scholarly journals Stiffness- and relaxation-based quantitation of radial left ventricular oscillations: elucidation of regional diastolic function mechanisms

2007 ◽  
Vol 102 (5) ◽  
pp. 1862-1870 ◽  
Author(s):  
Matt M. Riordan ◽  
Sándor J. Kovács
Keyword(s):  
Strain Rate ◽  
Diastolic Function ◽  
Causal Relation ◽  
Myocardial Strain ◽  
Left Ventricular ◽  
Tissue Imaging ◽  
Short Axis ◽  
Strain Rate Imaging ◽  
Strain And Strain Rate ◽  
Volume Property

Traditionally, global and longitudinal (i.e., regional) left ventricular (LV) diastolic function (DF) assessment has utilized features of transmitral Doppler E and A waves or Doppler tissue imaging (DTI)-derived mitral annular E′ and A′ waves, respectively. Quantitation of regional DF has included M-mode echocardiography-based approaches and strain and strain rate imaging (in selected imaging planes), while analysis of mitral annular “oscillations” has recently provided a new window into longitudinal (long-axis) function. The remaining major spatial degree of kinematic freedom during diastole, radial (short-axis) motion, has not been fully characterized, nor has it been exploited for its potential to provide radial LV stiffness ( krad) and relaxation/damping ( crad) indexes. Prior characterization of regional (longitudinal) DF used only annular E′- and A′-wave peak velocities or, alternatively, myocardial strain and strain rate. By kinematically modeling short-axis tissue motion as damped radial oscillation, we present a novel method of estimating krad and crad during early filling. As required by the (near) constant-volume property of the heart and tissue/blood incompressibility, in subjects ( n = 10) with normal DF, we show that oscillation duration-determined longitudinal ( klong and clong) and radial ( klong and crad) parameters are highly correlated ( R = 0.69 and 0.92, respectively). Selected examples of diabetic and LV hypertrophic subjects yield radial ( klong and crad) parameters that differ substantially from controls. Results underscore the utility of the incompressibility-based causal relation between DTI-determined mitral annular long-axis (longitudinal mode) and short-axis (radial mode) oscillations in healthy subjects. Selected pathological examples provide mechanistic insight and illustrate the value and potential role of regional (longitudinal and radial) DF indexes in fully characterizing normal vs. impaired DF states.

scholarly journals Echocardiographic Evaluation of Left Atrial Mechanics: Function, History, Novel Techniques, Advantages, and Pitfalls

2015 ◽  
Vol 2015 ◽  
pp. 1-12 ◽  
Author(s):  
Roman Leischik ◽  
Henning Littwitz ◽  
Birgit Dworrak ◽  
Pankaj Garg ◽  
Meihua Zhu ◽  
...  
Keyword(s):  
Diastolic Function ◽  
Left Atrial ◽  
Left Ventricular Diastolic Function ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Current Standard ◽  
Ventricular Diastolic Function ◽  
Strain Rate Imaging ◽  
Strain And Strain Rate

Left atrial (LA) functional analysis has an established role in assessing left ventricular diastolic function. The current standard echocardiographic parameters used to study left ventricular diastolic function include pulsed-wave Doppler mitral inflow analysis, tissue Doppler imaging measurements, and LA dimension estimation. However, the above-mentioned parameters do not directly quantify LA performance. Deformation studies using strain and strain-rate imaging to assess LA function were validated in previous research, but this technique is not currently used in routine clinical practice. This review discusses the history, importance, and pitfalls of strain technology for the analysis of LA mechanics.

Abstract 3157: Coupling of Left Ventricular Relaxation to Systolic Contraction in Normal, Hypertrophied, and Dilated Myocardium Quantified by Speckle-Tracking Global Strain and Strain Rate Imaging

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Takeshi Takamura ◽  
Kaoru Dohi ◽  
Katsuya Onishi ◽  
Naoki Fujimoto ◽  
Tairo Kurita ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Strain Rate ◽  
Speckle Tracking ◽  
Myocardial Dysfunction ◽  
Systolic Dysfunction ◽  
Disease Process ◽  
Left Ventricular ◽  
Strain Rate Imaging ◽  
Strain And Strain Rate ◽  
Contraction And Relaxation

Background: It has not been fully investigated whether impairments of left ventricular (LV) relaxation precede or couple to systolic dysfunction during the disease process ranged from latent myocardial dysfunction to failing myocardium in patients with either left ventricular hypertrophy (LVH) or dilated cardiomyopathy (DCM). Methods: To quantify global LV longitudinal (L) and circumferential (C) function, fifty-seven patients with hypertensive LVH (ejection fraction 58 ± 10 %), twenty-one patients with DCM (ejection fraction 33 ± 13 %), and fifty-seven normal controls (Controls: ejection fraction 65 ± 6 %) had echo-study with speckle-tracking strain and strain rate imaging (Vivid 7 and EchoPAC, GE Electronic) from apical 4-, 2-, long axis, and mid-ventricular short axis views. Global peak systolic strain (PSS) and peak relaxation rate (PRR) were used as indices of global LV contraction and relaxation, respectively. Results: PRR was significantly correlated to PSS from both (L) and (C) in LVH, DCM, and Controls with linear regressions, respectively (DCM (L); r = 0.81 * , (C); r = 0.81 * , LVH (L); r = 0.78 * , (C); r = 0.74 * , Control (L); r = 0.64 * , (C); r = 0.70 * , * p < 0.05). Furthermore, correlations between PSS and PRR were best fit with exponential regression from (L) and linear regression from (C) all through the subjects ((L); y = 0.18e -0.099x , r = 0.84 * , (C); y = −0.070x - 0.017, r = 0.79 * , * p < 0.05). Conclusion: Speckle-tracking strain and strain rate imaging exhibited the strong coupling of LV relaxation to systolic contraction ranged from the normal to failing myocardium regardless of their initiating disease process.

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