A New Approach to Evaluating the Pumping Function of the Heart by the Myocardial Work.

The function of left ventricular (LV) contractility consists of two aspects, the force of myocardial contraction, which provides a sufficient pressure gradient to open the heart valves, and deformation, which determines the actual cardiac output [1, 2]. The relationship between the characteristics of LV deformation and LV volume parameters remains poorly understood. The LV work may reflect the dependence between the volume and deformation characteristics of the left ventricle. Myocardial work indexes can more accurately describe the systolic LV function when the LV ejection fraction (EF) and global longitudinal strain (GLS) are not informative enough [3, 4]. A new approach was proposed for evaluating the LV pumping function, and a parameter was developed to characterize the efficiency of myocardial work for the cardiac cycle period from the aortic valve opening (AVO) to its closure (AVC), that is, the phase of blood ejection from the left ventricle.

Use of the Speckle tracking method for determining global parameters of heart contractility in healthy individuals.

The speckle tracking method allows one to quantify the temporal and spatial characteristics of myocardial contraction. Importantly, it does not depend on a scanning angle and allows one to record the movement of speckles in 2D mode in any direction, unlike tissue Doppler imaging. This examination is non-invasive, safe for patients, and economically more beneficial in comparison with other modern methods of assessing heart contractility: MRI and scintigraphy. Diagnostic thresholds are suggested for obtaining peak values of all types of global strains and strain rates by sampling a healthy group, which can reveal early signs of left ventricle contractility failure. Correlation relationships of deformation parameters between themselves and with left ventricular hemodynamic indices, as well as anthropometric parameters in healthy subjects highlight the features of heart contraction biomechanics. However, currently this method is scarcely studied because no generally accepted normal range of strain values exists. •It is necessary to have sufficient qualification and skills in dealing with the XStrain™ Esaote software to obtain optimal values ​​of myocardial deformation.•The study results expand the database of this software for users and determine the normal range of the left ventricular contractility parameters.•The revealed interrelationships of strain values ​​in healthy individuals are relevant for understanding how the contractility mechanisms are altered in patients, and open up the prospect of studying the heart's compensatory possibilities.