1
|
Park SH, Kim Y, Lee M, Lee SH, Bae JS, Lee JH, Kim TJ, Ko SB, Jeong SW, Kim DE, Ryu WS. The usefulness of global longitudinal peak strain and left atrial volume index in predicting atrial fibrillation in patients with ischemic stroke. Front Neurol 2024; 14:1287609. [PMID: 38249733 PMCID: PMC10797101 DOI: 10.3389/fneur.2023.1287609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 12/11/2023] [Indexed: 01/23/2024] Open
Abstract
Introduction Detection of atrial fibrillation (AF) is crucial for preventing recurrence in patients with ischemic stroke. We aimed to examine whether the left atrial volume index (LAVI) and global longitudinal peak strain (GLPS) are associated with AF in patients with ischemic stroke. Methods We prospectively analyzed 678 consecutive patients with ischemic stroke. LAVI and GLPS were assessed using three-dimensional transthoracic echocardiography with speckle-tracking imaging. Multiple logistic regression was used to evaluate the association of AF with LAVI and GLPS. To evaluate the predictive value of LAVI and GLPS for the presence of AF, we used optimism-corrected c-statistics calculated by 100 bootstrap repetitions and the net reclassification improvement (NRI). Results The mean patient age was 68 ± 13 years (men, 60%). Patients with AF (18%) were a higher LAVI (41.7 ml/m2 vs. 74.9 ml/m2, P < 0.001) and a higher GLPS than those without AF (-14.0 vs. -17.3, P < 0.001). Among the 89 patients classified with embolic stroke of unknown source, the probable cardioembolic group had higher GLPS (n= 17, -14.6 vs. -18.6, respectively; P= 0.014) than the other groups (n= 72). Adding GLPS to age, hypertension, and the LAVI significantly improved the NRI, with an overall NRI improvement of 6.1% (P= 0.03). Discussion The LAVI andGLPS with speckle-tracking imaging echocardiography may help identify patients with AF.
Collapse
Affiliation(s)
- Soo-Hyun Park
- Department of Neurology, Hallym University Kangdong Sacred Heart Hospital, Seoul, Republic of Korea
| | - Yerim Kim
- Department of Neurology, Hallym University Kangdong Sacred Heart Hospital, Seoul, Republic of Korea
| | - Minwoo Lee
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Sang-Hwa Lee
- Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Jong Seok Bae
- Department of Neurology, Hallym University Kangdong Sacred Heart Hospital, Seoul, Republic of Korea
| | - Ju-Hun Lee
- Department of Neurology, Hallym University Kangdong Sacred Heart Hospital, Seoul, Republic of Korea
| | - Tae Jung Kim
- Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sang-Bae Ko
- Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sang-Wuk Jeong
- Department of Neurology, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
| | - Dong-Eog Kim
- Department of Neurology, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
| | - Wi-Sun Ryu
- Department of Neurology, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
| |
Collapse
|
2
|
Xie Z, Wu T, Mu J, Zhang P, Wang X, Liang T, Weng Y, Luo J, Yu H. Influence of Left Ventricular Diastolic Dysfunction on the Diagnostic Performance of Coronary Computed Tomography Angiography-Derived Fractional Flow Reserve. J Clin Med 2023; 12:jcm12051724. [PMID: 36902511 PMCID: PMC10003343 DOI: 10.3390/jcm12051724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/05/2023] [Accepted: 02/19/2023] [Indexed: 02/24/2023] Open
Abstract
OBJECTIVES Our study aimed to demonstrate the influence of left ventricular (LV) diastolic dysfunction on the diagnostic performance of coronary computed tomography angiography-derived fractional flow reserve (CT-FFR). METHODS One hundred vessels from 90 patients were retrospectively analyzed. All patients underwent echocardiography, coronary computed tomography angiography (CCTA), CT-FFR, invasive coronary angiography (ICA), and fractional flow reserve (FFR). The study population was divided into normal and dysfunction groups according to the LV diastolic function, and the diagnostic performance in both groups was assessed. RESULTS There was a good correlation between CT-FFR and FFR (R = 0.768 p < 0.001) on a per-vessel basis. The sensitivity, specificity, and accuracy were 82.3%, 81.8%, and 82%, respectively. The sensitivity, specificity, and accuracy were 84.6%, 88.5%, and 87.2% in the normal group and 81%, 77.5%, and 78.7% in the dysfunction group, respectively. CT-FFR showed no statistically significant difference in the AUC in the normal group vs. the dysfunction group (AUC: 0.920 [95% CI 0.787-0.983] vs. 0.871 [95% CI 0.761-0.943], Z = 0.772 p = 0.440). However, there was still a good correlation between CT-FFR and FFR in the normal group (R = 0.767, p < 0.001) and dysfunction group (R = 0.767 p < 0.001). CONCLUSIONS LV diastolic dysfunction had no effect on the diagnostic accuracy of CT-FFR. CT-FFR has good diagnostic performance in both LV diastolic dysfunction and the normal group and can be used as an effective tool for finding lesion-specific ischemia while screening for arterial disease in patients.
Collapse
Affiliation(s)
- Zhixin Xie
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China
- Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
- Guangdong Cardiovascular Institute, Guangzhou 510080, China
| | - Tianlong Wu
- Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
- Guangdong Cardiovascular Institute, Guangzhou 510080, China
| | - Jing Mu
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China
- Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
- Guangdong Cardiovascular Institute, Guangzhou 510080, China
| | - Ping Zhang
- Department of Cardiology, Shenzhen Hospital, Southern Medical University, Shenzhen 518000, China
| | - Xuan Wang
- Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
- School of Medicine, South China University of Technology, Guangzhou 510006, China
| | - Tao Liang
- Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
- School of Medicine, South China University of Technology, Guangzhou 510006, China
| | - Yihan Weng
- Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
- Guangdong Cardiovascular Institute, Guangzhou 510080, China
- Shantou University Medical College, Shantou 515041, China
| | - Jianfang Luo
- Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
- Guangdong Cardiovascular Institute, Guangzhou 510080, China
| | - Huimin Yu
- Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
- Guangdong Cardiovascular Institute, Guangzhou 510080, China
- Department of Cardiology, Guangdong Provincial People’s Hospital’s Nanhai Hospital, Foshan 528000, China
- Correspondence:
| |
Collapse
|
3
|
Hsiao CS, Hsiao SH. Relationship of left atrial expansion index to exercise tolerance, pretest probability of restenosis, and positive predictive value of treadmill test in coronary artery disease. Echocardiography 2020; 37:388-398. [PMID: 32077515 DOI: 10.1111/echo.14620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 01/18/2020] [Accepted: 01/31/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Whether left atrial (LA) expansion index is associated with coronary restenosis, and exercise capacity (EC) reduction in coronary artery disease has not been established. METHODS This study analyzed 342 consecutive patients who had received a coronary stent implant. A treadmill exercise test (TET) was administered in all participants. The LA expansion indices were measured immediately before and after TET. Maximal EC measured on a breath-by-breath basis by a metabolic cart with gas analyzers and recorded as metabolic equivalent task. All patients with positive TET results received angiography, and those with restenosis received complete revascularization by either percutaneous coronary intervention (PCI) or bypass surgery. The LA expansion index and EC before and 1 month after PCI were then compared. RESULTS Out of 342 patients, 74 had positive TET results, and 54 had restenosis in angiography. Low LA expansion index was associated with poor EC. In patients with LA expansion index > 200%, only 5% had restenosis with 38.5% positive predictive value (PPV) of TET. In patients with LA expansion index < 100%, however, 64.3% had restenosis with 94.7% PPV of TET. Restenosis induced low pre-TET LA expansion index and further decline during TET. The LA expansion index significantly (P .001) improved from 133 ± 64% before PCI to184 ± 86% after PCI, and the improvement corresponded with EC recovery. A 10% reduction in LA expansion index was associated with a 15% increase in pretest probability of restenosis. CONCLUSION The LA expansion index is associated with EC, pretest probability of restenosis, and PPV of TET. Revascularization improves both EC and LA expansion index.
Collapse
Affiliation(s)
- Chao-Sheng Hsiao
- Department of Internal Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Shih-Hung Hsiao
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Division of Cardiology, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan
| |
Collapse
|
4
|
Madhavan S, Narayanapillai J, Paikada J, Jayaprakash K, Jayaprakash VL. Two-dimensional speckle tracking echocardiography as a predictor of significant coronary artery stenosis in female patients with effort angina who are treadmill test positive: An angiographic correlation. JOURNAL OF CLINICAL AND PREVENTIVE CARDIOLOGY 2019. [DOI: 10.4103/jcpc.jcpc_6_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
5
|
Diagnosis of Heart Failure With Preserved Ejection Fraction: Machine Learning of Spatiotemporal Variations in Left Ventricular Deformation. J Am Soc Echocardiogr 2018; 31:1272-1284.e9. [DOI: 10.1016/j.echo.2018.07.013] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Indexed: 11/20/2022]
|
6
|
Magdy G, Sadaka M, Elzawawy T, Elmaghraby A. Effect of elective percutaneous coronary intervention of left anterior descending coronary artery on regional myocardial function using strain imaging. Egypt Heart J 2018; 70:83-88. [PMID: 30166887 PMCID: PMC6112371 DOI: 10.1016/j.ehj.2017.12.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 12/03/2017] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Percutaneous coronary intervention (PCI) is a commonly used procedure for revascularization, however the impairment of regional myocardial function in patients with stable coronary artery disease (CAD) has not been well characterized, our study aimed to assess the improvement of left ventricular (LV) systolic function after elective PCI of the left anterior descending artery (LAD) using strain and strain rate imaging techniques. MATERIALS AND METHODS The study included 30 patients (aged 56.8 ± 6.6 years, 66.7% males) presented with stable CAD on optimal medical therapy, and recommended for elective PCI to LAD, all patients included in the study had a normal LV wall motions, and normal LV systolic function. Tissue Doppler imaging (TDI) was done before PCI, immediately, and three months post PCI. The peak systolic longitudinal strain (PSLS), and peak systolic strain rate (PSSR) were measured and averaged for the 6 LAD segments (the basal, mid, and apical segments of the anterior wall, the basal, mid anteroseptal, and the apicoseptal segments), 15 healthy control subjects were included as a control group. RESULTS The average PSLS and PSSR of the ischemic segments were significantly lower in patients compared to control in the ischemic segments, and significantly increased 3 months post PCI but not immediately post PCI. Using the ROC curve a cutoff value of -13.69% for PSLS can detect regional ischemia with a sensitivity 93.3% and a specificity of 80%. CONCLUSIONS TDI derived strain and strain rate can detect resting regional myocardial dysfunction in presence of preserved LV systolic function, and can assess the improvement of regional myocardial function after successful elective PCI in patients with stable CAD.
Collapse
Affiliation(s)
- Gehan Magdy
- Department of Cardiology, Alexandria University, Egypt
| | | | | | | |
Collapse
|
7
|
Zhang HM, Wang XT, Zhang LN, He W, Zhang Q, Liu DW. Left Ventricular Longitudinal Systolic Function in Septic Shock Patients with Normal Ejection Fraction: A Case-control Study. Chin Med J (Engl) 2018; 130:1169-1174. [PMID: 28485316 PMCID: PMC5443022 DOI: 10.4103/0366-6999.205856] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background: Septic cardiomyopathy is a common finding in septic shock patients. The accepted definition of septic cardiomyopathy is often based on the left ventricular ejection fraction (LVEF). The aim of this study was to determine whether the left ventricular longitudinal systolic function was more sensitive than the LVEF in heart function appraisal of septic shock patients. Methods: This was a case-control study conducted at a 40-bed Intensive Care Unit (ICU) of Peking Union Medical College Hospital. Septic shock patients admitted to the ICU were consecutively enrolled in the study group from March 1, 2016 to September 1, 2016. The control group was selected from nonsepsis patients who were admitted to the ICU and were comparable to the study group. Transthoracic echocardiography was performed to obtain the LVEF measurement, mitral annular plane systolic excursion (MAPSE), tissue Doppler velocity measurement of mitral annulus (Sa), and tricuspid annular plane systolic excursion. Results: The study group consisted of 45 septic shock patients. Another 45 nonsepsis patients were selected as the control group. There was no difference in the LVEF between the two groups (64.6% vs. 67.2%, t = −1.426, P = 0.161). MAPSE in the study group was much lower than in the control group (1.2 cm vs. 1.5 cm, t = −4.945, P < 0.001). Sa in the study group was also lower than in the control group (10.2 cm/s vs. 11.8 cm/s, t = −2.796, P = 0.014). Conclusions: Compared to the LVEF, longitudinal systolic function might be more sensitive in the detection of cardiac depression in septic shock patients. In the heart function appraisal of septic shock patients with a normal ejection fraction, more attention should be given to longitudinal function parameters such as MAPSE and Sa.
Collapse
Affiliation(s)
- Hong-Min Zhang
- Department of Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China
| | - Xiao-Ting Wang
- Department of Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China
| | - Li-Na Zhang
- Department of Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Hunan 410013, China
| | - Wei He
- Department of Critical Care Medicine, Beijing Tongren Hospital, Capital Medical College, Beijing 100730, China
| | - Qing Zhang
- Department of Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China
| | - Da-Wei Liu
- Department of Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China
| | | |
Collapse
|
8
|
T-wave changes in patients with Wellens syndrome are associated with increased myocardial mechanical and electrical dispersion. Int J Cardiovasc Imaging 2017; 33:1541-1549. [PMID: 28551719 DOI: 10.1007/s10554-017-1181-4] [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: 03/07/2017] [Accepted: 05/24/2017] [Indexed: 12/19/2022]
Abstract
Some patients with unstable angina and critical stenosis of the left anterior descending coronary artery (LAD) present with Wellens syndrome (WS), i.e., inverted or biphasic T-waves in the anterior precordial leads. We assessed clinical, angiographic, electro- and echocardiographic characteristic of patients with WS. In this retrospective study, clinical, angiographic, electro- and echocardiographic characteristic of 35 patients with WS were compared to 57 patients with critical LAD stenosis and normal resting electrocardiogram (ECG), and 45 subjects with normal coronary angiogram. QTc dispersion was measured from the 12-lead ECG as the difference between longest and shortest QTc intervals. Mechanical dispersion was defined as the time difference between the longest and shortest contraction durations which were measured as the time from the first deflection of the QRS complex to maximum myocardial shortening of each 18 segmental longitudinal strain curves derived by speckle tracking echocardiography. There were no significant differences in the complexity and location of the LAD lesion, anterograde and collateral flow in LAD and coronary artery dominance between patients with WS and normal ECG (P > 0.05, for all). Patients with WS had lower global longitudinal strain (GLS) and more pronounced both QTc and myocardial mechanical dispersion than patients with critical LAD stenosis and normal ECG, and control subjects (P < 0.05). T-wave changes in patients with WS are associated with more profound regional myocardial dysfunction and increased QTc and myocardial mechanical dispersion. Similar angiographic characteristics of the LAD lesion were seen in patients with WS and normal ECG.
Collapse
|
9
|
Vrettos A, Dawson D, Grigoratos C, Nihoyannopoulos P. Correlation between global longitudinal peak systolic strain and coronary artery disease severity as assessed by the angiographically derived SYNTAX score. Echo Res Pract 2016; 3:29-34. [PMID: 27248153 PMCID: PMC4989094 DOI: 10.1530/erp-16-0005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Accepted: 04/12/2016] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND In this study, we investigate the correlation between reduced global longitudinal peak systolic strain (GLPSS) and the SYNTAX score (SS) in patients undergoing coronary angiography. METHODS We examined 71 patients undergoing both echocardiogram and coronary angiography within 15 days. All patients had normal global and/or regional wall motion on resting echocardiogram. We calculated GLPSS using two-dimensional speckle-tracking echocardiography. SS was calculated for each group of patients based on the presence and/or the severity of coronary artery disease (CAD): no CAD on angiogram (n=10, control group), low SS (n=36, SS<22) and high SS (n=25, SS≥22). We hypothesised that GLPSS at rest is inversely correlated with the angiographically derived SS. RESULTS Age, sex and most of the risk factors were equally distributed among the groups. There was a significant inverse correlation between GLPSS and SS values (r(2)=0.3869, P<0.001). This correlation was weaker in the low-SS group (r(2)=0.1332, P<0.05), whereas it was lost in the high-SS group (r(2)=0.0002, P=NS). Receiver operating characteristic curve analysis identified that the optimal cut-off for the detection of high-SS patients was 13.95% (sensitivity=71%, specificity=90%, P<0.001). CONCLUSIONS The results of our study suggest that GLPSS might be promising for the detection of patients with high SYNTAX score on coronary angiogram. There is an inverse correlation between resting GLPSS and SS as assessed by coronary angiography. In patients with the highest SS, however, the correlation with GLPSS was less significant.
Collapse
Affiliation(s)
- Apostolos Vrettos
- Imperial College London, National Heart and Lung Institute, Hammersmith Hospital, London, UK
| | - David Dawson
- Imperial College London, National Heart and Lung Institute, Hammersmith Hospital, London, UK
| | - Chrysanthos Grigoratos
- Imperial College London, National Heart and Lung Institute, Hammersmith Hospital, London, UK
| | - Petros Nihoyannopoulos
- Imperial College London, National Heart and Lung Institute, Hammersmith Hospital, London, UK
| |
Collapse
|
10
|
Erdei T, Aakhus S, Marino P, Paulus WJ, Smiseth OA, Fraser AG. Pathophysiological rationale and diagnostic targets for diastolic stress testing. Heart 2015; 101:1355-60. [PMID: 26001845 DOI: 10.1136/heartjnl-2014-307040] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 04/27/2015] [Indexed: 12/25/2022] Open
Abstract
Cardiopulmonary functional reserve measured as peak oxygen uptake is predicted better at rest by measures of cardiac diastolic function than by systolic function. Normal adaptations in the trained heart include resting bradycardia, increased LV end-diastolic volume and augmented early diastolic suction on exercise. In normal populations early diastolic relaxation declines with age and end-diastolic stiffness increases, but in healthy older subjects who have exercised throughout their lives diastolic function can be well preserved. The mechanisms by which LV diastolic filling and pressures can be impaired during exercise include reduced early diastolic recoil and suction (which can be exacerbated by increased late systolic loading), increased preload and reduced compliance. Abnormal ventricular-arterial coupling and enhanced ventricular interaction may contribute in particular circumstances. One common final pathway that causes breathlessness is an increase in LV filling pressure and left atrial pressure. Testing elderly subjects with breathlessness of unknown aetiology in order to detect worsening diastolic function during stress is proposed to diagnose heart failure with preserved EF. In invasive studies, the most prominent abnormality is an early and rapid rise in pulmonary capillary wedge pressure. A systematic non-invasive diagnostic strategy would use validated methods to assess different mechanisms of inducible diastolic dysfunction and not just single parameters that offer imprecise estimates of mean LV filling pressure. Protocols should assess early diastolic relaxation and filling as well as late diastolic filling and compliance, as these may be affected separately. Better refined diagnostic targets may translate to more focused treatment.
Collapse
Affiliation(s)
- Tamás Erdei
- Wales Heart Research Institute, Cardiff University, Cardiff, UK
| | - Svend Aakhus
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Paolo Marino
- Cardiology Clinic, Universita Piemonte Orientale, Novara, Italy
| | - Walter J Paulus
- Department of Physiology, Institute for Cardiovascular Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Otto A Smiseth
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Alan G Fraser
- Wales Heart Research Institute, Cardiff University, Cardiff, UK
| |
Collapse
|
11
|
Lee M, Chang SA, Cho EJ, Park SJ, Choi JO, Lee SC, Oh JK, Park SW. Role of strain values using automated function imaging on transthoracic echocardiography for the assessment of acute chest pain in emergency department. Int J Cardiovasc Imaging 2015; 31:547-56. [DOI: 10.1007/s10554-015-0588-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 01/06/2015] [Indexed: 10/24/2022]
|
12
|
Byram B, Kim H, Van Assche L, Wolf PD, Trahey GE. The feasibility of myocardial infarct visualization using atrial kick induced strain (AKIS) contrast. ULTRASOUND IN MEDICINE & BIOLOGY 2014; 40:1104-17. [PMID: 24613554 PMCID: PMC4096930 DOI: 10.1016/j.ultrasmedbio.2013.12.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Revised: 12/13/2013] [Accepted: 12/17/2013] [Indexed: 06/03/2023]
Abstract
The most common mechanical measure of the heart integrates ventricular strain between end-diastole and end-systole in order to provide a measure of contraction. Here an approach is described for estimating a correlate to local passive mechanical properties. Passive strain is measured by estimating ventricular strain during atrial systole. During atrial systole the atria contract causing passive stretching in the ventricles from increased volume. This modification to traditional cardiac strain is here termed atrial kick induced strain (AKIS) imaging. AKIS imaging was evaluated in a canine ablation model of chronic infarct and a canine true chronic infarct model. AKIS images of ablation lesions were compared against acoustic radiation force impulse (ARFI) images and tissue blanching, and true chronic infarct AKIS images were compared against delayed enhanced-contrast magnetic resonance. AKIS images were made with 2-D and 3-D ultrasound data. In both studies, AKIS images and the comparison images show good qualitative agreement and good contrast and contrast-to-noise ratio.
Collapse
Affiliation(s)
- Brett Byram
- Department of Biomedical Engineering, Duke University, Durham, NC, USA.
| | - Han Kim
- Department of Cardiology, Duke University Medical Center, Durham, NC, USA
| | - Lowie Van Assche
- Department of Cardiology, Duke University Medical Center, Durham, NC, USA
| | - Patrick D Wolf
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - Gregg E Trahey
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| |
Collapse
|
13
|
Agarwal R, Gosain P, Kirkpatrick JN, Alyousef T, Doukky R, Singh G, Umscheid CA. Tissue Doppler imaging for diagnosis of coronary artery disease: a systematic review and meta-analysis. Cardiovasc Ultrasound 2012. [PMID: 23199010 PMCID: PMC3542063 DOI: 10.1186/1476-7120-10-47] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Global and regional left ventricular (LV) systolic dysfunction is a marker of coronary artery disease (CAD), which is conventionally assessed using two-dimensional echocardiography. Tissue Doppler imaging (TDI) has emerged as an adjunct tool in the diagnosis of regional wall motion abnormalities from CAD. We performed a systematic review and meta-analysis to assess the efficacy of TDI indices in the diagnosis of CAD. We searched MEDLINE and the Cochrane Library for controlled studies comparing TDI measurements in those with and without CAD as confirmed by coronary angiography. Meta-analyses of mean differences in TDI velocities between these populations were performed. Screening of titles and abstracts followed by full-text screening identified 8 studies. At rest, TDI was associated with a significant decrease in the pooled maximum systolic velocity among CAD patients compared to those without CAD [mean difference (MD): -0.66; 95% confidence interval (CI): -0.98 to −0.34]. There were no significant differences in maximum early and late diastolic velocities. Post-stress, TDI was associated with a significant decrease in maximum early diastolic velocity (MD: -1.91; 95% CI: -2.74 to −1.09) and maximum late diastolic velocity (MD: -1.57; 95% CI: -2.95 to −0.18) among CAD patients compared to those without CAD. There was no significant difference in maximum systolic velocity post-stress. Our results suggest that TDI may have a role in the evaluation of CAD. Future studies should evaluate the incremental value of TDI velocities over LV ejection fraction and two dimensional wall motion analysis in the detection of CAD and assessment of its severity. (Word Count: 249)
Collapse
Affiliation(s)
- Rajender Agarwal
- Department of Medicine, John H Stroger Jr Hospital of Cook County, Chicago, IL, USA.
| | | | | | | | | | | | | |
Collapse
|
14
|
Fichet J, Moreau L, Genée O, Legras A, Mercier E, Garot D, Dequin PF, Perrotin D. Feasibility of right ventricular longitudinal systolic function evaluation with transthoracic echocardiographic indices derived from tricuspid annular motion: a preliminary study in acute respiratory distress syndrome. Echocardiography 2012; 29:513-21. [PMID: 22324535 DOI: 10.1111/j.1540-8175.2011.01650.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Assessment of right ventricular (RV) function in patients with acute respiratory distress syndrome (ARDS) remains challenging. Transthoracic echocardiographic (TTE) indices based on longitudinal systolic RV function are now considered as a reliable evaluation of RV function. We investigated feasibility of two methods in ARDS patients. METHODS Prospective observational study. TTE was performed after 12-36 hours of mechanical ventilation. Feasibility of tricuspid annular motion (S(t) ), tricuspid annular plane systolic excursion (TAPSE) was compared to usual two-dimensional (2D) study: fractional area change (RV(FAC) ) and ratio of right to left ventricular end-diastolic area (RVEDA/LVEDA). RESULTS Fifty patients were investigated, with TTE possible in all but two patients. Feasibility was 62% for RV(FAC), 72% for RVEDA/LVEDA, and 96% for TAPSE and S(t). RV dilatation (RVEDA/LVEDA ≥ 0.60) was found in 16 patients, including 4 patients with acute cor pulmonale. A longitudinal RV dysfunction (TAPSE < 12 mm or S(t) < 11.5 cm/sec) was suspected in 30% of patients. Relation between both longitudinal indices was modest (r(2) = 0.36, P < 0.001). TAPSE (but not S(t) ) was found poorly related to RV(FAC) (r(2) = 0.27, P = 0.03). Both indices were related to LV function (S(t) : r(2) = 0.27, TAPSE: r(2) = 0.17, both P < 0.05). CONCLUSION Despite a superior feasibility than 2D study, our results suggest that both indices may not bring identical information to echo study. TAPSE may be more adapted to ICU use than S(t) . Both should be further investigated in terms of analysis of RV function and ventricular interdependence. Their relations with LV function may limit their use as sole markers of RV function in this population.
Collapse
Affiliation(s)
- Jérôme Fichet
- Medical Intensive Care Unit, Tours University Hospital, Tours, France.
| | | | | | | | | | | | | | | |
Collapse
|
15
|
Detection of prolonged regional myocardial systolic dysfunction after exercise-induced myocardial ischemia by strain echocardiography with high frame rate tissue Doppler echocardiography. J Echocardiogr 2011; 9:90-6. [PMID: 27277175 DOI: 10.1007/s12574-011-0082-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2010] [Revised: 12/10/2010] [Accepted: 12/13/2010] [Indexed: 01/16/2023]
Abstract
BACKGROUND Strain echocardiography has enabled quantification of regional myocardial systolic function objectively and is less influenced by tethering effects and cardiac translational artifact than Doppler tissue imaging. Although strain echocardiography has been applied for the detection of inducible ischemia during dobutamine stress, it has not been fully applied to exercise stress echocardiography (ESE) because of technical difficulties. Prolonged myocardial systolic dysfunction after exercise-induced ischemia has been shown previously. Thus, we designed this study to evaluate whether the myocardial strain analysis can detect myocardial ischemia by the assessment of prolonged regional left ventricular (LV) dysfunction in ESE. METHODS We performed ESE with myocardial strain imaging system in 20 consecutive patients who had exercise Tl-201 single photon emission computed tomography (SPECT). Myocardial strain curves were obtained at six segments in mid LV walls from the apical approach before and 5 min after ESE. We measured the duration from the R wave in the electrocardiogram to the timing of peak systolic strain corrected by the square root of the RR interval (TPSc). We finally calculated the differences of TPSc (ΔTPSc) before ESE and 5 min after ESE. The results were compared with SPECT as a reference standard. RESULTS A receiver operating characteristic curve demonstrated that a ΔTPSc cutoff value of 70 ms had a sensitivity of 80% and a specificity of 84% for the detection of myocardial ischemia. CONCLUSIONS Prolonged regional LV systolic dysfunction assessed by ESE with strain analysis was useful for the detection of myocardial ischemia.
Collapse
|
16
|
Affiliation(s)
- Brian D Hoit
- Harrington-McLaughlin Heart Vascular Institute, University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA.
| |
Collapse
|
17
|
MacLaren G, Kluger R, Connelly KA, Royse CF. Comparative Feasibility of Myocardial Velocity and Strain Measurements Using 2 Different Methods With Transesophageal Echocardiography During Cardiac Surgery. J Cardiothorac Vasc Anesth 2011; 25:216-20. [DOI: 10.1053/j.jvca.2010.05.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2010] [Indexed: 11/11/2022]
|
18
|
Cottrell C, Kirkpatrick JN. Echocardiographic strain imaging and its use in the clinical setting. Expert Rev Cardiovasc Ther 2010; 8:93-102. [PMID: 20030024 DOI: 10.1586/erc.09.165] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The use of echocardiography has grown tremendously over the past several years. It is used routinely for diagnosis, prognosis and monitoring changes of cardiac function in coronary artery disease, heart failure, pulmonary hypertension, arrhythmias, pericardial disease and valvular disease, as well as congenital conditions. In recent years, the advancing technology used to evaluate the heart by ultrasound has allowed physicians to understand the mechanics of the heart muscle and the contribution of abnormalities in myocardial movement to heart disease. This review will discuss novel echocardiographic strain imaging techniques, placing them in the context of myocardial mechanics and describing current and future applications.
Collapse
Affiliation(s)
- Caroline Cottrell
- University of Pennsylvania, Echocardiography Laboratory, 9021 Gates Pavilion, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | | |
Collapse
|
19
|
Detection of coronary artery disease using delayed strain imaging at 5 min after the termination of exercise stress: head to head comparison with conventional treadmill stress echocardiography. J Cardiol 2009; 55:41-8. [PMID: 20122547 DOI: 10.1016/j.jjcc.2009.08.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2009] [Revised: 07/17/2009] [Accepted: 08/05/2009] [Indexed: 11/22/2022]
Abstract
BACKGROUND Prolongation of the time to peak strain (TPS) is a sensitive marker of myocardial ischemia. The purpose of this study was to evaluate whether delayed strain imaging obtained at 5 min after the termination of exercise stress can detect patients with significant coronary artery disease (CAD). METHODS A total of 45 patients who underwent treadmill stress echocardiography and coronary angiography were studied. Patients with abnormal wall motion at rest were excluded. Digital echocardiographic images were recorded at baseline and immediately after the termination of treadmill stress. Exercise-induced wall motion abnormality was considered as a marker of myocardial ischemia. Tissue velocity images were also recorded at baseline and 5 min after the termination of treadmill stress, and TPS was measured. TPS ratio was calculated as the ratio between TPS at delayed post-exercise and TPS at baseline. RESULTS Coronary angiography revealed that 30 of the 45 patients had significant CAD > or =50% diameter stenosis. The receiver operating characteristics curve demonstrated that cut-off value of TPS ratio 1.10 provides best diagnostic accuracy for vessel-based detection of significant CAD. The sensitivity, specificity, and diagnostic accuracy of the conventional exercise stress echocardiography for detecting patients with CAD were 87%, 80%, and 84%, respectively. The sensitivity, specificity, and accuracy of delayed strain imaging for identifying patients with CAD were 93%, 73%, and 87%, respectively. CONCLUSION Delayed strain imaging obtained at 5 min after the termination of exercise stress can accurately detect patients with significant CAD.
Collapse
|
20
|
Kim HK, Chang SA, Sohn DW, Kim DH, Kim YJ, Oh BH, Park YB. Persistent regional diastolic dysfunction after myocardial ischemia and the effect of statin treatment: assessment with two-dimensional radial strain rate. Echocardiography 2009; 27:244-52. [PMID: 20070353 DOI: 10.1111/j.1540-8175.2009.01007.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Persistence of regional diastolic dysfunction after ischemic insult remains debatable. With speckle tracking echocardiography (STE), we sought to (1) prove the persistence of regional diastolic dysfunction, (2) assess the feasibility of applying persistent regional diastolic dysfunction to differentiating ischemic and nonischemic chest pain, and finally (3) examine statin effects on postischemic regional diastolic dysfunction. METHODS Nineteen patients with variant angina (VA) and 12 normal subjects were enrolled. Comprehensive echocardiographic examinations were performed before and 1 day after coronary angiography (CAG) with ergonovine provocation. Radial systolic (rSRsys) and diastolic (rSRdia) strain rates were obtained and averaged using standard segmentation models corresponding to the three major coronary territories assigned. RESULTS No significant changes in rSRsys and rSRdia values were observed for controls and in rSRsys for VA. However, rSRdia for VA demonstrated a weak, but significant, decrease from -2.25 +/- 0.71/sec to -2.04 +/- 0.71/sec (P = 0.003) 1 day after CAG. However, because of the wide overlap between rSRdia values in normal and ischemic segments for VA patients, predictability of remote ischemia based solely on the rSRdia was limited. Subgroup analysis according to statin prescription showed that statin administration contributed to the elimination of rSRdia reduction (-2.28 +/- 0.84/sec on pre-CAG vs. -2.29 +/- 0.77/sec on post-CAG, P = 0.72 for patients without statin premedication; -2.23 +/- 0.64/sec for pre-CAG vs. -1.88 +/- 0.65/sec for post-CAG, P = 0.002 for those without). Expectedly, rSRsys values showed no significant changes in all situations. CONCLUSIONS The presence and sustained nature of regional diastolic dysfunction can be demonstrated with STE. Statin minimized the persistence of regional diastolic dysfunction after an acute ischemia. Although the clinical usefulness of rSRdia by STE appears to be limited, its clinical utility requires further consideration, given the brevity of the ischemia provoked during CAG with ergonovine and the protracted regional diastolic dysfunction.
Collapse
Affiliation(s)
- Hyung-Kwan Kim
- Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Seoul National University Hospital, Seoul 110-744, Korea.
| | | | | | | | | | | | | |
Collapse
|
21
|
Thambyrajah J, Vijayalakshmi K, Graham RJ, Turley AJ, de Belder MA, Stewart MJ. Strain rate imaging pre- and post-percutaneous coronary intervention: a potential role in the objective detection of ischaemia in exercise stress echocardiography. EUROPEAN JOURNAL OF ECHOCARDIOGRAPHY 2008; 9:646-54. [PMID: 18296398 DOI: 10.1093/ejechocard/jen035] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
AIMS To determine the feasibility of strain rate imaging (SRI) in the objective detection of exercise-induced ischaemia. METHODS AND RESULTS Sixteen patients undergoing elective percutaneous coronary intervention (PCI) underwent treadmill exercise stress echocardiography (ESE) pre- and post-PCI. Measurement of systolic SRI parameters was attempted in all myocardial segments at baseline, peak stress, and in recovery. Segments were divided into those supplied by target (Group 1) and non-target vessels (Group 2). Percutaneous coronary intervention was successful in all patients. In Group 1, there was no significant difference in post-systolic strain rate (SRps) at baseline or at peak stress but there was significantly greater SRps pre-PCI compared with post-PCI at 30 min into recovery (-0.37 +/- 0.53 vs. -0.07 +/- 0.44 s(-1), P = 0.004). There were similar findings with the SRps index [ratio of SRps:peak systolic strain rate (SRsys)]. Group 2 segments did not demonstrate any significant differences in SRI parameters pre- and post-PCI. At peak exercise pre-PCI, Group 1 segments had significantly delayed time to SRsys compared with Group 2 (0.12 +/- 0.05 vs. 0.09 +/- 0.05 s, P = 0.013), a difference that was abolished post-PCI. CONCLUSION This suggests a potential role for SRI in the objective detection of exercise-induced ischaemia by echocardiography at peak stress and during recovery at the time of improved image quality.
Collapse
Affiliation(s)
- J Thambyrajah
- Cardiothoracic Division, The James Cook University Hospital, Middlesbrough TS4 3BW, UK.
| | | | | | | | | | | |
Collapse
|
22
|
Alterations of regional myocardial function in a swine model of myocardial infarction assessed by echocardiographic 2-dimensional strain imaging. J Am Soc Echocardiogr 2007; 20:498-504. [PMID: 17484990 DOI: 10.1016/j.echo.2006.10.029] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2006] [Indexed: 01/13/2023]
Abstract
BACKGROUND Tissue Doppler strain and strain rate imaging have been introduced for quantitative assessment of regional myocardial function. These techniques are largely limited to the evaluation of overall longitudinal myocardial function. This study attempted to apply radial strain, circumferential strain, radial displacement, and strain-based torsion analysis to differentiating the infarct, adjacent, and remote zones in a swine model of myocardial infarction. METHODS Seven pigs, body weight 24 to 26 kg, were subjected to myocardial infarction by occlusion of the left anterior descending coronary artery (LAD) and followed up for 8 weeks. Regional radial and circumferential deformations were quantified noninvasively by ultrasonic strain rate imaging before LAD occlusion, LAD occlusion immediately, and 4, 6, and 8 weeks after LAD occlusion. Strain-based left ventricular torsion was assessed at the same time points. RESULTS Both radial and circumferential strains, and torsion, were decreased significantly in the LAD territory areas as a result of myocardial ischemia and infarction. There were no significant changes in radial and circumferential strains, or torsion, in the areas of adjacent and remote zones over time. CONCLUSIONS These findings demonstrate that speckle-tracking strain imaging may be suitable for noninvasive quantification of left ventricular segmental function of ischemic heart disease.
Collapse
|
23
|
Migrino RQ, Zhu X, Pajewski N, Brahmbhatt T, Hoffmann R, Zhao M. Assessment of segmental myocardial viability using regional 2-dimensional strain echocardiography. J Am Soc Echocardiogr 2007; 20:342-51. [PMID: 17400112 DOI: 10.1016/j.echo.2006.09.011] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2006] [Indexed: 12/19/2022]
Abstract
We determined whether 2-dimensional strain echocardiography can identify viable from infarcted myocardium in a rat ischemia-reperfusion model. A total of 16 male Sprague-Dawley rats underwent left anterior descending coronary artery occlusion for 12 or 30 minutes followed by 60-minute reperfusion. Short-axis 2-dimensional strain echocardiography was performed at the mid-ventricle 60 minutes post-reperfusion. Post-sacrifice, triphenyl tetrazolium chloride was infused to the coronary circulation. Regional end-systolic radial and circumferential strain, and time to peak strain, were measured using software in all 96 segments and correlated with areas of infarct in corresponding histologic slices. Segments with greater than 50% area of infarct had lower end-systolic radial and circumferential strain and longer time to peak strain versus areas with 50% or less strain or no infarct. Extent of infarct correlates with radial and circumferential strain. End-systolic radial strain less than 2% has 88% sensitivity and 95% specificity for detecting infarcted area greater than 50%. Two-dimensional strain echocardiography-derived strain is useful in distinguishing infarcted from viable myocardium.
Collapse
Affiliation(s)
- Raymond Q Migrino
- Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin 53226, USA.
| | | | | | | | | | | |
Collapse
|
24
|
Maruo T, Nakatani S, Jin Y, Uemura K, Sugimachi M, Ueda-Ishibashi H, Kitakaze M, Ohe T, Sunagawa K, Miyatake K. Evaluation of transmural distribution of viable muscle by myocardial strain profile and dobutamine stress echocardiography. Am J Physiol Heart Circ Physiol 2006; 292:H921-7. [PMID: 17012363 DOI: 10.1152/ajpheart.00019.2006] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Transmural distribution of viable myocardium in the ischemic myocardium has not been quantified and fully elucidated. To address this issue, we evaluated transmural myocardial strain profile (TMSP) in dogs with myocardial infarction using a newly developed tissue strain imaging. TMSP was obtained from the posterior wall at the epicardial left ventricular short-axis view in 13 anesthetized open-chest dogs. After control measurements, the left circumflex coronary artery was occluded for 90 min to induce subendocardial infarction (SMI). Subsequently, latex microbeads (90 microm) were injected in the same artery to create transmural infarction (TMI). In each stage, measurements were done before and after dobutamine challenge (10 microg.kg(-1).min(-1) for 10 min) to estimate transmural myocardial viability. Strain in the subendocardium in the control stage increased by dobutamine (from 53.6 +/- 17.1 to 73.3 +/- 21.8%, P < 0.001), whereas that in SMI and TMI stages was almost zero at baseline and did not increase significantly by dobutamine [from 0.8 +/- 8.8 to 1.3 +/- 7.0%, P = not significant (NS) for SMI, from -3.9 +/- 5.6 to -1.9 +/- 6.0%, P = NS for TMI]. Strain in the subepicardium increased by dobutamine in the control stage (from 23.9 +/- 6.1 to 26.3 +/- 6.4%, P < 0.05) and in the SMI stage (from 12.4 +/- 7.3 to 27.1 +/- 8.8%, P < 0.005), whereas that in the TMI stage did not change (from -1.0 +/- 7.8 to -0.7 +/- 8.3%, P = NS). In SMI, the subendocardial contraction was lost, but the subepicardium showed a significant increase in contraction with dobutamine. However, in TMI, even the subepicardial increase was not seen. Assessment of transmural strain profile using tissue strain imaging was a new and useful method to estimate transmural distribution of the viable myocardium in myocardial infarction.
Collapse
Affiliation(s)
- Takeshi Maruo
- Department of Cardiology, National Cardiovascular Center, 5-7-1, Fujishiro-dai, Suita, Osaka 565-8565, Japan
| | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Maclaren G, Kluger R, Prior D, Royse A, Royse C. Tissue Doppler, Strain, and Strain Rate Echocardiography: Principles and Potential Perioperative Applications. J Cardiothorac Vasc Anesth 2006; 20:583-93. [PMID: 16884996 DOI: 10.1053/j.jvca.2006.02.034] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2005] [Indexed: 11/11/2022]
Affiliation(s)
- Graeme Maclaren
- Department of Anaesthesia, St Vincent's Hospital, Melbourne, Australia.
| | | | | | | | | |
Collapse
|
26
|
Yang M, Baldwin SL, Marutyan KR, Wallace KD, Holland MR, Miller JG. Elastic stiffness coefficients (c11, C33, and C13) for freshly excised and formalin-fixed myocardium from ultrasonic velocity measurements. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2006; 119:1880-7. [PMID: 16583926 DOI: 10.1121/1.2168547] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
The goal of this study was to measure elastic stiffness coefficients of freshly excised and subsequently formalin-fixed myocardial tissue. Our approach was to measure the angle-dependent phase velocities associated with the propagation of a longitudinal ultrasonic wave (3-8 MHz) in ovine myocardium using phase spectroscopy techniques and to interpret the results in the context of orthotropic and transversely isotropic models describing the elastic properties of myocardium. The phase velocity results together with density measurements were used to obtain the elastic stiffness coefficients c11, c33, and c13 for both symmetries. The results for the elastic stiffness coefficients c11, c33, and c13 are the same for both symmetries. Measurements for freshly excised myocardium and the same tissue after a period of formalin fixation were compared to examine the impact of fixation on the elastic stiffness coefficients.
Collapse
Affiliation(s)
- Min Yang
- Department of Physics, Washington University, One Brookings Drive, Campus Box 1105, St. Louis, Missouri 63130, USA
| | | | | | | | | | | |
Collapse
|