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Cardiac time intervals and the association with 2D-speckle-tracking, tissue Doppler and conventional echocardiography: the Thousand&1 Study

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Abstract

Cardiac time intervals (CTI) are prognostic above and beyond conventional echocardiographic measures. The explanation may be that CTI contain information about both systolic and diastolic measures; this is, however, unknown. The relationship between the CTI and systolic and diastolic function assessed by conventional, tissue Doppler (TDI) and speckle-tracking echocardiography (STE) was investigated. CTI and echocardiographic measurements, including conventional, STE, and TDI echocardiography, were studied in 1088 type 1 diabetes patients without known heart disease randomly selected from the out-patient clinic at Steno Diabetes Center. The CTI were obtained by TDI M-mode through the mitral leaflet and included the isovolumic relaxation time (IVRT), isovolumic contraction time (IVCT), and the myocardial performance index (MPI = (IVRT + IVCT)/ejection time). Standardized beta-values were assessed. Both systolic and diastolic measures associated with CTI. Conventional measures: left ventricular ejection fraction (stand. beta): MPI −0.34, IVRT 0.24, and IVCT −0.21, all p < 0.001. For the TDI measures, the most significant association was found with e′: MPI (stand. beta: −0.30, p < 0.001) and IVRT (−0.35, p < 0.001) but no association with IVCT −0.05, p = 0.1). Speckle-tracking derived measures were in general strongly associated with the cardiac time intervals. Thus, global longitudinal strain and MPI (−0.38, p < 0.001), IVRT (−0.23, p < 0.001), and IVCT (−0.10, p < 0.001); and global longitudinal strain rate e and MPI (−0.40, p < 0.001), IVRT (−0.42, p < 0.001), and IVCT (−0.04, p = 0.11). CTI, in particular MPI and IVRT, associate with both systolic and diastolic myocardial function assessed by conventional and newer echocardiographic measures. This may possibly help to explain the prognostic significance of CTI.

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Funding sources

The work was supported by The European Foundation for the Study of Diabetes/Pfizer European Programme 2010 for Research into Cardiovascular Risk Reduction in Patients with Diabetes; and The Danish Heart Foundation (#: 12-04-R90-A3840-22725).

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Authors and Affiliations

  1. Department of Internal Medicine, Holbaek Hospital, Smedelundsgade 60, 4300, Holbæk, Denmark

    Magnus Thorsten Jensen

  2. Department of Cardiology, Copenhagen University Hospital Gentofte, Kildegårdsvej 28, 2900, Hellerup, Denmark

    Tor Biering-Sørensen, Jan Skov Jensen & Magnus Thorsten Jensen

  3. Steno Diabetes Center, Niels Steensens Vej 2, 2820, Gentofte, Denmark

    Henrik Ullits Andersen, Peter Rossing & Magnus Thorsten Jensen

  4. Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen N, Denmark

    Jan Skov Jensen

  5. Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen N, Denmark

    Peter Rossing

  6. Faculty of Health, University of Aarhus, Katrinebjergvej 89F, 8200, Aarhus N, Denmark

    Peter Rossing

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Correspondence to Magnus Thorsten Jensen.

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PR has board memberships in Astra Zeneca/BMS, Eli Lilly, Janssen, Novo Nordisk, Astellas, has received grants and/or have grants pending from Novo Nordisk, Novartis and Abbott, has received payment for lectures by Astra Zeneca/BMS, Novartis and Sanofi Aventis, and has stocks in Novo Nordisk. HUA has a member of an advisory board of Abbott and has stocks in Novo Nordisk. All other authors report no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous 3 years; no other relationships or activities that could appear to have influenced the submitted work.

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Biering-Sørensen, T., Jensen, J.S., Andersen, H.U. et al. Cardiac time intervals and the association with 2D-speckle-tracking, tissue Doppler and conventional echocardiography: the Thousand&1 Study. Int J Cardiovasc Imaging 32, 789–798 (2016). https://doi.org/10.1007/s10554-016-0839-7

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  • DOI: https://doi.org/10.1007/s10554-016-0839-7

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