From the Guidelines
Global Hypokinesia of the Left Ventricle
Global hypokinesia of the left ventricle (LV) suggests a condition where the entire left ventricle is not contracting properly, which can be a sign of various cardiac conditions such as cardiomyopathy, coronary artery disease, or heart failure 1, 2.
- This condition is characterized by reduced LV ejection fraction and LV fractional shortening, indicating LV global systolic dysfunction and LV radial systolic dysfunction respectively 1.
- The presence of hypokinesis in the LV also suggests myocardial infarction/ischaemia or cardiomyopathy 1.
- It is recommended to further evaluate with echocardiography, cardiac MRI, or other imaging modalities to determine the underlying cause 3.
- Medications such as beta blockers, ACE inhibitors, or diuretics may be considered depending on the underlying diagnosis, but treatment should be individualized based on the patient's specific condition and medical history.
- Close monitoring and follow-up with a cardiologist is advised to manage the condition and prevent further cardiac complications.
- The use of advanced techniques such as 3-D echocardiography and tissue Doppler imaging can provide further information on ventricular function and myocardial deformation 3.
From the Research
Global Hypokinesia of the Left Ventricle (LV)
Global hypokinesia of the Left Ventricle (LV) suggests a condition where the left ventricle of the heart does not contract properly, leading to reduced cardiac output and potentially life-threatening complications. The following points summarize the key aspects of global hypokinesia of the LV:
- Global left ventricular hypokinesia is defined as a left ventricular ejection fraction of <45% 4.
- It is a common condition in adult septic shock, affecting up to 60% of patients 4.
- Global hypokinesia can be primary (present at admission) or secondary (developing after 24 or 48 hours of hemodynamic support) 4.
- Left ventricular systolic dysfunction, including global hypokinesia, is frequently triggered by critical illness and is linked to an increased risk of death 5.
- Regional left ventricular systolic dysfunction, including hypokinesia, is more common than global hypokinesia and is often reversible 5.
- Global hypokinesia can be caused by various factors, including coronary artery stenosis, myocardial infarction, and cardiomyopathy 6, 7, 8.
- The prognosis of patients with global hypokinesia depends on the underlying cause and the presence of other cardiac or non-cardiac diseases 4, 5, 7, 8.
- Treatment of global hypokinesia may involve the use of inotropic agents, such as dobutamine, and coronary revascularization in selected cases 4, 7.