Skip to main content
SpringerLink
Log in

Clinical implications of the echocardiographic assessment of left ventricular long axis function

  • Review
  • Published:
Clinical Research in Cardiology Aims and scope Submit manuscript

Abstract

The assessment of the left and right ventricular long axis function by Doppler echocardiography was started many years ago with the use of M-mode. Two-dimensional echocardiography was subsequently used to study the longitudinal function of the left ventricle. The studies of that era led to useful conclusions. However, tissue Doppler imaging, a relatively new echocardiographic technique, recently became the first choice for such an assessment. Moreover, the advances of tissue tracking and strain rate also have an important contribution. New studies were conducted and new data derived for left and right ventricular function in various cardiac diseases. Τhe aim of this review was to present the accumulated knowledge of the Doppler echocardiography study of the left ventricular long axis function and the relevant clinical implications.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10

Similar content being viewed by others

References

  1. Agricola E, Galderisi M, Mele D, Ansalone G, Dini FL, Di Salvo G, Gallina S, Montisci R, Sciomer S, Di Bello V, Mondillo S, Marino PN (2008) Mechanical dyssynchrony and functional mitral regurgitation: pathophysiology and clinical implications. J Cardiovasc Med (Hagerstown) 9:461–469

    Google Scholar 

  2. Alam M (1991) The atrioventricular plane displacement as a means of evaluating left ventricular systolic function in acute myocardial infarction. Clin Cardiol 14:588–594

    Article  PubMed  CAS  Google Scholar 

  3. Alam M, Hoglund C, Thorstrand C, Carlens P (1991) Effects of exercise on the displacement of the atrioventricular plane in patients with coronary artery disease. A new echocardiographic method of detecting reversible myocardial ischaemia. Eur Heart J 12:760–765

    PubMed  CAS  Google Scholar 

  4. Anao AO, Monge J, Galvao J, Bronze L, Azevedo J, Custodio H, Arroja I, Aleixo A (2007) Pseudonormalization of transmitral pulsed doppler flow: A/e′ ratio during the Valsalva maneuver: a new discriminative index. Rev Port Cardiol 26:623–633

    PubMed  Google Scholar 

  5. Andersen NH, Bojesen A, Christiansen JS, Gravholt CH (2008) Glycemia, lipidemia and systolic left ventricular function evaluated by myocardial strain rate: a tissue Doppler echocardiographic study. Ultrasound Med Biol 34:151–154

    Article  PubMed  Google Scholar 

  6. Andersen NH, Terkelsen CJ, Sloth E, Poulsen SH (2004) Influence of preload alterations on parameters of systolic left ventricular long-axis function: a Doppler tissue study. J Am Soc Echocardiogr 17:941–947

    Article  PubMed  Google Scholar 

  7. Bax JJ, Marwick TH, Molhoek SG, Bleeker GB, van Erven L, Boersma E, Steendijk P, van der Wall EE, Schalij MJ (2003) Left ventricular dyssynchrony predicts benefit of cardiac resynchronization therapy in patients with end-stage heart failure before pacemaker implantation. Am J Cardiol 92:1238–1240

    Article  PubMed  Google Scholar 

  8. Blendea D, Duncea C, Bedreaga M, Crisan S, Zarich S (2007) Abnormalities of left ventricular long-axis function predict the onset of hypertension independent of blood pressure: a 7-year prospective study. J Hum Hypertens 21:539–545

    PubMed  CAS  Google Scholar 

  9. Butz T, Faber L, Piper C, Langer C, Kottmann T, Schmidt HK, Wiemer M, Korfer R, Horstkotte D (2008) Constrictive pericarditis or restrictive cardiomyopathy? Echocardiographic tissue Doppler analysis. Dtsch Med Wochenschr 133:399–405

    Article  PubMed  CAS  Google Scholar 

  10. Chung ES, Leon AR, Tavazzi L, Sun JP, Nihoyannopoulos P, Merlino J, Abraham WT, Ghio S, Leclercq C, Bax JJ, Yu CM, Gorcsan J III, St John Sutton M, De Sutter J, Murillo J (2008) Results of the predictors of response to CRT (PROSPECT) trial. Circulation 117:2608–2616

    Article  PubMed  Google Scholar 

  11. Dagianti A, Vitarelli A, Conde Y, Penco M, Fedele F (2000) Assessment of regional left ventricular function during exercise test with pulsed tissue Doppler imaging. Am J Cardiol 86:30G–32G

    Article  PubMed  CAS  Google Scholar 

  12. Duncan AM, Francis DP, Gibson DG, Henein MY (2003) Differentiation of ischemic from nonischemic cardiomyopathy during dobutamine stress by left ventricular long-axis function: additional effect of left bundle-branch block. Circulation 108:1214–1220

    Article  PubMed  Google Scholar 

  13. Gorcsan J III, Tanabe M, Bleeker GB, Suffoletto MS, Thomas NC, Saba S, Tops LF, Schalij MJ, Bax JJ (2007) Combined longitudinal and radial dyssynchrony predicts ventricular response after resynchronization therapy. J Am Coll Cardiol 50:1476–1483

    Article  PubMed  Google Scholar 

  14. Gruner Svealv B, Fritzon G, Andersson B (2006) Gender and age-related differences in left ventricular function and geometry with focus on the long axis. Eur J Echocardiogr 7:298–307

    Article  PubMed  Google Scholar 

  15. Hettwer S, Panzner-Grote B, Witthaut R, Werdan K (2007) Isolated diastolic dysfunction: diagnostic value of tissue Doppler imaging, colour M-mode and N-terminal pro B-type natriuretic peptide. Clin Res Cardiol 96:874–882

    Article  PubMed  CAS  Google Scholar 

  16. Jensen-Urstad K, Bouvier F, Hojer J, Ruiz H, Hulting J, Samad B, Thorstrand C, Jensen-Urstad M (1998) Comparison of different echocardiographic methods with radionuclide imaging for measuring left ventricular ejection fraction during acute myocardial infarction treated by thrombolytic therapy. Am J Cardiol 81:538–544

    Article  PubMed  CAS  Google Scholar 

  17. Kato TS, Noda A, Izawa H, Yamada A, Obata K, Nagata K, Iwase M, Murohara T, Yokota M (2004) Discrimination of nonobstructive hypertrophic cardiomyopathy from hypertensive left ventricular hypertrophy on the basis of strain rate imaging by tissue Doppler ultrasonography. Circulation 110:3808–3814

    Article  PubMed  Google Scholar 

  18. Kranidis A, Bouki T, Kostopoulos K, Kappos K, Sideris A, Antonellis J, Kardaras F, Margaris N, Lolas C, Anthopoulos L (1996) The contribution of the left atrioventricular plane displacement during low dose dobutamine stress echocardiography in predicting recovery of left ventricular dyssynergies. Echocardiography 13:587–598

    Article  PubMed  Google Scholar 

  19. Kranidis A, Kostopoulos K, Filippatos G, Antonelis J, Kappos K, Kardaras F, Margaris N, Sideris A, Amartolos P, Kritharidou G et al (1995) Analysis of left atrioventricular plane movement during diastole in ischemic heart disease. Jpn Heart J 36:545–556

    PubMed  CAS  Google Scholar 

  20. Kranidis A, Kostopoulos K, Margaris N, Sioras E, Kappos K, Kardaras F, Filippatos G, Anthopoulos L (1995) Significance of echocardiographic atrioventricular plane displacement for the evaluation of left ventricular filling and end-diastolic pressure in patients with coronary artery disease. Int J Card Imaging 11:185–192

    Article  PubMed  CAS  Google Scholar 

  21. Kranidis A, Kostopoulos K, Anthopoulos L (1995) Echocardiographic assessment of left ventricular diastolic function in hypertensive patients using atrioventricular plane displacement. J Cardiovasc Diagn Proced 12:227–232

    Google Scholar 

  22. Lafitte S, Bordachar P, Lafitte M, Garrigue S, Reuter S, Reant P, Serri K, Lebouffos V, Berrhouet M, Jais P, Haissaguerre M, Clementy J, Roudaut R, DeMaria AN (2006) Dynamic ventricular dyssynchrony: an exercise-echocardiography study. J Am Coll Cardiol 47:2253–2259

    Article  PubMed  Google Scholar 

  23. Lauschke J, Maisch B (2009) Athlete’s heart or hypertrophic cardiomyopathy? Clin Res Cardiol 98:80–88

    Article  PubMed  CAS  Google Scholar 

  24. Matsuoka M, Oki T, Mishiro Y, Yamada H, Tabata T, Wakatsuki T, Ito S (2002) Early systolic mitral annular motion velocities responses to dobutamine infusion predict myocardial viability in patients with previous myocardial infarction. Am Heart J 143:552–558

    Article  PubMed  Google Scholar 

  25. Mishra MB, Lythall DA, Chambers JB (2002) A comparison of wall motion analysis and systolic left ventricular long axis function during dobutamine stress echocardiography. Eur Heart J 23:579–585

    Article  PubMed  CAS  Google Scholar 

  26. Mottram PM, Haluska B, Yuda S, Leano R, Marwick TH (2004) Patients with a hypertensive response to exercise have impaired systolic function without diastolic dysfunction or left ventricular hypertrophy. J Am Coll Cardiol 43:848–853

    Article  PubMed  Google Scholar 

  27. Nagarakanti R, Ezekowitz M (2008) Diastolic dysfunction and atrial fibrillation. J Interv Card Electrophysiol 22:111–118

    Article  PubMed  Google Scholar 

  28. Nazli C, Kinay O, Ergene O, Yavuz T, Gedikli O, Hoscan Y, Ozaydin M, Altinbas A, Dogan A, Kahraman H, Acar G (2003) Use of tissue Doppler echocardiography in early detection of left ventricular systolic dysfunction in patients with mitral regurgitation. Int J Cardiovasc Imaging 19:199–209

    Article  PubMed  Google Scholar 

  29. Nishikage T, Nakai H, Lang RM, Takeuchi M (2008) Subclinical left ventricular longitudinal systolic dysfunction in hypertension with no evidence of heart failure. Circ J 72:189–194

    Article  PubMed  Google Scholar 

  30. Ozer N, Can I, Atalar E, Sade E, Aksoyek S, Ovunc K, Aytemir K, Tokgozoglu L, Ozmen F, Kes S (2004) Left ventricular long-axis function is reduced in patients with rheumatic mitral stenosis. Echocardiography 21:107–112

    Article  PubMed  Google Scholar 

  31. Paraskevaidis IA, Kyrzopoulos S, Farmakis D, Parissis J, Tsiapras D, Iliodromitis EK, Kremastinos DT (2007) Ventricular long-axis contraction as an earlier predictor of outcome in asymptomatic aortic regurgitation. Am J Cardiol 100:1677–1682

    Article  PubMed  Google Scholar 

  32. Paulus WJ, Tschope C, Sanderson JE, Rusconi C, Flachskampf FA, Rademakers FE, Marino P, Smiseth OA, De Keulenaer G, Leite-Moreira AF, Borbely A, Edes I, Handoko ML, Heymans S, Pezzali N, Pieske B, Dickstein K, Fraser AG, Brutsaert DL (2007) How to diagnose diastolic heart failure: a consensus statement on the diagnosis of heart failure with normal left ventricular ejection fraction by the Heart Failure and Echocardiography Associations of the European Society of Cardiology. Eur Heart J 28:2539–2550

    Article  PubMed  Google Scholar 

  33. Penicka M, Bartunek J, De Bruyne B, Vanderheyden M, Goethals M, De Zutter M, Brugada P, Geelen P (2004) Improvement of left ventricular function after cardiac resynchronization therapy is predicted by tissue Doppler imaging echocardiography. Circulation 109:978–983

    Article  PubMed  Google Scholar 

  34. Perugini E, Rapezzi C, Reggiani LB, Poole-Wilson P, Branzi A, Henein MY (2005) Comparison of ventricular long-axis function in patients with cardiac amyloidosis versus idiopathic restrictive cardiomyopathy. Am J Cardiol 95:146–149

    Article  PubMed  Google Scholar 

  35. Rydberg E, Gudmundsson P, Kennedy L, Erhardt L, Willenheimer R (2004) Left atrioventricular plane displacement but not left ventricular ejection fraction is influenced by the degree of aortic stenosis. Heart 90:1151–1155

    Article  PubMed  CAS  Google Scholar 

  36. Saghir M, Areces M, Makan M (2007) Strain rate imaging differentiates hypertensive cardiac hypertrophy from physiologic cardiac hypertrophy (athlete’s heart). J Am Soc Echocardiogr 20:151–157

    Article  PubMed  Google Scholar 

  37. Shim CY, Park S, Choi EY, Kang SM, Cha BS, Ha JW, Rim SJ, Lee HC, Chung N (2008) Is albuminuria an indicator of myocardial dysfunction in diabetic patients without overt heart disease? A study with Doppler strain and strain rate imaging. Metabolism 57:448–452

    Article  PubMed  CAS  Google Scholar 

  38. Sun JP, Popovic ZB, Greenberg NL, Xu XF, Asher CR, Stewart WJ, Thomas JD (2004) Noninvasive quantification of regional myocardial function using Doppler-derived velocity, displacement, strain rate, and strain in healthy volunteers: effects of aging. J Am Soc Echocardiogr 17:132–138

    Article  PubMed  Google Scholar 

  39. Sutherland GR, Kukulski T, Kvitting JE, D’Hooge J, Arnold M, Brandt E, Hatle L, Wranne B (2000) Quantitation of left-ventricular asynergy by cardiac ultrasound. Am J Cardiol 86:4G–9G

    Article  PubMed  CAS  Google Scholar 

  40. Vinereanu D, Lim PO, Frenneaux MP, Fraser AG (2005) Reduced myocardial velocities of left ventricular long-axis contraction identify both systolic and diastolic heart failure: a comparison with brain natriuretic peptide. Eur J Heart Fail 7:512–519

    Article  PubMed  CAS  Google Scholar 

  41. Voigt JU, Lindenmeier G, Exner B, Regenfus M, Werner D, Reulbach U, Nixdorff U, Flachskampf FA, Daniel WG (2003) Incidence and characteristics of segmental postsystolic longitudinal shortening in normal, acutely ischemic, and scarred myocardium. J Am Soc Echocardiogr 16:415–423

    Article  PubMed  Google Scholar 

  42. Wang YC, Hwang JJ, Yu CC, Lai LP, Tsai CT, Lin LC, Katra R, Lin JL (2008) Provocation of masked left ventricular mechanical dyssynchrony by treadmill exercise in patients with systolic heart failure and narrow QRS complex. Am J Cardiol 101:658–661

    Article  PubMed  Google Scholar 

  43. Weidemann F, Strotmann JM (2008) Use of tissue Doppler imaging to identify and manage systemic diseases. Clin Res Cardiol 97:65–73

    Article  PubMed  Google Scholar 

  44. Winter R, Gudmundsson P, Ericsson G, Willenheimer R (2004) Correlation of the M-mode atrioventricular plane early diastolic downward slope and systolic parameters. Coupling of LV systolic and early diastolic function. Int J Cardiovasc Imaging 20:101–106

    Article  PubMed  Google Scholar 

  45. Yu CM, Chau E, Sanderson JE, Fan K, Tang MO, Fung WH, Lin H, Kong SL, Lam YM, Hill MR, Lau CP (2002) Tissue Doppler echocardiographic evidence of reverse remodeling and improved synchronicity by simultaneously delaying regional contraction after biventricular pacing therapy in heart failure. Circulation 105:438–445

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. General Hospital K.A.T., Nikis 2, Kifissia, 145 61, Athens, Greece

    Konstantinos A. Triantafyllou & Dimitrios Babalis

  2. Euroclinic, Athens, Greece

    Elias Karabinos

  3. General Hospital of Western Attica, Athens, Greece

    Heleni Kalkandi & Athanasios I. Kranidis

Authors
  1. Konstantinos A. Triantafyllou
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Elias Karabinos
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Heleni Kalkandi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Athanasios I. Kranidis
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Dimitrios Babalis
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Konstantinos A. Triantafyllou.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Triantafyllou, K.A., Karabinos, E., Kalkandi, H. et al. Clinical implications of the echocardiographic assessment of left ventricular long axis function. Clin Res Cardiol 98, 521–532 (2009). https://doi.org/10.1007/s00392-009-0046-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00392-009-0046-9

Keywords

Search

Navigation