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Tissue motion annular displacement to assess the left ventricular systolic function in healthy cats. Vet Res Commun 2022; 46:823-836. [PMID: 35258757 DOI: 10.1007/s11259-022-09907-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 02/16/2022] [Indexed: 10/18/2022]
Abstract
The tissue motion annular displacement (TMAD) measures the longitudinal displacement of the mitral annulus during systole, using speckle-tracking echocardiography (STE). The main objective was to determine the TMAD means in healthy cats, exploring the correlations with systolic surrogates. The influence of age, body surface area (BSA), heart rate, and systemic blood pressure on the indices was also analyzed. One hundred ninety-three healthy, client-owned cats participated in this prospective, cross-sectional observational study undergoing conventional and STE. Apical four-chamber (AP4) and two-chamber (AP2) images were recorded for offline calculations. Mean TMAD values were similar to mitral annulus plane systolic excursion (MAPSE), varying between 4 to 4.8 mm depending on the annulus and image used. No significant differences between age and BSA categories were detected, except for AP4 MP%, reduced in the heavier group. TMAD variables showed moderate correlation with longitudinal strain (LSt) and MAPSE, but not with fraction shortening (FS) and ejection fraction (EF). The median time required for the offline calculation was 12.2 s for AP4 and 11.8 s for AP2. The technique showed moderate inter and intraobserver variation, proving a reliable tool for assessing left ventricular longitudinal systolic function in cats.
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Sugimoto K, Kawase N, Aoki T, Fujii Y. Effects of dehydration on echocardiographic diastolic parameters in healthy cats. J Vet Sci 2019; 20:e18. [PMID: 31161736 PMCID: PMC6538523 DOI: 10.4142/jvs.2019.20.e18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 03/11/2019] [Accepted: 04/02/2019] [Indexed: 12/02/2022] Open
Abstract
This study aimed to assess the effects of dehydration on echocardiographic indices in healthy cats: specifically, it aimed to assess the effects of volume depletion on diastolic function. Nine experimental cats were subjected to both a dehydration and placebo protocol separated by a 21-day washout period. Echocardiography was performed at baseline and on completion of each protocol. Results were compared between the two protocols. Volume depletion was induced by intravenous administration of furosemide. Volume depletion showed a significant association with increased interventricular septal and left ventricular free wall thickness at end-diastole, decreased left ventricular internal diameter at end-diastole, and left atrial diameter at end-systole. The peak early (E) and late (A) diastolic filling velocities, and the peak early diastolic velocities (E′) were significantly decreased by dehydration. Volume depletion did not affect peak longitudinal strain rate during early diastole, E/A, or E/E′. Volume depletion significantly affected the echocardiographic diastolic indices and conventional echocardiographic parameters in healthy cats.
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Affiliation(s)
- Keisuke Sugimoto
- Laboratory of Surgery 1, School of Veterinary Medicine, Azabu University, Kanagawa 252-5201, Japan.
| | - Nana Kawase
- Laboratory of Surgery 1, School of Veterinary Medicine, Azabu University, Kanagawa 252-5201, Japan
| | - Takuma Aoki
- Laboratory of Surgery 1, School of Veterinary Medicine, Azabu University, Kanagawa 252-5201, Japan
| | - Yoko Fujii
- Laboratory of Surgery 1, School of Veterinary Medicine, Azabu University, Kanagawa 252-5201, Japan
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Shen T, Picard MH, Hua L, Burns SM, Andrawes MN. Assessment of Tricuspid Annular Motion by Speckle Tracking in Anesthetized Patients Using Transesophageal Echocardiography. Anesth Analg 2018; 126:62-67. [PMID: 29116970 DOI: 10.1213/ane.0000000000002614] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND The perioperative assessment of right ventricular (RV) function remains a challenge. Tricuspid annular plane systolic excursion (TAPSE) using M-mode is a widely used measure of RV function. However, accurate alignment of the ultrasound beam with the direction of annular movement can be difficult with transesophageal echocardiography (TEE) to measure TAPSE, precluding effective use of M-mode to measure annular excursion. Tracking of specular reflectors in the myocardium may provide an angle-independent method to assess annular motion with TEE. We hypothesized that TEE speckle tracking of the lateral tricuspid annular motion represents a comparable measurement to the well-validated M-mode TAPSE on transthoracic echocardiogram (TTE), and may be considered as a reasonable alternative to TAPSE. METHODS This is a prospective, observational cohort study. We included all patients, who were in sinus rhythm, with a preoperative TTE within 3 months of scheduled cardiac surgery that required intraoperative TEE. Tissue motion annular displacements (TMAD) of the lateral (L), septal (S), and midpoint (M) tricuspid annulus were measured (QLAB Cardiac Motion Quantification; Philips Medical, Andover, MA) after induction of general anesthesia. This was compared to the preoperative M-mode TAPSE on TTE. RESULTS Seventy-two consecutive patients who met eligibility requirements were enrolled from September to November 2016. Twelve were excluded due to poor image quality, allowing TMAD to be analyzed in 60 patients. TMAD was analyzed offline and TMAD analysis was able to track tricuspid annular motion in all patients. The mean TMAD (L), TMAD (S), and TMAD (M) were 17.4 ± 5.2, 10.2 ± 4.8, and 14.2 ± 4.8 mm, respectively. TMAD (L) showed close correlation with M-mode TAPSE on TTE (r = 0.87, 95% confidence interval, 0.79-0.92; P < .01). All patients with a preoperative TAPSE <17 mm had a TMAD (L) <17 mm, while 71% of those with a TAPSE ≥ 17 mm had a TMAD (L) ≥ 17 mm. There was strong positive correlation between TMAD (L) and intraoperative RV fractional area change (r = 0.86, 95% confidence interval, 0.77-0.91; P < .01). Reproducibility analysis of TMAD within and across observers showed excellent correlation. CONCLUSIONS TMAD is a quick and angle-independent method to quantitatively assess RV longitudinal function by TEE. It correlates strongly with M-mode TAPSE on TTE. Because TMAD and TAPSE were not simultaneously measured in this study, their correlation is subject to differences in loading conditions, general anesthesia, and changes in the disease process. TMAD may be easily applied in routine clinical settings and its role in the perioperative environment deserves to be further explored.
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Affiliation(s)
- Tao Shen
- From the Department of Anesthesia, Critical Care and Pain Medicine
| | - Michael H Picard
- Cardiac Ultrasound Laboratory, Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Lanqi Hua
- Cardiac Ultrasound Laboratory, Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Sara M Burns
- From the Department of Anesthesia, Critical Care and Pain Medicine
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Abstract
BACKGROUND The postnatal period in preterm infants involves multiple physiological changes occurring immediately after birth and continuing for days or weeks. To recognise and treat compromise, it is important to measure cardiovascular function. The aim of this study was to describe longitudinal left ventricular function using conventional and novel echocardiography techniques in preterm infants who did not experience significant antenatal or postnatal complications and treatments. METHODS We prospectively obtained cardiac ultrasound images at days 3, 7, 14, 21, and 28 in 25 uncomplicated, preterm infants <30 weeks of gestation. Speckle tracking analysis of the four chambers and short-axis images provided parameters of left ventricular volume, deformation, and basal myocardial velocities. The patent ductus arteriosus, cardiac dimensions, and atrial volume were also measured. RESULTS Stroke volume increased by 24% during the study period (1.05-1.30 ml/kg, p<0.05). Cardiac length, diameter, and systolic basal myocardial velocity increased with unchanged wall stress and deformation parameters. Diastolic function parameters resembled that of the fetus with predominance of atrial contraction compared with early diastolic velocities. Blood pressure and estimates of left ventricular filing pressure increased, suggesting that left ventricular compliance did not change in this period. CONCLUSION Stroke volume increased in the first 28 days after preterm birth. The preterm heart adapted by increasing its size, while maintaining systolic and atrial function, independent of early diastolic maturation. Longitudinal deformation of the left ventricle remained unchanged, suggesting relatively preserved function with maturation.
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Kauer F, van Dalen BM, Michels M, Schinkel AFL, Vletter WB, van Slegtenhorst M, Soliman OII, Geleijnse ML. Delayed and decreased LV untwist and unstrain rate in mutation carriers for hypertrophic cardiomyopathy. Eur Heart J Cardiovasc Imaging 2017; 18:383-389. [PMID: 28013283 DOI: 10.1093/ehjci/jew213] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 09/15/2016] [Indexed: 11/12/2022] Open
Abstract
Background The echocardiographic focus to detect abnormalities in genetically hypertrophic cardiomyopathy (HCM) affected subjects without left ventricular (LV) hypertrophy (G+/LVH-) has been on diastolic abnormalities in transmitral flow and longitudinal myocardial function with tissue Doppler imaging. The aim of this study was to assess diastolic LV unstrain and untwist. Methods and results Forty-one consecutive genotyped family members of HCM patients (mean age 37 ± 11 years, 16 men) and 41 age- and gender-matched healthy volunteers underwent speckle-tracking echocardiography to measure untwist and unstrain. No significant differences between G+/LVH- and control subjects were seen in maximal systolic twist and global longitudinal strain. In diastole, the early peak untwist rate was significantly lower in G+/LVH- subjects compared with control subjects (62 ± 19°s - 1 vs. 76 ± 30°s - 1, P <0.05), whereas the late peak untwist rate tended to be higher. Untwist from maximal twist until the first 20% of diastole was delayed in G+/LVH- subjects (39.3 ± 12.9% vs. 51.3 ± 15.6%, P <0.005). Late diastolic unstrain rate was significantly higher in G+/LVH- subjects in the inferoseptal wall (111 ± 33 s - 1 vs. 94 ± 32 s - 1, P = 0.024), the inferolateral wall (105 ± 42 vs. 75 ± 35 s - 1, P = 0.007) and the anteroseptal wall (97 ± 26 vs. 80 ± 23 s - 1, P = 0.010). Unstrain from maximal twist until the first 20% of diastole was delayed in G+/LVH- subjects in the inferoseptal (18.9 ± 14.0% vs. 30.1 ± 17.7%, P = 0.005), inferolateral (27.1 ± 16.3% vs. 39.2 ± 18.0%, P = 0.015) and anteroseptal (19.1 ± 14.7% vs. 35.8 ± 18.5%, P = 0.0003) segments. Conclusions In mutation carriers, for HCM LV, untwist and unstrain are delayed and untwist rate and unstrain rate are decreased.
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Affiliation(s)
- Floris Kauer
- Department of Cardiology, The Thoraxcenter, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Bas M van Dalen
- Department of Cardiology, The Thoraxcenter, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Michelle Michels
- Department of Cardiology, The Thoraxcenter, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Arend F L Schinkel
- Department of Cardiology, The Thoraxcenter, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Wim B Vletter
- Department of Cardiology, The Thoraxcenter, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Marjon van Slegtenhorst
- Department of Genetics, The Thoraxcenter, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Osama I I Soliman
- Department of Cardiology, The Thoraxcenter, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Marcel L Geleijnse
- Department of Cardiology, The Thoraxcenter, Erasmus University Medical Center, Rotterdam, The Netherlands
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Geleijnse ML, Di Martino LFM, Vletter WB, Ren B, Galema TW, Van Mieghem NM, de Jaegere PPT, Soliman OII. Limitations and difficulties of echocardiographic short-axis assessment of paravalvular leakage after corevalve transcatheter aortic valve implantation. Cardiovasc Ultrasound 2016; 14:37. [PMID: 27600600 PMCID: PMC5011797 DOI: 10.1186/s12947-016-0080-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 08/25/2016] [Indexed: 12/20/2022] Open
Abstract
To make assessment of paravalvular aortic leakage (PVL) after transcatheter aortic valve implantation (TAVI) more uniform the second Valve Academic Research Consortium (VARC) recently updated the echocardiographic criteria for mild, moderate and severe PVL. In the VARC recommendation the assessment of the circumferential extent of PVL in the short-axis view is considered critical. In this paper we will discuss our observational data on the limitations and difficulties of this particular view, that may potentially result in overestimation or underestimation of PVL severity.
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Affiliation(s)
- Marcel L Geleijnse
- From the department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Thoraxcenter, Ba304, 's-Gravendijkwal 230, 3015, CE, Rotterdam, The Netherlands.
| | - Luigi F M Di Martino
- From the department of Cardiology, Ospedali Riuniti, Università degli Studi di Foggia, Foggia, Italy
| | - Wim B Vletter
- From the department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Thoraxcenter, Ba304, 's-Gravendijkwal 230, 3015, CE, Rotterdam, The Netherlands
| | - Ben Ren
- From the department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Thoraxcenter, Ba304, 's-Gravendijkwal 230, 3015, CE, Rotterdam, The Netherlands
| | - Tjebbe W Galema
- From the department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Thoraxcenter, Ba304, 's-Gravendijkwal 230, 3015, CE, Rotterdam, The Netherlands
| | - Nicolas M Van Mieghem
- From the department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Thoraxcenter, Ba304, 's-Gravendijkwal 230, 3015, CE, Rotterdam, The Netherlands
| | - Peter P T de Jaegere
- From the department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Thoraxcenter, Ba304, 's-Gravendijkwal 230, 3015, CE, Rotterdam, The Netherlands
| | - Osama I I Soliman
- From the department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Thoraxcenter, Ba304, 's-Gravendijkwal 230, 3015, CE, Rotterdam, The Netherlands.,From the Cardialysis Cardiovascular Core Laboratory, Rotterdam, The Netherlands
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de Waal K, Phad N, Collins N, Boyle A. Myocardial function during bradycardia events in preterm infants. Early Hum Dev 2016; 98:17-21. [PMID: 27351349 DOI: 10.1016/j.earlhumdev.2016.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 05/11/2016] [Accepted: 05/12/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Transient bradycardia episodes are common in preterm infants and often secondary to apnea. Decreased ventilation with resultant hypoxemia is believed to be the predominant mechanism. Sudden bradycardias without apnea are also reported, possibly due to vagal stimulation. Point of care ultrasound is used to diagnose and follow cardiovascular complications in preterm infants. Inadvertently, the operator would sometimes capture bradycardia events. This study reports on left ventricular function during such events. METHODS We retrospectively reviewed our cardiac ultrasound database for bradycardia events. Apical four or three chamber images before, during and after a bradycardia event were analysed with speckle tracking software which provides systolic and diastolic parameters of myocardial motion, deformation and volume. RESULTS Over a 2year period, 15 bradycardia events were noted in 14 patients with a median gestational age of 26weeks (range 23 to 29). Heart rate decreased by an average of 43% (171/min to 98/min). Myocardial velocity and longitudinal strain rate during the atrial component of diastole were reduced during bradycardia. Longitudinal strain during systole was increased and radial deformation was unchanged. Ventricular volumes and ejection fraction did not change. Most parameters returned to baseline values after the event. Longitudinal systolic strain rate remained lower and stroke volume was 12% higher compared to baseline. CONCLUSION Parameters of systolic contractility and stroke volume were maintained and parameters of atrial contractility were reduced during mild to moderate bradycardia in preterm infants. Bradycardia reduces total cardiac output with a compensatory increase detected following the event.
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Affiliation(s)
- Koert de Waal
- Department of Neonatology, John Hunter Children's Hospital and University of Newcastle, Newcastle, NSW, Australia.
| | - Nilkant Phad
- Department of Neonatology, John Hunter Children's Hospital and University of Newcastle, Newcastle, NSW, Australia
| | - Nick Collins
- Department of Cardiology, John Hunter Hospital and University of Newcastle, Newcastle, NSW, Australia
| | - Andrew Boyle
- Department of Cardiology, John Hunter Hospital and University of Newcastle, Newcastle, NSW, Australia
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Coronary flow velocity reserve by echocardiography: feasibility, reproducibility and agreement with PET in overweight and obese patients with stable and revascularized coronary artery disease. Cardiovasc Ultrasound 2016; 14:22. [PMID: 27267255 PMCID: PMC4897868 DOI: 10.1186/s12947-016-0066-3] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 06/01/2016] [Indexed: 11/15/2022] Open
Abstract
Background Coronary flow velocity reserve (CFVR) measured by transthoracic Doppler echocardiography of the LAD is used to assess microvascular function but validation studies in clinical settings are lacking. We aimed to assess feasibility, reproducibility and agreement with myocardial flow reserve (MFR) measured by PET in overweight and obese patients. Methods Participants with revascularized coronary artery disease were examined by CFVR. Subgroups were examined by repeated CFVR (reproducibility) or Rubidium-82-PET (agreement). To account for time variation, results were computed for scans performed within a week (1-week) and for all scans regardless of time gap (total) and to account for scar tissue for patients with and without previous myocardial infarction (MI). Results Eighty-six patients with median BMI 30.9 (IQR 29.4–32.9) kg × m−2 and CFVR 2.29 (1.90–2.63) were included. CFVR was feasible in 83 (97 %) using a contrast agent in 14 %. For reproducibility overall (n = 21) limits of agreement (LOA) were (−0.75;0.71), within-subjects coefficient of variation (CV) 11 %, and reliability 0.84. For reproducibility within 1-week (n = 13) LOA were (−0.33;0.25), within-subjects CV 5 %, and reliability 0.97. Agreement with MFR of the LAD territory (n = 35) was without significant bias and overall LOA were (−1.40;1.46). Agreement was best for examinations performed within 1-week of participants without MI of the LAD-territory (n = 12); LOA = (−0.68;0.88). Conclusions CFVR was highly feasible with a good reproducibility on par with other contemporary measures applied in cardiology. Agreement with MFR was acceptable, though discrepancy related to prior MI has to be considered. CFVR of LAD is a valid tool in overweight and obese patients.
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Cardiac Function After the Immediate Transitional Period in Very Preterm Infants Using Speckle Tracking Analysis. Pediatr Cardiol 2016; 37:295-303. [PMID: 26472651 DOI: 10.1007/s00246-015-1277-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2015] [Accepted: 10/07/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND The postnatal period in preterm infants involves multiple physiologic changes starting directly after birth and continuing for days or weeks. To recognize and treat compromise, it is important to measure cardiovascular function. We used a novel technique (speckle tracking echocardiography, STE) to measure cardiac function in this period. METHODS We obtained cardiac ultrasound images at day 3, 7, 14, 21 and 28 in preterm infants <30-week gestation. Conventional measures included cardiac size, left ventricular stroke volume, atrial volume and the patent ductus arteriosus (PDA). Four chamber images were analyzed with STE, which provided parameters of left ventricular volume, longitudinal deformation and myocardial velocities. RESULTS Images of 54 infants (gestational age 23-29 weeks) were analyzed. STE-derived stroke volume correlated well with conventional echocardiography-derived stroke volume, but agreement was suboptimal. Most STE parameters showed good reliability. All volume parameters and systolic and atrial velocities increased over time. Cardiac deformation and early diastolic velocity did not change. A PDA was associated with 33 % increased stroke volume at day 3 up to 98 % at day 28 with a spherically enlarged heart and increased filling pressure. CONCLUSION Speckle tracking echocardiography analysis is a feasible and reliable technique that can simultaneously obtain systolic and diastolic volumes, longitudinal deformation and myocardial velocities from one ultrasound window. Preterm hearts maintain cardiac function well during the first weeks of life, even with increased preload as a consequence of a PDA.
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Aguilar FG, Selvaraj S, Martinez EE, Katz DH, Beussink L, Kim KYA, Ping J, Rasmussen-Torvik L, Goyal A, Sha J, Irvin MR, Arnett DK, Shah SJ. Archeological Echocardiography: Digitization and Speckle Tracking Analysis of Archival Echocardiograms in the HyperGEN Study. Echocardiography 2015; 33:386-97. [PMID: 26525308 DOI: 10.1111/echo.13095] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Several large epidemiologic studies and clinical trials have included echocardiography, but images were stored in analog format and these studies predated tissue Doppler imaging (TDI) and speckle tracking echocardiography (STE). We hypothesized that digitization of analog echocardiograms, with subsequent quantification of cardiac mechanics using STE, is feasible, reproducible, accurate, and produces clinically valid results. METHODS In the NHLBI HyperGEN study (N = 2234), archived analog echocardiograms were digitized and subsequently analyzed using STE to obtain tissue velocities/strain. Echocardiograms were assigned quality scores and inter-/intra-observer agreement was calculated. Accuracy was evaluated in: (1) a separate second study (N = 50) comparing prospective digital strain versus post hoc analog-to-digital strain, and (2) in a third study (N = 95) comparing prospectively obtained TDI e' velocities with post hoc STE e' velocities. Finally, we replicated previously known associations between tissue velocities/strain, conventional echocardiographic measurements, and clinical data. RESULTS Of the 2234 HyperGEN echocardiograms, 2150 (96.2%) underwent successful digitization and STE analysis. Inter/intra-observer agreement was high for all STE parameters, especially longitudinal strain (LS). In accuracy studies, LS performed best when comparing post hoc STE to prospective digital STE for strain analysis. STE-derived e' velocities correlated with, but systematically underestimated, TDI e' velocity. Several known associations between clinical variables and cardiac mechanics were replicated in HyperGEN. We also found a novel independent inverse association between fasting glucose and LS (adjusted β = -2.4 [95% CI -3.6, -1.2]% per 1-SD increase in fasting glucose; P < 0.001). CONCLUSIONS Archeological echocardiography, the digitization and speckle tracking analysis of archival echocardiograms, is feasible and generates indices of cardiac mechanics similar to contemporary studies.
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Affiliation(s)
- Frank G Aguilar
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Senthil Selvaraj
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Eva E Martinez
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Daniel H Katz
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Lauren Beussink
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Kwang-Youn A Kim
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Jie Ping
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Laura Rasmussen-Torvik
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Amita Goyal
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Jin Sha
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Marguerite R Irvin
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Donna K Arnett
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Sanjiv J Shah
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Sugimoto K, Fujii Y, Sunahara H, Aoki T. Assessment of left ventricular longitudinal function in cats with subclinical hypertrophic cardiomyopathy using tissue Doppler imaging and speckle tracking echocardiography. J Vet Med Sci 2015; 77:1101-8. [PMID: 25877405 PMCID: PMC4591151 DOI: 10.1292/jvms.14-0354] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Hypertrophic cardiomyopathy (HCM) in cats is characterized by concentric left
ventricular (LV) hypertrophy and both diastolic and systolic dysfunction. Although
impaired cardiac function detected by tissue Doppler imaging (TDI) in cats with HCM was
previously reported, reference ranges of TDI in normal cats and cats with HCM have been
reported as widely variable. Two-dimensional speckle tracking echocardiography (STE) was
useful for assessment of cardiac function in human patients with HCM, but clinical utility
was not known in cats. The aim of this study was to assess global and segmental LV
myocardial function using STE in cats with HCM whose TDI variables were within the
reference range. A total of 35 cats of different breeds were enrolled in this study. The
HCM group (n=22) was cats diagnosed as HCM without left atrial enlargement and with normal
TDI measurements. HCM cats were further divided into a segmental hypertrophy (S-HCM) group
and a diffuse hypertrophy (D-HCM) group. The control group consisted of 13 clinically
healthy cats. No cats in any group showed any clinical symptoms. Conventional
echocardiography, TDI, and global and segmental STE indices were evaluated and compared
between groups. Only the longitudinal strain rate during early diastole was significantly
decreased in both HCM groups, even in all segments including those without hypertrophy in
S-HCM group. This study suggests that STE parameters are the more sensitive variables
compared with conventional TDI parameters to detect early myocardial diastolic dysfunction
in cats with HCM.
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Affiliation(s)
- Keisuke Sugimoto
- Laboratory of Surgery 1, Azabu University, 1-17-71 Fuchinobe, Chuo-ku, Sagamihara-shi, Kanagawa 252-5201, Japan
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12
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LV Mechanics in Mitral and Aortic Valve Diseases. JACC Cardiovasc Imaging 2014; 7:1151-66. [DOI: 10.1016/j.jcmg.2014.07.015] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Revised: 07/22/2014] [Accepted: 07/24/2014] [Indexed: 11/22/2022]
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Gonçalves S, Cortez-Dias N, Nunes A, Belo A, Zimbarra Cabrita I, Sousa C, Pinto FJ. Left ventricular systolic dysfunction detected by speckle tracking in hypertensive patients with preserved ejection fraction. Rev Port Cardiol 2014; 33:27-37. [PMID: 24405559 DOI: 10.1016/j.repc.2013.07.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Accepted: 07/22/2013] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION The spectrum of hypertensive heart disease is wide, and can include left ventricular dysfunction. The development of echocardiographic parameters to improve patient stratification and to identify early adverse changes could be clinically useful. Aim To identify subclinical left ventricular dysfunction in hypertensive subjects with preserved ejection fraction (>55%), identified by global parameters of myocardial strain on speckle tracking imaging. METHODS This was a comparative observational study of two groups of individuals: normotensive (n=20, age 59 ± 7 years, 55% male) and hypertensive (n=229, age 62 ± 12 years, 57% male). Left ventricular function was assessed by various conventional clinical and echocardiographic parameters and global longitudinal and circumferential myocardial strain. Cut-off values to detect subclinical left ventricular dysfunction were established and applied in the hypertensive group. The Student's t test, Mann-Whitney test and chi-square test were used for the comparative statistical analysis. RESULTS Most hypertensive subjects (53.7%) had grade I hypertension; blood pressure was controlled in 64.9%, and 54.8% showed left ventricular structural changes. Comparison between the normotensive and hypertensive groups showed no significant differences in parameters of global longitudinal or circumferential systolic strain. Application of the cut-offs to the hypertensive group identified 35 individuals (15.3%) as having subclinical left ventricular systolic dysfunction as assessed by global longitudinal myocardial strain parameters. CONCLUSIONS In this group of hypertensive patients, global myocardial strain parameters identified a group of individuals with subclinical left ventricular systolic dysfunction despite preserved ejection fraction. The clinical relevance of these findings needs to be assessed in long-term follow-up studies.
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Affiliation(s)
- Susana Gonçalves
- Departamento de Cardiologia, Instituto Cardiovascular de Lisboa, Lisboa, Portugal; Serviço de Cardiologia, Centro Académico de Medicina de Lisboa, Hospital de Santa Maria, CCUL, Lisboa, Portugal.
| | - Nuno Cortez-Dias
- Serviço de Cardiologia, Centro Académico de Medicina de Lisboa, Hospital de Santa Maria, CCUL, Lisboa, Portugal
| | - Ana Nunes
- Departamento de Cardiologia, Instituto Cardiovascular de Lisboa, Lisboa, Portugal
| | - Adriana Belo
- Departamento de Estatística, Centro Nacional de Coleção de Dados em Cardiologia, Sociedade Portuguesa de Cardiologia, Lisboa, Portugal
| | - Inês Zimbarra Cabrita
- Departamento de Cardiologia, Instituto Cardiovascular de Lisboa, Lisboa, Portugal; Serviço de Cardiologia, Centro Académico de Medicina de Lisboa, Hospital de Santa Maria, CCUL, Lisboa, Portugal
| | - Catarina Sousa
- Departamento de Cardiologia, Instituto Cardiovascular de Lisboa, Lisboa, Portugal
| | - Fausto J Pinto
- Departamento de Cardiologia, Instituto Cardiovascular de Lisboa, Lisboa, Portugal; Serviço de Cardiologia, Centro Académico de Medicina de Lisboa, Hospital de Santa Maria, CCUL, Lisboa, Portugal
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14
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Gonçalves S, Cortez-Dias N, Nunes A, Belo A, Zimbarra Cabrita I, Sousa C, Pinto FJ. Left ventricular systolic dysfunction detected by speckle tracking in hypertensive patients with preserved ejection fraction. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2014. [DOI: 10.1016/j.repce.2013.07.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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15
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McGhie JS, Vletter WB, de Groot-de Laat LE, Ren B, Frowijn R, van den Bosch AE, Soliman OII, Geleijnse ML. Contributions of simultaneous multiplane echocardiographic imaging in daily clinical practice. Echocardiography 2013; 31:245-54. [PMID: 24138028 DOI: 10.1111/echo.12407] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Jackie S McGhie
- Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, The Netherlands
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16
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Elmayergi NH, Goodman JM, Lee LS, Sasson Z. Are measures of left ventricular systolic performance during low dose dobutamine stress echocardiograms repeatable over time? Int J Cardiovasc Imaging 2013; 29:1281-6. [PMID: 23589004 DOI: 10.1007/s10554-013-0219-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2012] [Accepted: 04/07/2013] [Indexed: 11/30/2022]
Abstract
To establish the test-retest reliability and the normal dose-response relationship of echocardiographic measures of Left Ventricular (LV) contractile function to low dose dobutamine stress in healthy individuals. Thirty healthy volunteers (23 males, 7 females) with an average age of 38 ± 13 years underwent dobutamine stress echocardiography (DSE) (at successive doses of 0, 5, 10, and 20 mcg/kg/min) on two occasions, separated by 14 days. Ejection fraction (EF) was determined from 2D echocardiographic measures of left ventricular (LV) end diastolic and end systolic volumes. Longitudinal strain (S) and strain rate (SR) were measured using 2D speckle tracking analysis from three consecutive cardiac cycles. The Intraclass Correlation Coefficient (ICC) and the Coefficient of Variation (CV) were calculated to assess reliability and variability of the study population's EF, S, and SR responses to increasing doses of dobutamine. Left ventricular S and EF gradually increased with low doses of dobutamine but reached a plateau between 10 and 20 mcg/kg/min. Strain rate, however, gradually increases with each increasing dose of dobutamine. These responses were replicated on Day 2 with a high degree of reliability as determined from the ICC and low variability as determined from the CV, which fell within acceptable limits (<10 %). Left ventricular EF, S and SR can be measured during DSE with a high degree of test-retest reliability, and may be of clinical value when serial follow up of DSE measures of LV performance is indicated over time.
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Affiliation(s)
- Nader H Elmayergi
- Division of Cardiology, Mount Sinai Hospital, University of Toronto, 600 University Ave, Suite 1602, Toronto, ON, M5G 1X5, Canada.
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17
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Mokhles P, van den Bosch AE, Vletter - McGhie JS, Van Domburg RT, Ruys TPE, Kauer F, Geleijnse ML, Roos - Hesselink JW. Feasibility and Observer Reproducibility of Speckle Tracking Echocardiography in Congenital Heart Disease Patients. Echocardiography 2013; 30:961-6. [DOI: 10.1111/echo.12172] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Affiliation(s)
- Palwasha Mokhles
- Department of Cardiology; Thorax Center; Erasmus University Medical Center; Rotterdam; The Netherlands
| | | | | | - Ron T. Van Domburg
- Department of Cardiology; Thorax Center; Erasmus University Medical Center; Rotterdam; The Netherlands
| | - Titia P. E. Ruys
- Department of Cardiology; Thorax Center; Erasmus University Medical Center; Rotterdam; The Netherlands
| | - Floris Kauer
- Department of Cardiology; Thorax Center; Erasmus University Medical Center; Rotterdam; The Netherlands
| | - Marcel L. Geleijnse
- Department of Cardiology; Thorax Center; Erasmus University Medical Center; Rotterdam; The Netherlands
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18
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Echocardiography and Vascular Ultrasound: New Developments and Future Directions. Can J Cardiol 2013; 29:304-16. [DOI: 10.1016/j.cjca.2012.11.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Revised: 10/22/2012] [Accepted: 11/02/2012] [Indexed: 12/15/2022] Open
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19
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Kauer F, van Dalen BM, Michels M, Soliman OII, Vletter WB, van Slegtenhorst M, ten Cate FJ, Geleijnse ML. Diastolic abnormalities in normal phenotype hypertrophic cardiomyopathy gene carriers: a study using speckle tracking echocardiography. Echocardiography 2012; 30:558-63. [PMID: 23228071 DOI: 10.1111/echo.12076] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Tissue Doppler imaging (TDI) of the mitral annulus has been proposed as an alternative for the identification of hypertrophic cardiomyopathy (HCM) genetically affected subjects without left ventricular hypertrophy (G+/LVH-). Unfortunately, conflicting results have been described in the literature, potentially caused by the angle-dependency of TDI. This study sought to assess abnormalities in mitral annular velocities in G+/LVH- subjects as detected by speckle tracking echocardiography (STE). METHODS The study population consisted of 23 consecutive genotyped family members without major or minor criteria for the diagnosis of HCM (mean age 37 ± 13 years, 9 men) and 23 healthy volunteers (age 38 ± 12 years, 12 men) who prospectively underwent STE. RESULTS There were no significant differences in global peak systolic annular velocity (7.4 ± 1.2 vs. 7.1 ± 1.0 cm/sec) and early diastolic annular velocity (10.2 ± 2.5 vs. 11.3 ± 2.2 cm/sec) between G+/LVH- and control subjects. Global peak late diastolic annular velocity was higher in G+/LVH- subjects (8.1 ± 1.7 vs. 5.7 ± 1.1 cm/sec, P < 0.001). Regionally, this difference was seen in all 6 studied LV walls. CONCLUSIONS This STE study confirms our previous TDI observations on increased peak late diastolic annular velocities in G+/LVH- subjects. Because of the complete overlap in early diastolic annular velocities this parameter cannot be used in the genotypes we studied to differentiate genotype (+) from genotype (-) individuals.
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Affiliation(s)
- Floris Kauer
- Department of Cardiology, The Thoraxcenter, Erasmus University Medical Center, Rotterdam, The Netherlands
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20
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Soliman OI, Geleijnse ML, Caliskan K, Vletter WB, Ten Cate FJ. Diagnostic uncertainties and future perspectives in noncompaction cardiomyopathy. ACTA ACUST UNITED AC 2012; 6:221-33. [PMID: 23480687 DOI: 10.1517/17530059.2012.673582] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Noncompaction cardiomyopathy (NCCM) is a new pathoanatomic entity, disputably believed to result from abnormal arrest in embryonic endomyocardial morphogenesis. During almost three decades of research of NCCM, more knowledge has developed alongside diagnostic uncertainties and precise definition. In this article, we present these uncertainties and provide perspectives on how to overcome these challenges. AREAS COVERED The uncertainties, about NCCM regarding nomenclature, classification, pathophysiology, and limitations of the current diagnostic criteria will be reviewed. The application of newer imaging modalities will be contrasted in relation to conventional assessments. Finally, future aspirations will be outlined providing a more thoughtful appraisal toward NCCM diagnosis. EXPERT OPINION Our current understanding of NCCM is limited by heterogeneity of disease spectrum and phenotype-genotype overlap with other cardiac anomalies. Selection bias, small sampling, and retrospective nature limit most of published studies on NCCM. There are three main research fields related to NCCM: pathoanatomic studies, imaging studies, and genetic screening. Besides conventional echocardiography, imaging should include both structural (cardiac MRI, contrast and 3D echocardiography) and functional diagnosis using deformation imaging. These research aspects should be integrated in a collaborative international registry of nonselective populations in order to achieve better understanding and optimal diagnosis of NCCM. Moreover, it holds the promise of the detection of earlier stages of disease. A clear pathoanatomic cut-off definition of NCCM should be the initial step toward uniform imaging diagnosis.
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Affiliation(s)
- Osama Ii Soliman
- Department of Cardiology , Thoraxcenter, Erasmus MC, Rotterdam , The Netherlands
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21
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Echocardiographic Evaluation of Left Ventricular Structure and Function: New Modalities and Potential Applications in Clinical Trials. J Card Fail 2012; 18:159-72. [DOI: 10.1016/j.cardfail.2011.10.019] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2011] [Revised: 10/10/2011] [Accepted: 10/28/2011] [Indexed: 12/17/2022]
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22
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Kimura K, Takenaka K, Ebihara A, Okano T, Uno K, Fukuda N, Ando J, Fujita H, Morita H, Yatomi Y, Nagai R. Speckle Tracking Global Strain Rate E/E′ Predicts LV Filling Pressure More Accurately Than Traditional Tissue Doppler E/E′. Echocardiography 2011; 29:404-10. [DOI: 10.1111/j.1540-8175.2011.01587.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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23
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Ahmad H, Mor-Avi V, Lang RM, Nesser HJ, Weinert L, Tsang W, Steringer-Mascherbauer R, Niel J, Salgo IS, Sugeng L. Assessment of right ventricular function using echocardiographic speckle tracking of the tricuspid annular motion: comparison with cardiac magnetic resonance. Echocardiography 2011; 29:19-24. [PMID: 21967480 DOI: 10.1111/j.1540-8175.2011.01519.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Assessment of right ventricular (RV) function is difficult due to the complex shape of this chamber. Tricuspid annular plane systolic excursion (TAPSE) measured with M-mode echocardiography is frequently used as an index of RV function. However, its accuracy may be limited by ultrasound beam misalignment. We hypothesized that two-dimensional (2D) speckle tracking echocardiography (STE) could provide more accurate estimates of RV function. Accordingly, STE was used to quantify tricuspid annular displacement (TAD), from which RV longitudinal shortening fraction (LSF) was calculated. These STE derived indices were compared side-by-side with M-mode TAPSE measurements against cardiac magnetic resonance (CMR) derived RV ejection fraction (EF). METHODS Echocardiography (Philips iE33, four-chamber view) and CMR (Siemens, 1.5 T) were performed on the same day in 63 patients with a wide range of RV EF (23-70% by CMR). TAPSE was measured using M-mode echocardiography. TAD and RV LSF were obtained using STE analysis (QLAB CMQ, Philips). TAPSE, TAD and RV LSF values were compared with RV EF obtained from CMR short axis stacks. RESULTS STE analysis required <15 seconds and was able to track tricuspid annular motion in all patients as verified visually. Correlation between RV EF and TAD (0.61 free-wall, 0.65 septal) was similar to that with M-mode TAPSE (0.63). However, STE-derived RV LSF showed a higher correlation with CMR EF (r = 0.78). CONCLUSION RV LSF measurement by STE is fast and easy to obtain and provides more accurate evaluation of RV EF than the traditional M-mode TAPSE technique, when compared to CMR reference. (Echocardiography 2012;29:19-24).
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Affiliation(s)
- Homaa Ahmad
- Department of Medicine, University of Chicago Medical Center, Chicago, IL 60637, USA
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24
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Abstract
Diabetic heart disease is currently defined as left ventricular dysfunction that occurs independently of coronary artery disease and hypertension. Its underlying etiology is likely to be multifactorial, acting synergistically together to cause myocardial dysfunction. Multimodality cardiac imaging, such as echocardiography, nuclear, computed tomography, and magnetic resonance imaging, can provide invaluable insight into different aspects of the disease process, from imaging at the cellular level for altered myocardial metabolism to microvascular and endothelial dysfunction, autonomic neuropathy, coronary atherosclerosis, and finally, interstitial fibrosis with scar formation. Furthermore, cardiac imaging is pivotal in diagnosing diabetic heart disease. Thus, the aim of the present review is to illustrate the role of multimodality cardiac imaging in elucidating the underlying pathophysiologic mechanisms of diabetic heart disease.
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25
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Tzikas A, van Dalen BM, Van Mieghem NM, Gutierrez-Chico JL, Nuis RJ, Kauer F, Schultz C, Serruys PW, de Jaegere PPT, Geleijnse ML. Frequency of conduction abnormalities after transcatheter aortic valve implantation with the Medtronic-CoreValve and the effect on left ventricular ejection fraction. Am J Cardiol 2011; 107:285-9. [PMID: 21129715 DOI: 10.1016/j.amjcard.2010.09.015] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2010] [Revised: 09/10/2010] [Accepted: 09/14/2010] [Indexed: 11/27/2022]
Abstract
New conduction abnormalities occur frequently after transcatheter aortic valve implantation (TAVI). The relation between new conduction disorders and left ventricular (LV) systolic function after TAVI is unknown. The purpose of the present prospective, single-center study was to investigate the effect of TAVI on LV systolic function in relation to TAVI-induced conduction abnormalities. A total of 27 patients had undergone electrocardiography and transthoracic echocardiography the day before and 6 days after TAVI with the Medtronic-CoreValve system. The LV ejection fraction (EF) was calculated using the biplane Simpson method. The systolic mitral annular velocities and longitudinal strain were measured using speckle tracking echocardiography. After TAVI, 18 patients (67%) had new conduction abnormalities; 4 (15%) had a new paced rhythm and 14 patients (52%) had new left bundle branch block. In the patients with new conduction abnormalities, the EF decreased from 47 ± 12% to 44 ± 10%. In contrast, in those without new conduction abnormalities, the EF increased from 49 ± 12% to 54% ± 12%. The change in EF was significantly different among those with and without new conduction abnormalities (p <0.05). In patients without new conduction abnormalities, an improvement was found in the systolic mitral annular velocities and longitudinal strain (p <0.05). In contrast, in patients with new conduction abnormalities, the changes were not significant. In conclusion, the induction of new conduction abnormalities after TAVI with the Medtronic-CoreValve was associated with a lack of improvement in LV systolic function.
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Affiliation(s)
- Apostolos Tzikas
- Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands.
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Myocardial Tissue Doppler Velocity Imaging in Children: Comparative Study between Two Ultrasound Systems. J Am Soc Echocardiogr 2010; 23:929-37. [DOI: 10.1016/j.echo.2010.06.028] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2010] [Indexed: 11/20/2022]
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27
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Koopman LP, Slorach C, Hui W, Manlhiot C, McCrindle BW, Friedberg MK, Jaeggi ET, Mertens L. Comparison between Different Speckle Tracking and Color Tissue Doppler Techniques to Measure Global and Regional Myocardial Deformation in Children. J Am Soc Echocardiogr 2010; 23:919-28. [DOI: 10.1016/j.echo.2010.06.014] [Citation(s) in RCA: 143] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2010] [Indexed: 11/24/2022]
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