BACKGROUND Global left ventricular (LV) myocardial work efficiency, the ratio of constructive to wasted work in all LV segments, reflects the efficiency by which mechanical energy is expended during the cardiac cycle. Global LV myocardial work efficiency can be derived from LV pressure-strain loop analysis incorporating both noninvasively estimated blood pressure recordings and echocardiographic strain data. The aim of this study was to characterize global LV myocardial work efficiency in healthy individuals and patients with cardiovascular (CV) risk factors or overt cardiac disease. METHODS We retrospectively included healthy individuals without structural heart disease or CV risk factors, who were selected from an ongoing database of normal individuals, and matched for age and sex with (1) individuals without structural heart disease but with CV risk factors, (2) postinfarct patients without heart failure, and (3) heart failure patients with reduced ejection fraction (HFrEF). Global LV myocardial work efficiency was estimated with a proprietary algorithm from speckle-tracking strain analyses, as well as noninvasive blood pressure measurements. RESULTS In total, 120 individuals (44% male, 53 ± 13 years) were included (n = 30 per group). In healthy individuals without structural heart disease or CV risk factors, global LV myocardial work efficiency was 96.0% (interquartile range, 95.0%-96.3%). Myocardial efficiency of the LV did not differ significantly between individuals without structural heart disease and those with CV risk factors (96.0% vs 96.0%; P = .589). Global LV myocardial work efficiency, however, was significantly decreased in postinfarct patients (96.0% vs 93.0%, P < .001) and in those with HFrEF (96.0% vs 69.0%; P < .001). CONCLUSIONS While global LV myocardial work efficiency was similar in normal individuals and in those with CV risk factors, it was decreased in postinfarct and HFrEF patients. The global LV myocardial work efficiency values presented here show distinct patterns in different cardiac pathologies.

中文翻译：

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健康个体和心血管疾病患者的整体左心室心肌工作效率。

背景技术总的左心室（LV）心肌工作效率，即在所有LV段中建设性工作与浪费性工作的比率，反映了在心动周期中消耗机械能的效率。可以通过合并无创估计的血压记录和超声心动图应变数据的LV压力-应变环分析来得出总体LV心肌的工作效率。这项研究的目的是表征健康个体和患有心血管（CV）危险因素或明显心脏疾病的患者的整体LV心肌工作效率。方法我们回顾性纳入没有结构性心脏病或CV危险因素的健康个体，这些个体是从持续进行的正常个体数据库中选择的，并按年龄和性别与（1）没有结构性心脏病但具有CV危险因素的个体，（2）没有心力衰竭的梗塞后患者和（3）射血分数降低（HFrEF）的心力衰竭患者进行年龄和性别匹配。通过散斑跟踪应变分析以及无创血压测量，使用专有算法估算了全球左心室心肌的工作效率。结果总共包括120名个体（44％男性，53±13岁）（每组n = 30）。在没有结构性心脏病或心血管危险因素的健康个体中，全球左心室心肌工作效率为96.0％（四分位间距为95.0％-96.3％）。没有结构性心脏病的人和具有心血管危险因素的人的左心室心肌效率没有显着差异（96.0％vs 96.0％； P = .589）。然而，梗塞后患者和HFrEF患者的整体LV心肌工作效率显着降低（96.0％vs 93.0％，P <.001）和HFrEF患者（96.0％vs 69.0％； P <.001）。结论虽然正常人和具有CV危险因素的人的整体LV心肌工作效率相似，但在梗死后和HFrEF患者中却有所下降。此处介绍的全球左心室心肌工作效率值在不同的心脏病理图中显示出不同的模式。