CME

Thomas Rowland, Viswanath Unnithan, Piers Barker, Míriam Guerra, Denise Roche, Martin Lindley

Research output: Contribution to journalArticle

Abstract

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.
Original languageEnglish
Pages (from-to)523-527
Number of pages5
JournalEchocardiography
Volume29
Issue number5
DOIs
Publication statusPublished - 13 Feb 2012

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Stroke Volume
Ventricular Function
Supine Position
Posture
Cardiac Output
Vascular Resistance
Leg
Heart Rate

Cite this

Rowland, T., Unnithan, V., Barker, P., Guerra, M., Roche, D., & Lindley, M. (2012). CME. Echocardiography, 29(5), 523-527. https://doi.org/10.1111/j.1540-8175.2011.01634.x
Rowland, Thomas ; Unnithan, Viswanath ; Barker, Piers ; Guerra, Míriam ; Roche, Denise ; Lindley, Martin. / CME. In: Echocardiography. 2012 ; Vol. 29, No. 5. pp. 523-527.
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Rowland, T, Unnithan, V, Barker, P, Guerra, M, Roche, D & Lindley, M 2012, 'CME' Echocardiography, vol. 29, no. 5, pp. 523-527. https://doi.org/10.1111/j.1540-8175.2011.01634.x

CME. / Rowland, Thomas; Unnithan, Viswanath; Barker, Piers; Guerra, Míriam; Roche, Denise; Lindley, Martin.

In: Echocardiography, Vol. 29, No. 5, 13.02.2012, p. 523-527.

Research output: Contribution to journalArticle

TY - JOUR

T1 - CME

AU - Rowland, Thomas

AU - Unnithan, Viswanath

AU - Barker, Piers

AU - Guerra, Míriam

AU - Roche, Denise

AU - Lindley, Martin

PY - 2012/2/13

Y1 - 2012/2/13

N2 - 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.

AB - 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.

U2 - 10.1111/j.1540-8175.2011.01634.x

DO - 10.1111/j.1540-8175.2011.01634.x

M3 - Article

VL - 29

SP - 523

EP - 527

JO - Echocardiography

JF - Echocardiography

SN - 0742-2822

IS - 5

ER -

Rowland T, Unnithan V, Barker P, Guerra M, Roche D, Lindley M. CME. Echocardiography. 2012 Feb 13;29(5):523-527. https://doi.org/10.1111/j.1540-8175.2011.01634.x