Regional myocardial systolic function during acute myocardial ischemia assessed by strain Doppler echocardiography
TL;DR: The new SDE approach might be a more accurate marker than TDE for detecting systolic regional myocardial dysfunction induced by LAD occlusion and reduced velocities in all septal segments during angioplasty.
About: This article is published in Journal of the American College of Cardiology.The article was published on 2001-03-01 and is currently open access. It has received 264 citations till now. The article focuses on the topics: Tissue Doppler echocardiography & Doppler echocardiography.
Citations
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TL;DR: Speckle tracking echocardiography provides accurate and angle-independent measurements of LV dimensions and strains and has potential to become a clinical bedside tool for quantifying myocardial strain.
1,236 citations
TL;DR: The present study demonstrates the ability of Doppler echocardiography to measure myocardial strains in a clinical setting and may represent a new powerful method for quantifying left ventricular function noninvasively in humans.
Abstract: Tissue Doppler echocardiography-derived strain rate and strain measurements (SDE) are new quantitative indices of intrinsic cardiac deformation. The aim of this study was to validate and compare these new indices of regional cardiac function to measurements of 3-dimensional myocardial strain by tagged MRI.
542 citations
TL;DR: Cardiac amyloidosis is characterized by an early impairment in systolic function at a time when fractional shortening remains normal, and can be detected by strain and SR but is not apparent by TV imaging.
Abstract: Background— AL amyloidosis with heart failure is associated with decreased longitudinal myocardial contraction measured by pulsed tissue Doppler imaging. We sought to clarify whether new modalities of myocardial strain Doppler (change in length per unit length) or strain rate (the temporal derivative of strain) were more sensitive than tissue Doppler and could detect early regional myocardial dysfunction before the onset of congestive heart failure (CHF) in patients with AL (primary) amyloidosis. Methods and Results— Ninety-seven biopsy-proven patients with AL amyloidosis were divided into 3 groups. Group 1 patients had no cardiac involvement (n=36), group 2 had heart involvement but no CHF (n=32), and group 3 had heart involvement and CHF (n=29). All patients underwent tissue velocity (TV) imaging, strain, and strain rate imaging (SR) at the basal, mid, and apical ventricle in 2 apical views. With the use of TV, differences in systolic function were only apparent between group 3 (basal mean value, 3.0±1....
411 citations
TL;DR: Strain and strain rate data provide valuable prognostic information, especially prediction of future reverse remodelling after left ventricular restoration surgery or after cardiac resynchronization therapy and prediction of short and median-term outcome without transplantation or ventricular assist device implantation of patients referred for heart transplantation.
Abstract: Echocardiographic strain and strain-rate imaging (deformation imaging) is a new non-invasive method for assessment of myocardial function. Due to its ability to differentiate between active and passive movement of myocardial segments, to quantify intraventricular dyssynchrony and to evaluate components of myocardial function, such as longitudinal myocardial shortening, that are not visually assessable, it allows comprehensive assessment of myocardial function and the spectrum of potential clinical applications is very wide. The high sensitivity of both tissue Doppler imaging (TDI) derived and two dimensional (2D) speckle tracking derived myocardial deformation (strain and strain rate) data for the early detection of myocardial dysfunction recommend these new non-invasive diagnostic methods for extensive clinical use. In addition to early detection and quantification of myocardial dysfunction of different etiologies, assessment of myocardial viability, detection of acute allograft rejection and early detection of allograft vasculopathy after heart transplantation, strain and strain rate data are helpful for therapeutic decisions and also useful for follow-up evaluations of therapeutic results in cardiology and cardiac surgery. Strain and strain rate data also provide valuable prognostic information, especially prediction of future reverse remodelling after left ventricular restoration surgery or after cardiac resynchronization therapy and prediction of short and median-term outcome without transplantation or ventricular assist device implantation of patients referred for heart transplantation.The Review explains the fundamental concepts of deformation imaging, describes in a comparative manner the two major deformation imaging methods (TDI-derived and speckle tracking 2D-strain derived) and discusses the clinical applicability of these new echocardiographic tools, which recently have become a subject of great interest for clinicians.
374 citations
Cites background from "Regional myocardial systolic functi..."
...very useful for the assessment of myocardial damage after infarction, evaluation of myocardial revascularization efficiency and prediction of patient outcome with heart failure [11,30-46]....
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TL;DR: Diabetic patients without overt heart disease demonstrate evidence of systolic dysfunction and increased myocardial reflectivity, although these changes are similar to those caused by LVH, they are independent and incremental to the effects of LVH.
356 citations
References
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TL;DR: An alternative approach, based on graphical techniques and simple calculations, is described, together with the relation between this analysis and the assessment of repeatability.
43,884 citations
TL;DR: Myocardial strain by Doppler echocardiography may represent a new, powerful method for quantifying regional myocardial function and is less influenced by tethering effects than Dopplers tissue imaging.
Abstract: Background—Myocardial strain is a measure of regional deformation, and by definition, negative strain means shortening and positive strain, elongation. This study investigates whether myocardial strain can be measured by Doppler echocardiography as the time integral of regional velocity gradients, using sonomicrometry as reference method. Methods and Results—In 13 anesthetized dogs, myocardial longitudinal strain was measured on apical images as the time integral of regional Doppler velocity gradients. Ultrasonic segment-length crystals were placed near the left ventricular (LV) apex and near the base. Apical ischemia was induced by occluding the left anterior descending coronary artery (LAD), and preload was increased by saline. Percentage systolic strain by Doppler correlated well with strain by sonomicrometry (y=0.82x−1.79, r=0.92, P<0.01). During LAD occlusion, apical myocardium became dyskinetic, as indicated by positive strain values and negative Doppler velocities. At the LV base, myocardial strain...
1,112 citations
TL;DR: In the healthy hearts, a spatially homogeneous distribution of the strain rate was found and all the infarcted areas in this study showed up as hypokinetic or akinetic, demonstrating that this method may be used for imaging of regional dysfunction.
Abstract: The regional function of the left ventricle can be visualized in real-time using the new strain rate imaging method. Deformation or strain of a tissue segment occurs over time during the cardiac cycle. The rate of this deformation, the strain rate, is equivalent to the velocity gradient, and can be estimated using the tissue Doppler technique. We present the strain rate as color-coded 2-dimensional cine-loops and color M-modes showing the strain rate component along the ultrasound beam axis. We tested the method in 6 healthy subjects and 6 patients with myocardial infarction. In the healthy hearts, a spatially homogeneous distribution of the strain rate was found. In the infarcted hearts, all the infarcted areas in this study showed up as hypokinetic or akinetic, demonstrating that this method may be used for imaging of regional dysfunction. Shortcomings of the method are discussed, as are some possible future applications of the method. (J Am Soc Echocardiogr 1998;11:1013-9.)
883 citations
"Regional myocardial systolic functi..." refers background in this paper
...(20) found that tissue Doppler measures positive LV velocities even in akinetic myocardial infarcts whereas SDE showed zero strains....
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...A new algorithm that calculates strain from Doppler tissue velocities has been developed (20)....
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TL;DR: The concomitant enhancement of the myocardial Doppler signal after an intravenous injection of a transpulmonary echocardiographic contrast agent could permit the noninvasive assessment of regional myocardIAL perfusion.
Abstract: Color Doppler myocardial imaging is a new technique that has been developed specifically to allow color Doppler imaging of myocardial wall motion rather than blood pool imaging. Such a technique has the potential to interrogate velocities, accelerations, and Doppler signal strength within the myocardial wall. Moreover, the concomitant enhancement of the myocardial Doppler signal after an intravenous injection of a transpulmonary echocardiographic contrast agent could permit the noninvasive assessment of regional myocardial perfusion. Thus this new imaging modality could be a valuable adjunct to the ultrasound assessment of myocardial ischemia.
645 citations