Non-invasive assessment of left ventricular myocardial work in healthy subjects with echocardiography

Purpose: to evaluate the left ventricular (LV) echocardiographic indices of myocardial work using the LV pressure-strain loops method in healthy individuals.

Material and methods. The study included 50 healthy subjects (28 men, mean age: 44 ± 14 years). The inclusion criteria were the absence of any cardiovascular diseases and diabetes mellitus. After calculating global longitudinal strain (GLS) from speckle-tracking Echo and inserting values of brachial artery cuff blood pressure (BP), the vendor-specific module constructed non-invasive LV pressure-strain loops. The following parameters were calculated: global myocardial work index (GWI), global constructive work (GCW), global wasted work (GWW), global work efficiency (GWE).

Results. The lowest values of GWI in men and women were 1382 mmHg% and 1821 mmHg%, the highest values were 2875 mmHg% and 2589 mmHg%, mean values were 2056 ± 326 mmHg% and 2109 ± 200 mmHg%, respectively. Mean values of GCW were 2292 ± 329 mmHg% in men and 2304 ± 211 mmHg% in women. The median and the highest value of GWW were 66 mmHg% and 313 mmHg% in men and 79,5 mmHg% and 172 mmHg% in women, respectively. The lowest value of GWE were 89% in men and 91% in women. GWI was significantly and naturally correlated only with systolic BP (r = 0,30, р = 0,03) and GLS (r = -0,72, р < 0,001). GCW was significantly correlated with systolic BP (r = 0,36, р = 0,01) and GLS (r = -0,72, р < 0,001) too, however, the negative relationship with the age of the patients was found (r = -0,27, р = 0,04). LV myocardial work indices did not significantly differ between men and women. Coefficients of variation for GWI, GCW and GWE did not exceed 10%, which is typical for good reproducible indices.

Conclusion. The study presents values of the echocardiographic LV myocardial work indices, obtained with help of the LV pressure-strain loops method in healthy individuals. The natural correlation of LV myocardial work indices with strain and blood pressure was demonstrated, as well as a dependence on the age of the subjects and good reproducibility.

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