregor, J. H.; Petrank, Y. F.; Bergman, D. W.; Belenkie, I.; Smith, E. R.; Tyberg, J. V.; Beyar, R.

In: Circulation, Vol. 91, No. 9, 1995, p. 2359-2370.

Research output: Contribution to journalArticle

Dong, SJ, Crawley, AP, MacGregor, JH, Petrank, YF, Bergman, DW, Belenkie, I, Smith, ER, Tyberg, JV & Beyar, R 1995, 'Regional left ventricular systolic function in relation to the cavity geometry in patients with chronic right ventricular pressure overload: A three-dimensional tagged magnetic resonance imaging study', Circulation, vol. 91, no. 9, pp. 2359-2370.
Dong, S. J. ; Crawley, A. P. ; MacGregor, J. H. ; Petrank, Y. F. ; Bergman, D. W. ; Belenkie, I. ; Smith, E. R. ; Tyberg, J. V. ; Beyar, R. / Regional left ventricular systolic function in relation to the cavity geometry in patients with chronic right ventricular pressure overload : A three-dimensional tagged magnetic resonance imaging study. In: Circulation. 1995 ; Vol. 91, No. 9. pp. 2359-2370.
@article{edd655fc8fab451b8654430f6b30efbd,
title = "Regional left ventricular systolic function in relation to the cavity geometry in patients with chronic right ventricular pressure overload: A three-dimensional tagged magnetic resonance imaging study",
abstract = "Background: Distortion of the left ventricular (LV) cavity in patients with right ventricular pressure overload (RVPO) is well known. However, no direct measurements of regional myocardial function in terms of myocardial shortening and wall thickening are available; therefore, exactly how RVPO disturbs LV regional performance remains unclear. By using three-dimensional (3D) tagged magnetic resonance imaging, we were able to measure regional systolic function directly. Our objective was to study the relation between the distortion of the LV circular shape and regional LV function. Methods and Results: In nine patients with RVPO and six healthy volunteers, four parallel short-axis images (with 12 radial tags) and two mutually orthogonal long- axis images (with four parallel tags) were generated, and endocardial and epicardial borders were manually traced. By integration of the short- and long-axis images, 3D reconstruction of the LV tracking points from end diastole to end systole was obtained. Data from the midventricular two short- axis image slices were analyzed. These were then divided into anterior, lateral, posterior, and septal regions. Circumferential and longitudinal shortening were then calculated from the endocardial and epicardial tag intersection points. Wall thickness and thickening were calculated by the 3D volume-element approach. An eccentricity index (EI), the ratio of septum-to- free-wall to anteroposterior diameters, was used to describe the shape of the LV cavity. The regional curvature was also measured. The RVPO group was characterized by flattening of the septum and LV lateral wall, decreased EI reflecting the distorted LV shape, altered distribution of endocardial circumferential shortening, and preserved ejection fraction. Changes in EI closely correlated with the septal curvature. The EI was smaller at end systole, reflecting further shape distortion relative to end diastole. Reduced myocardial performance, as measured by wall thickening and circumferential and longitudinal shortening fractions, was observed for the septum. A reduction in endocardial circumferential shortening of the septal and lateral walls was directly related to the end-systolic EI. In addition, whereas for healthy subjects a linear relation between area ejection fraction and endocardial circumferential shortening was observed, in RVPO patients a curvilinear (quadratic) relation was observed. Conclusions: In patients with RVPO, compared with healthy subjects, the septal function was reduced, as evidenced by reduced thickening and shortening fractions. The distortion in LV cavity at end systole due to the flattening of the septum contributes to preserved systolic ventricular function and nonuniform distribution in endocardial circumferential shortening.",
keywords = "magnetic resonance imaging, pressure, systole, ventricles",
author = "Dong, {S. J.} and Crawley, {A. P.} and MacGregor, {J. H.} and Petrank, {Y. F.} and Bergman, {D. W.} and I. Belenkie and Smith, {E. R.} and Tyberg, {J. V.} and R. Beyar",
year = "1995",
language = "English (US)",
volume = "91",
pages = "2359--2370",
journal = "Circulation",
issn = "0009-7322",
publisher = "Lippincott Williams and Wilkins",
number = "9",

}

TY - JOUR

T1 - Regional left ventricular systolic function in relation to the cavity geometry in patients with chronic right ventricular pressure overload

T2 - A three-dimensional tagged magnetic resonance imaging study

AU - Dong, S. J.

AU - Crawley, A. P.

AU - MacGregor, J. H.

AU - Petrank, Y. F.

AU - Bergman, D. W.

AU - Belenkie, I.

AU - Smith, E. R.

AU - Tyberg, J. V.

AU - Beyar, R.

PY - 1995

Y1 - 1995

N2 - Background: Distortion of the left ventricular (LV) cavity in patients with right ventricular pressure overload (RVPO) is well known. However, no direct measurements of regional myocardial function in terms of myocardial shortening and wall thickening are available; therefore, exactly how RVPO disturbs LV regional performance remains unclear. By using three-dimensional (3D) tagged magnetic resonance imaging, we were able to measure regional systolic function directly. Our objective was to study the relation between the distortion of the LV circular shape and regional LV function. Methods and Results: In nine patients with RVPO and six healthy volunteers, four parallel short-axis images (with 12 radial tags) and two mutually orthogonal long- axis images (with four parallel tags) were generated, and endocardial and epicardial borders were manually traced. By integration of the short- and long-axis images, 3D reconstruction of the LV tracking points from end diastole to end systole was obtained. Data from the midventricular two short- axis image slices were analyzed. These were then divided into anterior, lateral, posterior, and septal regions. Circumferential and longitudinal shortening were then calculated from the endocardial and epicardial tag intersection points. Wall thickness and thickening were calculated by the 3D volume-element approach. An eccentricity index (EI), the ratio of septum-to- free-wall to anteroposterior diameters, was used to describe the shape of the LV cavity. The regional curvature was also measured. The RVPO group was characterized by flattening of the septum and LV lateral wall, decreased EI reflecting the distorted LV shape, altered distribution of endocardial circumferential shortening, and preserved ejection fraction. Changes in EI closely correlated with the septal curvature. The EI was smaller at end systole, reflecting further shape distortion relative to end diastole. Reduced myocardial performance, as measured by wall thickening and circumferential and longitudinal shortening fractions, was observed for the septum. A reduction in endocardial circumferential shortening of the septal and lateral walls was directly related to the end-systolic EI. In addition, whereas for healthy subjects a linear relation between area ejection fraction and endocardial circumferential shortening was observed, in RVPO patients a curvilinear (quadratic) relation was observed. Conclusions: In patients with RVPO, compared with healthy subjects, the septal function was reduced, as evidenced by reduced thickening and shortening fractions. The distortion in LV cavity at end systole due to the flattening of the septum contributes to preserved systolic ventricular function and nonuniform distribution in endocardial circumferential shortening.

AB - Background: Distortion of the left ventricular (LV) cavity in patients with right ventricular pressure overload (RVPO) is well known. However, no direct measurements of regional myocardial function in terms of myocardial shortening and wall thickening are available; therefore, exactly how RVPO disturbs LV regional performance remains unclear. By using three-dimensional (3D) tagged magnetic resonance imaging, we were able to measure regional systolic function directly. Our objective was to study the relation between the distortion of the LV circular shape and regional LV function. Methods and Results: In nine patients with RVPO and six healthy volunteers, four parallel short-axis images (with 12 radial tags) and two mutually orthogonal long- axis images (with four parallel tags) were generated, and endocardial and epicardial borders were manually traced. By integration of the short- and long-axis images, 3D reconstruction of the LV tracking points from end diastole to end systole was obtained. Data from the midventricular two short- axis image slices were analyzed. These were then divided into anterior, lateral, posterior, and septal regions. Circumferential and longitudinal shortening were then calculated from the endocardial and epicardial tag intersection points. Wall thickness and thickening were calculated by the 3D volume-element approach. An eccentricity index (EI), the ratio of septum-to- free-wall to anteroposterior diameters, was used to describe the shape of the LV cavity. The regional curvature was also measured. The RVPO group was characterized by flattening of the septum and LV lateral wall, decreased EI reflecting the distorted LV shape, altered distribution of endocardial circumferential shortening, and preserved ejection fraction. Changes in EI closely correlated with the septal curvature. The EI was smaller at end systole, reflecting further shape distortion relative to end diastole. Reduced myocardial performance, as measured by wall thickening and circumferential and longitudinal shortening fractions, was observed for the septum. A reduction in endocardial circumferential shortening of the septal and lateral walls was directly related to the end-systolic EI. In addition, whereas for healthy subjects a linear relation between area ejection fraction and endocardial circumferential shortening was observed, in RVPO patients a curvilinear (quadratic) relation was observed. Conclusions: In patients with RVPO, compared with healthy subjects, the septal function was reduced, as evidenced by reduced thickening and shortening fractions. The distortion in LV cavity at end systole due to the flattening of the septum contributes to preserved systolic ventricular function and nonuniform distribution in endocardial circumferential shortening.

KW - magnetic resonance imaging

KW - pressure

KW - systole

KW - ventricles

UR - http://www.scopus.com/inward/record.url?scp=0028936501&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028936501&partnerID=8YFLogxK

M3 - Article

C2 - 7729022

AN - SCOPUS:0028936501

VL - 91

SP - 2359

EP - 2370

JO - Circulation

JF - Circulation

SN - 0009-7322

IS - 9

ER -