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Echocardiography (Mount Kisco, N.Y.)
Mar, 2025;42 (3): e70128.

Changes in Left Ventricular Function Assessed by 3D Echocardiography During Severe Central Hypovolemia in Healthy Humans.

Kazukuni Hirabuki, Noritaka Hata, Marina Fukuie, Rina Suzuki, Tomoya Suda, Takahiro Uechi, Ai Hirasawa, Jun Sugawara, Takeaki Matsuda, Shigeki Shibata
Author Information
  1. Kazukuni Hirabuki: Department of General Medicine, Faculty of Medicine, Kyorin University, Mitaka City, Tokyo, Japan. ORCID
  2. Noritaka Hata: Department of General Medicine, Faculty of Medicine, Kyorin University, Mitaka City, Tokyo, Japan.
  3. Marina Fukuie: The National Institute of Advanced Industrial Science and Technology, Mitaka City, Tokyo, Japan.
  4. Rina Suzuki: Department of General Medicine, Faculty of Medicine, Kyorin University, Mitaka City, Tokyo, Japan.
  5. Tomoya Suda: Department of General Medicine, Faculty of Medicine, Kyorin University, Mitaka City, Tokyo, Japan.
  6. Takahiro Uechi: Department of General Medicine, Faculty of Medicine, Kyorin University, Mitaka City, Tokyo, Japan.
  7. Ai Hirasawa: Department of Health and Welfare, Faculty of Health Sciences, Kyorin University, Mitaka City, Tokyo, Japan.
  8. Jun Sugawara: The National Institute of Advanced Industrial Science and Technology, Mitaka City, Tokyo, Japan.
  9. Takeaki Matsuda: Department of General Medicine, Faculty of Medicine, Kyorin University, Mitaka City, Tokyo, Japan.
  10. Shigeki Shibata: Department of Physical Therapy, Faculty of Health Science, Kyorin University, Mitaka City, Tokyo, Japan.
PMID: 40073426 DOI: 10.1111/echo.70128

Abstract

PURPOSE: Central hypovolemia is considered to lead to a compensatory increase in cardiac contractility. From a physiological perspective, left ventricular (LV) twisting motion, which plays an important role in maintaining cardiac output, should be enhanced during central hypovolemia, but previous studies have shown inconsistent findings. Using 3D echocardiography, we tested the hypothesis that the LV twisting and untwisting motion would be enhanced during severe central hypovolemia.
METHODS: Thirteen healthy men (25 �� 5 years old) underwent the maximal lower body negative pressure (LBNP) protocol; graded increase in LBNP loads up to presyncope. We evaluated the basic hemodynamics and LV function with 3D and Doppler echocardiography at each stage of LBNP. Indices were compared among baseline, half maximal LBNP (LBNP1/2max), and one stage before the presyncope (LBNPpre-max) to consider individual differences in orthostatic tolerance.
RESULTS: In response to LBNP, ejection fraction (baseline: 62 �� 3, LBNP1/2max: 55 �� 5, LBNPpre-max: 43% �� 9%, mean �� SD, p < 0.01, ANOVA), global longitudinal strain (-20.5 �� 2.8, -17.6 �� 2.7, -13.6% �� 4.7%, p < 0.01), and global circumferential strain (-31.2 �� 3.7, -26.8 �� 3.3, -19.4% �� 5.3%, p < 0.01) were weakened. Twist (15.2 �� 5.1, 14.5 �� 5.4, 20.9�� �� 7.7��, p = 0.012) and peak untwisting rate (-138 �� 42, -164 �� 50, -245��/cm �� 88��/cm, p < 0.01) were strengthened at the LBNPpre-max. e' (14.1 �� 2.0, 11.1 �� 1.5, 8.2�� �� 2.2 cm/s, p < 0.01) decreased in response to LBNP, while E/e' (5.8 �� 0.8, 5.4 �� 1.0, 7.8 �� 2.3, p < 0.01) increased at LBNPpre-max.
CONCLUSION: The present findings indicate that LV twisting motion is enhanced during severe central hypovolemia. On the other hand, conventional echocardiographic indices appeared to deteriorate. Intriguingly, an index of LV filling (E/e') was paradoxically enhanced during severe central hypovolemia.

Keywords

cardiac mechanics left ventricular twist left ventricular untwist orthostatic tolerance

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Grants

  1. 17K19949/Japan Society for the Promotion of Science
  2. 19K19984/Japan Society for the Promotion of Science

MeSH Term

Humans
Male
Hypovolemia
Adult
Echocardiography, Three-Dimensional
Ventricular Function, Left
Stroke Volume
Heart Ventricles
Lower Body Negative Pressure
Reproducibility of Results
Reference Values
Journal Article
Article has an altmetric score of 1

Word Cloud

Created with Highcharts 10.0.0��50p2LBNP<018hypovolemiaLV31enhancedcentral7cardiacleftventriculartwistingmotion3DsevereLBNPpre-max4Centralincreasefindingsechocardiographyuntwistingmaximalpresyncopestageorthostatictoleranceresponseglobalstrain14E/e'PURPOSE:consideredleadcompensatorycontractilityphysiologicalperspectiveplaysimportantrolemaintainingoutputpreviousstudiesshowninconsistentUsingtestedhypothesisMETHODS:Thirteenhealthymen25yearsoldunderwentlowerbodynegativepressureprotocolgradedloadsevaluatedbasichemodynamicsfunctionDopplerIndicescomparedamongbaselinehalfLBNP1/2maxoneconsiderindividualdifferencesRESULTS:ejectionfractionbaseline:62LBNP1/2max:55LBNPpre-max:43%9%meanSDANOVAlongitudinal-20-176-136%7%circumferential-31-26-194%3%weakenedTwist15209��7��=012peakrate-13842-16450-245��/cm88��/cmstrengthenede'112��2 cm/sdecreasedincreasedCONCLUSION:presentindicatehandconventionalechocardiographicindicesappeareddeteriorateIntriguinglyindexfillingparadoxicallyChangesLeftVentricularFunctionAssessedEchocardiographySevereHypovolemiaHealthyHumansmechanicstwistuntwist

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