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Asanuma T. Myocardial motion in acute ischemia: revealing invisible deformation by echocardiography. J Echocardiogr 2024; 22:71-78. [PMID: 38615090 DOI: 10.1007/s12574-024-00650-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 03/14/2024] [Accepted: 03/16/2024] [Indexed: 04/15/2024]
Abstract
Echocardiography has been used clinically to assess regional myocardial wall motion for the diagnosis of acute myocardial ischemia or stress-induced ischemia, but it is often difficult to distinguish hypokinetic motion from normal motion. Myocardial wall motion is affected by loading conditions as well as intrinsic contractility, making it challenging to define a normal range of wall motion. Therefore, hypokinesis is usually diagnosed by comparing target areas with other areas of myocardium considered normal (relative hypokinesis). Myocardial strain analysis by tissue Doppler echocardiography and speckle-tracking echocardiography has enabled objective and quantitative evaluation of regional myocardial wall motion. Peak systolic strain decreases during acute ischemia, but subtle and invisible myocardial motion, such as early systolic lengthening (ESL) and postsystolic shortening (PSS), also occurs, and the analysis of these subtle motions can improve the diagnostic accuracy of ischemia. However, the diagnosis of ischemic myocardium by strain analysis is not widely performed in clinical practice at this time due to several limitations. This article reviews the features of myocardial motion during acute ischemia, the mechanisms of ESL and PSS, the diagnosis of ischemic myocardium using strain analysis, and current approaches and future challenges to overcome the limitations in the detection of relative hypokinesis. This article also explains the use of ESL and PSS to detect myocardial ischemic memory that remains after brief ischemia.
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Affiliation(s)
- Toshihiko Asanuma
- Division of Cardiology, Shimane University Faculty of Medicine, 89-1 Enya-Cho, Izumo, Shimane, 693-8501, Japan.
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Brainin P. Myocardial Postsystolic Shortening and Early Systolic Lengthening: Current Status and Future Directions. Diagnostics (Basel) 2021; 11:diagnostics11081428. [PMID: 34441362 PMCID: PMC8393947 DOI: 10.3390/diagnostics11081428] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/26/2021] [Accepted: 08/04/2021] [Indexed: 11/21/2022] Open
Abstract
The concept of paradoxical myocardial deformation, commonly referred to as postsystolic shortening and early systolic lengthening, was originally described in the 1970s when assessed by invasive cardiac methods, such as ventriculograms, in patients with ischemia and animal experimental models. Today, novel tissue-based imaging technology has revealed that these phenomena occur far more frequently than first described. This article defines these deformational patterns, summarizes current knowledge about their existence and highlights the clinical potential associated with their understanding.
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Affiliation(s)
- Philip Brainin
- Department of Cardiology, Herlev-Gentofte Hospital, Copenhagen University Hospital, DK-2900 Gentofte, Denmark
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Takeda S, Asanuma T, Masuda K, Nakatani S. Novel Estimation of Left Ventricular Filling Pressure Using 3-D Speckle-Tracking Echocardiography: Assessment in a Decompensated Systolic Heart Failure Model. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:1536-1547. [PMID: 33771416 DOI: 10.1016/j.ultrasmedbio.2021.02.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 02/10/2021] [Accepted: 02/14/2021] [Indexed: 06/12/2023]
Abstract
E/e' allows for the non-invasive estimation of left ventricular (LV) filling pressure; however, Doppler malalignment can make the estimation unreliable, especially in dilated systolic failing hearts. The ratio of peak early diastolic filling rate to peak early diastolic global strain rate (FRe/SRe), which is a parameter derived from 3-D speckle-tracking echocardiography to estimate filling pressure, may be better applied in dilated systolic failing hearts because it can be obtained without the Doppler method. We investigated whether FRe/SRe could provide a better estimation of filling pressure than E/e' in 23 dogs with decompensated systolic heart failure induced by microembolization. FRe/SRe had better correlation coefficients with LV end-diastolic pressure (0.75-0.90) than did E/e' (0.40). The diagnostic accuracy of FRe/SRe in distinguishing elevated filling pressure was significantly higher than that of E/e'. This study indicates that FRe/SRe may provide a better estimation of LV filling pressure than E/e' in dilated systolic failing hearts.
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Affiliation(s)
- Serina Takeda
- Division of Functional Diagnostics, Department of Health Sciences, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Toshihiko Asanuma
- Division of Functional Diagnostics, Department of Health Sciences, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
| | - Kasumi Masuda
- Division of Functional Diagnostics, Department of Health Sciences, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Satoshi Nakatani
- Division of Functional Diagnostics, Department of Health Sciences, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
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Asanuma T, Nakayama T, Masuda K, Takeda S, Nakatani S. Regional heterogeneity of afterload sensitivity in myocardial strain. J Med Ultrason (2001) 2020; 47:501-506. [PMID: 32770371 DOI: 10.1007/s10396-020-01045-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 07/07/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE The peak systolic strain decreases due to afterload augmentation. However, its deterioration (i.e., afterload sensitivity) may be different within the left ventricular (LV) segments. We investigated how afterload influences regional strain and whether there is regional heterogeneity of afterload sensitivity. METHODS Afterload was increased by aortic banding in 20 open-chest dogs. Short-axis images were acquired at baseline and during banding. Circumferential strain was analyzed in six segments, and the absolute decrease in the peak systolic strain during banding (Δε) was calculated for each segment. To assess the effect of the compensatory preload recruitment during banding, the endocardial lengths of the septum and free wall were measured at end-diastole, and the rate of increase due to banding was calculated. RESULTS LV systolic pressure was significantly increased during banding (100 ± 14 vs. 143 ± 18 mmHg, P < 0.001). The peak systolic strain in all segments was significantly decreased during banding. Δɛ in the anterior segment, which is a part of the free wall, was significantly lower than that in the inferoseptal segment (2.6 ± 4.7 vs. 6.5 ± 3.5%, P = 0.035). The rate of increase in endocardial length in the free wall was significantly larger than that in the septum (15.6 ± 10.4 vs. 8.1 ± 7.4%, P = 0.014). CONCLUSION The decrease in septal strain during afterload augmentation was larger than that in free wall strain, indicating that there was regional heterogeneity of afterload sensitivity in circumferential strain. The larger compensatory preload recruitment in the free wall than in the septum is implicated as a cause of the heterogeneity.
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Affiliation(s)
- Toshihiko Asanuma
- Division of Functional Diagnostics, Department of Health Sciences, Osaka University Graduate School of Medicine, 1-7 Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Tomohito Nakayama
- Division of Functional Diagnostics, Department of Health Sciences, Osaka University Graduate School of Medicine, 1-7 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Kasumi Masuda
- Division of Functional Diagnostics, Department of Health Sciences, Osaka University Graduate School of Medicine, 1-7 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Serina Takeda
- Division of Functional Diagnostics, Department of Health Sciences, Osaka University Graduate School of Medicine, 1-7 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Satoshi Nakatani
- Division of Functional Diagnostics, Department of Health Sciences, Osaka University Graduate School of Medicine, 1-7 Yamadaoka, Suita, Osaka, 565-0871, Japan
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Detection of abnormal myocardial deformation during acute myocardial ischemia using three-dimensional speckle tracking echocardiography. J Echocardiogr 2019; 18:57-66. [DOI: 10.1007/s12574-019-00449-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 09/24/2019] [Accepted: 10/16/2019] [Indexed: 10/25/2022]
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Assessment of Myocardial Ischemic Memory Using Three-Dimensional Speckle-Tracking Echocardiography: A Novel Integrated Analysis of Early Systolic Lengthening and Postsystolic Shortening. J Am Soc Echocardiogr 2019; 32:1477-1486. [PMID: 31466849 DOI: 10.1016/j.echo.2019.06.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 04/29/2019] [Accepted: 06/15/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND Persistence of subtle abnormal myocardial deformation such as postsystolic shortening (PSS) after transient ischemia can be used to diagnose a history of myocardial ischemia (myocardial ischemic memory). Furthermore, early systolic lengthening (ESL) has recently attracted attention as another marker of myocardial ischemia. However, it is unclear whether the persistence of such abnormal deformation can be detected by three-dimensional (3D) speckle-tracking echocardiography, which has relatively low spatial and temporal resolution compared with two-dimensional echocardiography. The aim of this study was to evaluate the diagnostic accuracy of myocardial ischemic memory and its spatial extent using 3D speckle-tracking echocardiography. METHODS The left circumflex coronary artery was occluded for 2 min, followed by reperfusion, in 33 dogs. Their hemodynamic and 3D echocardiographic data were chronologically acquired. Peak systolic strain, early systolic strain index as a parameter of ESL, postsystolic strain index as a parameter of PSS, and myocardial dysfunction index as a combined parameter of ESL and PSS were analyzed in all left ventricular segments. RESULTS At the center of the risk area, early systolic strain index and postsystolic strain index significantly increased until 20 min after reperfusion compared with baseline, although peak systolic strain recovered by 20 min. Myocardial dysfunction index significantly increased for >20 min after reperfusion and allowed better diagnostic accuracy of ischemic memory than the other parameters. In the 147 risk segments, abnormal values of myocardial dysfunction index remained in 49 segments (33%) at 20 min after reperfusion, whereas abnormal peak systolic strain was observed in only 13 segments (9%). CONCLUSIONS ESL and PSS persisted after transient ischemia and could be detected by 3D speckle-tracking echocardiography. Integrated analysis of ESL and PSS provided higher diagnostic accuracy of ischemic memory. This method may be useful for detecting transient ischemic insults in patients after the disappearance of anginal attack.
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Afterload Augmentation Can Reveal Concealed Myocardial Ischemic Memory. JACC Cardiovasc Imaging 2018; 11:1727-1729. [DOI: 10.1016/j.jcmg.2018.03.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 03/12/2018] [Accepted: 03/20/2018] [Indexed: 11/19/2022]
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Brainin P, Hoffmann S, Fritz-Hansen T, Olsen FJ, Jensen JS, Biering-Sørensen T. Usefulness of Postsystolic Shortening to Diagnose Coronary Artery Disease and Predict Future Cardiovascular Events in Stable Angina Pectoris. J Am Soc Echocardiogr 2018; 31:870-879.e3. [DOI: 10.1016/j.echo.2018.05.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Indexed: 11/16/2022]
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Kim KH, Na SH, Park JS. Role of Quantitative Wall Motion Analysis in Patients with Acute Chest Pain at Emergency Department. J Cardiovasc Ultrasound 2017; 25:20-27. [PMID: 28400932 PMCID: PMC5385313 DOI: 10.4250/jcu.2017.25.1.20] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 02/06/2017] [Accepted: 02/21/2017] [Indexed: 11/23/2022] Open
Abstract
Background Evaluation of acute chest pain in emergency department (ED), using limited resource and time, is still very difficult despite recent development of many diagnostic tools. In this study, we tried to determine the applicability of new semi-automated cardiac function analysis tool, velocity vector imaging (VVI), in the evaluation of the patients with acute chest pain in ED. Methods We prospectively enrolled 48 patients, who visited ED with acute chest pain, and store images to analyze VVI from July 2005 to July 2007. Results In 677 of 768 segments (88%), the analysis by VVI was feasible among 48 patients. Peak systolic radial velocity (Vpeak) and strain significantly decreased according to visual regional wall motion abnormality (Vpeak, 3.50 ± 1.34 cm/s for normal vs. 3.46 ± 1.52 cm/s for hypokinesia, 2.51 ± 1.26 for akinesia, p < 0.01; peak systolic radial strain -31.74 ± 9.15% fornormal, -24.33 ± 6.28% for hypokinesia, -20.30 ± 7.78% for akinesia, p < 0.01). However, the velocity vectors at the time of mitral valve opening (MVO) were directed outward in the visually normal myocardium, inward velocity vectors were revealed in the visually akinetic area (VMVO, -0.85 ± 1.65 cm/s for normal vs. 0.10 ± 1.46 cm/s for akinesia, p < 0.001). At coronary angiography, VMVO clearly increased in the ischemic area (VMVO, -0.88+1.56 cm/s for normal vs. 0.70 + 2.04 cm/s for ischemic area, p < 0.01). Conclusion Regional wall motion assessment using VVI showed could be used to detect significant ischemia in the patient with acute chest pain at ED.
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Affiliation(s)
- Kyung-Hee Kim
- Division of Cardiology, Department of Internal Medicine, Sejong General Hospital, Bucheon, Korea
| | - Sang-Hoon Na
- Division of Cardiology, Department of internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.; Institute on Aging, Seoul National University, Seoul, Korea
| | - Jin-Sik Park
- Division of Cardiology, Department of Internal Medicine, Sejong General Hospital, Bucheon, Korea
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Myocardial layer-specific analysis of ischemic memory using speckle tracking echocardiography. Int J Cardiovasc Imaging 2014; 30:739-48. [PMID: 24532055 DOI: 10.1007/s10554-014-0388-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Accepted: 02/09/2014] [Indexed: 10/25/2022]
Abstract
The assessment of post-systolic shortening (PSS) by speckle tracking echocardiography allows myocardial ischemic memory imaging. Because the endocardial layer is more vulnerable to ischemia, the assessment of this layer might be useful for detecting ischemic memory. Serial echocardiographic data were acquired from nine dogs with 2 min of coronary occlusion followed by reperfusion. Regional deformation parameters were measured in the risk and normal areas. Using speckle tracking echocardiography, circumferential strain was analyzed in the endocardial, mid-wall, and epicardial layers; and radial strain was analyzed in the inner half, outer half and entire (transmural) layers. In the risk area, peak systolic and end-systolic strain in the circumferential and radial directions significantly decreased during occlusion, but recovered to the baseline levels immediately after reperfusion in all layers. However, circumferential post-systolic strain index (PSI), a parameter of PSS, significantly increased during occlusion, and the significant increases persisted until 20 min after reperfusion in the endocardial and mid-wall layers. Radial PSI tended to increase after reperfusion in the inner half and entire layers but these increases were not significant compared with baseline. In the normal area, systolic strains and PSI in the radial and circumferential directions hardly changed before and after occlusion/reperfusion in all layers. In layer-specific analysis with speckle tracking echocardiography, circumferential PSS in the endocardial and mid-wall layers may be useful for detecting ischemic memory.
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From speckle tracking echocardiography to torsion: research tool today, clinical practice tomorrow. Curr Opin Crit Care 2014; 19:250-7. [PMID: 23519081 DOI: 10.1097/mcc.0b013e32836092b7] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Speckle tracking is the latest available technology in echocardiography. However, the technology is still mainly used as a research tool. The potential applications of speckle tracking are many, including cardiac synchronization, regional wall motion analysis, and in the areas of cardiac mechanic studies. This review presents the background theory of speckle tracking echocardiography (STE) and how this technology can be extended to velocity vector analysis, strain, and torsion measurements. The interpretations of these measurements are covered. We also present some potential applications in the critical care setting. RECENT FINDINGS Speckle tracking is almost always available in high-end ultrasound machines. The technology has been applied to velocity vector analysis, strain and strain rate measurements, and twist and torsion analysis. Torsion analysis and velocity vector analyses are impossible without using speckle tracking. Speckle tracking-derived strain is superior to tissue Doppler strain because it is angle-independent. A number of studies demonstrated that STE is useful in left and right heart assessments and can be used in assessing preload and afterload. SUMMARY Speckle tracking can be used to measure instantaneous myocardial contractility, strain, and left ventricular torsion. It is still a research tool at present, but shows the promise of being a clinical tool in the future.
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Kurosawa K, Watanabe H, Aikawa M, Mihara H, Iguchi N, Asano R, Umemura J, Kurabayashi M, Sumiyoshi T. Post-exercise diastolic stunning detected by velocity vector imaging is a useful marker for induced ischemia in ischemic heart disease. J Echocardiogr 2013; 11:50-8. [DOI: 10.1007/s12574-012-0163-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Revised: 12/04/2012] [Accepted: 12/28/2012] [Indexed: 11/25/2022]
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Left and right ventricular strain and strain rate measurement in normal adults using velocity vector imaging: an assessment of reference values and intersystem agreement. Int J Cardiovasc Imaging 2012; 29:571-80. [DOI: 10.1007/s10554-012-0120-7] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Accepted: 08/21/2012] [Indexed: 10/27/2022]
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Iwama M, Kawasaki M, Tanaka R, Ono K, Watanabe T, Hirose T, Nagaya M, Noda T, Watanabe S, Minatoguchi S. Left atrial appendage emptying fraction assessed by a feature-tracking echocardiographic method is a determinant of thrombus in patients with nonvalvular atrial fibrillation. J Cardiol 2012; 59:329-36. [DOI: 10.1016/j.jjcc.2012.01.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2011] [Revised: 12/10/2011] [Accepted: 01/02/2012] [Indexed: 01/24/2023]
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Kazui T, Niinuma H, Tsuboi J, Okabayashi H. Changes in left ventricular twist after mitral valve repair. J Thorac Cardiovasc Surg 2011; 141:716-24. [DOI: 10.1016/j.jtcvs.2010.05.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2009] [Revised: 04/07/2010] [Accepted: 05/09/2010] [Indexed: 10/19/2022]
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Rodríguez-Bailón I, Jiménez-Navarro MF, Pérez-González R, García-Orta R, Morillo-Velarde E, de Teresa-Galván E. Left ventricular deformation and two-dimensional echocardiography: temporal and other parameter values in normal subjects. Rev Esp Cardiol 2011; 63:1195-9. [PMID: 20875360 DOI: 10.1016/s1885-5857(10)70234-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Segmental contractility can be assessed quantitatively by analyzing deformation, or strain, and the rate of deformation, or the strain rate. This type of analysis can be performed using either tissue Doppler imaging or, more recently, two-dimensional speckle-tracking echocardiography. The aim of this study was to determine typical parameter values in healthy subjects and their reproducibility. The study involved 105 healthy individuals, including 55 women (52.45%). Their mean age was 38.8 ± 9.5 years (range, 20-59 years). All underwent speckle-tracking echocardiography with velocity vector imaging. Mean values for the strain and strain rate for each segment as well as for the time-to-peak normalized by the length of the cycle (TPN) were obtained. The resulting mean values were: circumferential strain, 22.2 ± 4.81% with a TPN of 0.39 ± 0.06; longitudinal strain, 19.84 ± 4.59% with a TPN of 0.42 ± 0.06; circumferential strain rate, 1.64 ± 0.48 1/s with a TPN of 0.23 ± 0.06; and longitudinal strain rate, 1.3 ± 0.49 1/s with a TPN of 0.21 ± 0.09. Intra- and inter-observer variability were moderate in magnitude.
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Butz T, Lang CN, van Bracht M, Prull MW, Yeni H, Maagh P, Plehn G, Meissner A, Trappe HJ. Segment-orientated analysis of two-dimensional strain and strain rate as assessed by velocity vector imaging in patients with acute myocardial infarction. Int J Med Sci 2011; 8:106-13. [PMID: 21326953 PMCID: PMC3039226 DOI: 10.7150/ijms.8.106] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2010] [Accepted: 01/31/2011] [Indexed: 11/15/2022] Open
Abstract
AIMS Strain rate imaging techniques have been proposed for the detection of ischemic or viable myocardium in coronary artery disease, which is still a challenge in clinical cardiology. This retrospective comparative study analyzed regional left ventricular function and scaring with two-dimensional strain (2DS) in the first 4 to 10 days after acute anterior myocardial infarction (AMI). METHODS AND RESULTS The study population consisted of 32 AMI patients with an LAD occlusion and successful reperfusion. The assessment of peak systolic 2DS and peak systolic strain rate (SR) was performed segment-oriented with the angle-independent speckle tracking algorithm Velocity Vector Imaging (VVI). The infarcted, adjacent and non-infarcted segments were revealed by late enhancement MRI (LE-MRI), which was used as reference for the comparison with 2DS. The infarcted segments showed a significant decrease of tissue velocities, 2DS and SR in comparison to the non-affected segments. CONCLUSION 2DS and SR as assessed by VVI seem to be a suitable approach for echocardiographic quantification of global and regional myocardial function as well as a promising tool for multimodal risk stratification after anterior AMI.
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Affiliation(s)
- Thomas Butz
- Department of Cardiology and Angiology, Marienhospital Herne, Ruhr University Bochum, Herne, Germany.
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Asanuma T, Masuda K, Beppu S, Nakatani S. After-the-fact recognition of myocardial ischemic insult: significance of post-systolic thickening evaluated by speckle tracking echocardiography. J Echocardiogr 2010; 8:140-1. [PMID: 27278950 DOI: 10.1007/s12574-010-0047-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2010] [Revised: 04/26/2010] [Accepted: 04/27/2010] [Indexed: 11/25/2022]
Affiliation(s)
- Toshihiko Asanuma
- Department of Health Sciences, Division of Functional Diagnostics, Osaka University Graduate School of Medicine, 1-7 Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Kasumi Masuda
- Department of Health Sciences, Division of Functional Diagnostics, Osaka University Graduate School of Medicine, 1-7 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Shintaro Beppu
- Department of Health Sciences, Division of Functional Diagnostics, Osaka University Graduate School of Medicine, 1-7 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Satoshi Nakatani
- Department of Health Sciences, Division of Functional Diagnostics, Osaka University Graduate School of Medicine, 1-7 Yamadaoka, Suita, Osaka, 565-0871, Japan
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Rodríguez-Bailón I, Jiménez-Navarro MF, Pérez-González R, García-Orta R, Morillo-Velarde E, de Teresa-Galván E. Deformación ventricular izquierda en ecocardiografía bidimensional: valores y tiempos en sujetos normales. Rev Esp Cardiol 2010. [DOI: 10.1016/s0300-8932(10)70252-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Truong UT, Li X, Broberg CS, Houle H, Schaal M, Ashraf M, Kilner P, Sheehan FH, Sable CA, Ge S, Sahn DJ. Significance of mechanical alterations in single ventricle patients on twisting and circumferential strain as determined by analysis of strain from gradient cine magnetic resonance imaging sequences. Am J Cardiol 2010; 105:1465-9. [PMID: 20451696 DOI: 10.1016/j.amjcard.2009.12.074] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2009] [Revised: 12/22/2009] [Accepted: 12/22/2009] [Indexed: 10/19/2022]
Abstract
Preliminary speckle-tracking echocardiographic studies show that patients with single ventricles (SVs) have significantly decreased twisting and dyssynchrony of twisting. This could be related to abnormal cardiac looping, which leads to hearts that lack helical fiber patterns. The aim of this study was to analyze gradient cine magnetic resonance imaging (MRI) using Velocity Vector Imaging to assess cardiac mechanics. Subjects were 38 patients (aged 8 to 37 years) with SVs of left ventricular (n = 30) and indeterminate (n = 8) type who underwent cardiac MRI. Controls were 14 normal children and adults. Gradient cine MRI sequences close to the apex were subjected to a Velocity Vector Imaging analysis program adapted for MRI. In the control group, mean circumferential strain was -18.02 +/- 7.31%, mean dispersion of peak circumferential strain was 44.23 +/- 37.14 ms, and average rotation was -7.7 +/- 1.38 degrees . The rotation values were negative, or counterclockwise. In patients with SVs, mean circumferential strain was -8.87 +/- 7.30%, mean dispersion of peak circumferential strain was 181.55 +/- 76.07 ms, and average rotation was -2.6 +/- 1.24 degrees (p <0.001). Mean dispersion of the peak of rotation in the control group was 39.6 +/- 22.8 ms, compared to 166.5 +/- 72.4 ms in patients with SVs. In conclusion, this study showed a dramatic decrease in apical rotation and circumferential strain in the SV group compared to the control group. Strain and rotation mechanics at the apex in patients with SVs showed marked dyssynchrony.
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