Assessment of cardiac function using global and regional left ventricular endomyocardial and epimyocardial peak systolic strain and strain rate in healthy Labrador retriever dogs

Worsening right ventricular (RV) dysfunction in the presence of pulmonary artery hypertension (PAH) increases morbidity and mortality in this patient population. Transthoracic echocardiography (TTE) is a non-invasive modality to evaluate RV function over time. Using a monocrotaline-induced PAH rat model, we evaluated the effect of acute inflammation on RV function. In this study, both PAH and control rats were injected with Escherichia coli lipopolysaccharide (LPS) to induce an acute inflammatory state. We evaluated survival curves, TTE parameters, and inflammatory markers to better understand the mechanism and impact of acute inflammation on RV function in the presence of PAH. The survival curve of the PAH rats dropped sharply within 9 h after LPS treatment. Several echocardiographic parameters including left ventricular (LV) stroke volume, RV tricuspid annular plane systolic excursion, RV longitudinal peak systolic strain, and strain rate decreased significantly in PAH rats before LPS injection and 2 h after LPS injection. The expression of phospholamban (PLB) and tumor necrosis factor-α (TNF-α) significantly increased and the expression of SERCA2a significantly decreased in PAH rats after LPS administration. LPS suppressed the RV longitudinal peak systolic strain and strain rate and cardiac function deteriorated in PAH rats. These effects may be associated with the signal pathway activity of SERCA2a/PLB.

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Left Atrial Strain to Identify Diastolic Dysfunction in Children with Cardiomyopathies

Journal of Clinical Medicine ◽

10.3390/jcm8081243 ◽

2019 ◽

Vol 8 (8) ◽

pp. 1243 ◽

Cited By ~ 2

Author(s):

Jolanda Sabatino ◽

Giovanni Di Salvo ◽

Costantina Prota ◽

Valentina Bucciarelli ◽

Manjit Josen ◽

...

Keyword(s):

Strain Rate ◽

Diastolic Dysfunction ◽

Left Atrial ◽

Left Ventricular ◽

Systolic Strain ◽

Operating Characteristics ◽

Left Atrial Strain ◽

Peak Systolic Strain ◽

Strain And Strain Rate ◽

Significant Difference

Background: Left ventricular (LV) diastolic dysfunction (DD) carries worse prognosis in childhood. 2-dimensional (2-D) left atrial (LA) strain accurately categorizes DD in adults but its role in children is unknown. Thus, the aim of this study is to investigate whether LA strain and strain rate could diagnose and classify DD in children with dilated (CMD), hypertrophic (HCM) and restrictive (RCM) cardiomyopathies (CM). Methods and Results: The study includes 136 children (aged 8.8 ± 6 years): 44 with DCM, 40 with HCM, 7 with RCM and 45 healthy controls (CTRL). They underwent standard echocardiographic examination and 2-D speckle-tracking analyses (LV longitudinal peak systolic strain (LS), LA peak systolic strain and strain rate). No significant differences in mitral E/A and pulmonary S/D ratios were observed among the four groups. Although E/E’ and indexed left atrial volumes were found to be significantly higher in HCM, DCM and RCM compared to CTRL (p < 0.001), they showed no significant difference among the three CM groups. LV LS values were significantly reduced in CM vs CTRL (p < 0.001) and in DCM vs HCM (p < 0.01), with no other differences between the remaining groups. LA peak systolic strain and strain rate values showed a steady and significant decrease with worsening of DD. Receiver Operating Characteristics (ROC) curves showed area under the curve of 0.976 (p < 0.001) for LA strain and 0.946 (p < 0.001) for LA strain rate, to distinguish CTRL from CMs. Conclusions: LA strain and strain rate could be a promising tool to better understand and classify DD in children with cardiomyopathies, opening the way to its clinical use.

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Abstract 11769: Impact of Exercise to the Heterogeneity of Regional Left Ventricular Mechanics

Circulation ◽

10.1161/circ.130.suppl_2.11769 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Rayji S Tsutsui ◽

Kenya Kusunose ◽

James D Thomas ◽

Zoran B Popovic

Keyword(s):

Strain Rate ◽

Left Ventricular ◽

Peak Exercise ◽

Exercise Heart Rate ◽

Strain Rates ◽

Systolic Strain ◽

Ventricular Mechanics ◽

Peak Systolic Strain ◽

Strain And Strain Rate ◽

Segmental Heterogeneity

Background: The segmental heterogeneity of strain and strain rate in speckle tracking echocardiography are pitfalls in the assessment of left ventricular (LV) mechanics in subjects without LV wall motion abnormality. We aimed to assess the segmental heterogeneity of strain and strain rate at rest and during exercise in healthy subjects. Methods: Twenty-three healthy young volunteers (38 ± 10 years, 13 female) underwent supine bicycle stress testing. Segmental circumferential (Scirc), radial (Srad) and longitudinal (Slong) end-systolic strains and corresponding peak systolic strain rates (SRcirc, SRrad, SRlong) were obtained by STE (EchoPac, GE Medical) for each of 16 LV segments at rest and during exercise. Global values of strain and strain rate components were obtained by averaging segmental values. Results: At rest, all three end-systolic strains showed significant segmental heterogeneity (p < 0.01 for all comparisons). In contrast, peak systolic SRcirc and SRrad had uniform values throughout segments, while SRlong had modest segmental heterogeneity (p = 0.02). During exercise, heart rate (67 ± 10 to 136 ± 19 bpm), systolic blood pressure (124 ± 13 to 170 ± 21mmHg), and biplane ejection fraction (58 ± 4 to 72 ± 5 %), increased significantly (p < 0.001 for all comparisons). At peak exercise, there was a small, but significant increase in global Slong (-19.9 to -23.9%, p < 0.001) and Scirc (-19.6 to -24.2%, p < 0.001) without the change in Srad (46.8 to 41.1%, p > 0.05). On the other hand, all global systolic strain rates almost doubled during exercise; SRcirc from -1.26 to -2.49 s -1 , p < 0.0001; SRrad from 1.82 to 3.26 s -1 , p < 0.0001; SRlong from -1.56 to -2.93 s -1 , p < 0.0001. Importantly, segmental heterogeneity following exercise was not present for all strain and strain rate components (p > 0.05 for all comparisons). Conclusions: Segmental heterogeneity was less pronounced in peak systolic strain rates than in end-systolic strains at rest. Exercise abolished segmental heterogeneity for all strain and strain rate components. Overall, peak systolic strain rate is least affected by segmental heterogeneity and may be more useful in the assessment of LV mechanics than end-systolic strain.

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Comparison of global and regional right and left ventricular longitudinal peak systolic strain, strain rate and velocity in healthy fetuses using a novel feature tracking technique

Journal of Perinatal Medicine ◽

10.1515/jpm.2011.060 ◽

2011 ◽

Vol 39 (5) ◽

Cited By ~ 20

Author(s):

Arne M. Willruth ◽

Annegret K. Geipel ◽

Christoph Th. Berg ◽

Ralf Fimmers ◽

Ulrich G. Gembruch

Keyword(s):

Strain Rate ◽

Feature Tracking ◽

Left Ventricular ◽

Systolic Strain ◽

Peak Systolic Strain ◽

Tracking Technique

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Transmural Peak Systolic Strain and Strain Rate Predict Transmural Myocardial Blood Flow in a Pig Myocardial Infarction Model

Cardiology ◽

10.1159/000142722 ◽

2009 ◽

Vol 112 (2) ◽

pp. 122-128 ◽

Cited By ~ 1

Author(s):

Huixia Lu ◽

Guihua Yao ◽

Huili Lin ◽

Xinsheng Xu ◽

Changjiang Li ◽

...

Keyword(s):

Myocardial Infarction ◽

Blood Flow ◽

Myocardial Blood Flow ◽

Strain Rate ◽

Systolic Strain ◽

Peak Systolic Strain ◽

Strain And Strain Rate

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Echocardiographic Evaluation of Changes in Cardiac Hemodynamics, Loading Conditions, and Atrial Function after Transcatheter Closure of Atrial Septal Defect

QJM ◽

10.1093/qjmed/hcab090.019 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Mohamed Abdelfattah Shoeir ◽

Ghada Elshahed ◽

Yasmin Abdelrazek Esmail ◽

Dina Adel Ezz Eldin

Keyword(s):

Atrial Septal Defect ◽

Strain Rate ◽

Septal Defect ◽

Atrial Function ◽

Loading Conditions ◽

Systolic Strain ◽

Peak Systolic Strain ◽

Strain And Strain Rate ◽

Significant Difference ◽

Asd Closure

Abstract Background The changes in loading conditions, atrial function, and the different echocardiographic parameters before and after transcatheter atrial septal defect (ASD) closure are still under study. So we felt the need to evaluate the echocardiographic changes that occur and detect the timing after closure at which the right-sided heart hemodynamics, and measurements are back to normal. Objectives To evaluate the changes in cardiac hemodynamics, loading conditions, and atrial function after percutaneous closure of ASD using echocardiography. Patients and Methods The study included 30 patients referred to percutaneous closure of ASD in Ain Shams University hospital we performed echocardiography before, 1 week, and 3 months after closure. Results The study showed that RV dimensions and volumes decreased significantly 1 week, and 3 months after ASD closure (p < 0.001). RA dimensions and volumes decreased significantly 1 week, and 3 months after ASD closure (p < 0.001). RA peak systolic strain, and strain rate increased significantly 1 week, and 3 months after ASD closure (p < 0.001). LA dimensions and volumes increased significantly 1 week, and 3 months after ASD closure (P < 0.001). LA peak systolic strain showed no significant difference before, 1week, and 3 months after ASD closure (P = 0.063), and strain rate showed no significant difference before, 1week, and 3 months after ASD closure (P = 0.207). Conclusion In our study, we have concluded that RV dimensions and volumes decreased significantly 1 week, and 3 months after ASD closure. RA dimensions and volumes decreased significantly 1 week, and 3 months after ASD closure. RA peak systolic strain, and strain rate increased significantly 1 week, and 3 months after ASD closure, as a result of improvement of the RA wall velocity, due to relief of the volume overload after closure of the shunt. LA peak systolic strain, and strain rate showed no significant difference before, 1week, and 3 months after ASD closure. Abbreviations list ASD (atrial septal defect), RV (right ventricle), RA (right atrium), LA (left atrium).

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Abstract 5781: Evaluation of Global and Regional Right Ventricular Systolic Function in Patient Prosthesis Mismatch after Mitral Valve Replacement using Velocity Vector Imaging

Circulation ◽

10.1161/circ.118.suppl_18.s_101 ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Aylin Tugcu ◽

Yelda Tayyareci ◽

Ozlem Yildirimturk ◽

Saide Aytekin

Keyword(s):

Strain Rate ◽

Velocity Vector ◽

Systolic Function ◽

Strain Rates ◽

Free Wall ◽

Systolic Strain ◽

Peak Systolic Strain ◽

Strain And Strain Rate ◽

Patient Prosthesis Mismatch ◽

Rv Function

The aim of this study was to compare right ventricular (RV) global and regional systolic function in patients with and without patient prosthesis mismatch (PPM) after isolated mitral valve replacement (MVR) using Velocity Vector Imaging (VVI) method. The PPM group consisted of 20 patients that underwent isolated MVR with an indexed effective orifice area (EOA) ≤ 1.2 cm 2 /m 2 determined by continuity equation and indexed for body surface area. The non-PPM group consisted of 20 patients that also underwent isolated MVR with an indexed EOA > 1.2cm 2 /m 2 . Echocardiographic images in apical planes were analyzed for RV volumes, ejection fractions, myocardial velocity, strain and strain rate at the basal, mid and apical segments of RV free wall and ventricular septum using VVI. The demographic and preoperative data were similar between PPM and non-PPM groups. Evidence of PA hypertension defined as systolic PA pressure > 40 mmHg was present in 50% of patients in PPM group, whereas none of the patients in non-PPM group had PA hypertension. RV volumes were significantly increased, and RV ejection fraction, peak systolic myocardial velocities, strain and strain rates were significantly impaired in patients with PPM compared to non-PPM group (p<0.001 for all). Indexed EOA correlated strongly with myocardial velocities, strain and strain rates in all segments of the RV (p<0.05 for all). Multivariate stepwise regression analysis demonstrated that indexed EOA and systolic PA pressure were the independent determinants of basal free wall peak systolic strain (β=0.547, p<0.001 and β=−0.304, p=0.033 respectively) and strain rate (β=0.497, p=0.001 and β=−0.332, p = 0.026 respectively). Using receiver-operating characteristics analysis cut-off values for basal free wall peak systolic strain and strain rate in determining patients with indexed EOA ≤ 1.2 cm 2 /m 2 were −25.62 % (sensitivity 85%, specificity 95%) and −1.87 1/s (sensitivity 95%, specificity 95%) respectively. PPM after MVR is associated with RV global and regional RV dysfunction. Two-dimensional echocardiography has some limitations in evaluating RV function due to its complex geometry. VVI is a feasible modality in assessment of RV global and regional RV function.

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Abstract 4246: Dobutamine-induced Reserve of the Two-dimensional Longitudinal Strain Rate Predicts Clinical and Neurohumoral Improvement After Levosimendan Treatment in Acutely Decompensated Chronic Heart Failure

Circulation ◽

10.1161/circ.118.suppl_18.s_853 ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Vasiliki Bistola ◽

Ioannis Paraskevaidis ◽

Ignatios Ikonomidis ◽

Ioannis Parissis ◽

Gerasimos Filippatos ◽

...

Keyword(s):

Strain Rate ◽

Speckle Tracking ◽

Longitudinal Strain ◽

Nyha Class ◽

Radial Strain ◽

Left Ventricular ◽

Contractile Reserve ◽

Systolic Strain ◽

Strain And Strain Rate ◽

Longitudinal Strain Rate

Objective: Levosimendan improves symptoms and the hemodynamic profile in patients with acutely decompensated chronic heart failure (ADCHF). We aimed to investigate: the association of low dose dobutamine (DSE)-induced changes of two-dimensional strain parameters with the corresponding changes of left ventricular ejection fraction (LVEF) and left ventricular outflow tract velocity time integral (LVOT VTI) in patients with ADCHF, and whether left ventricular contractile reserve assessed by both conventional and speckle tracking echocardiography is associated with clinical and neurohumoral improvement after levosimendan treatment. Methods: Thirty one consecutive patients with ADCHF (mean age 65 ± 10 years, NYHA class 3.6 ± 0.3, LVEF 22 ± 6%) were studied by DSE (peak dose 20 μg/kg/min) prior to 24-hour infusion of levosimendan (0.01 μg/kg/min, without bolus). The LVEF, LVOT VTI, mean longitudinal, circumferential and radial strain and strain rate using speckle tracking imaging were measured. Results: Twenty-three patients (74%) had evidence of contractile reserve (increase of LVEF > 10% and LVOT VTI > 20% after peak dobutamine dose, CR+), and 8 (26%) showed no reserve (CR−). CR+ versus CR- patients demonstrated greater improvement of NYHA class (mean NYHA change: −1.0±0.5 vs −0.5±0.3 NYHA class, p=0.01), and reduction of b-type natriuretic peptide levels (− 34±30 vs + 4±31%, p <0.01) 48 hours after completion of treatment. By multivariate analysis, mean longitudinal systolic strain rate reserve (resting - peak longitudinal strain rate ΔLSR (%)) was the best predictor of improvement of NYHA class (p= 0.039) and BNP (p= 0.042) after levosimendan administration among the reserve of: LV FS, EF, LVOT VTI, longitudinal strain, circumferential and radial strain and strain rate. Conclusion: Dobutamine-induced reserve of 2-dimentional speckle tracking longitudinal systolic strain rate is associated with clinical and neurohumoral improvement after treatment with levosimendan in patients with ADCHF.

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Longitudinal strain and strain rate by tissue Doppler are more sensitive indices than fractional shortening for assessing the reduced myocardial function in asphyxiated neonates

Cardiology in the Young ◽

10.1017/s1047951109991314 ◽

2010 ◽

Vol 21 (1) ◽

pp. 1-7 ◽

Cited By ~ 38

Author(s):

Eirik Nestaas ◽

Asbjørn Støylen ◽

Leif Brunvand ◽

Drude Fugelseth

Keyword(s):

Strain Rate ◽

Myocardial Function ◽

Troponin T ◽

Tissue Doppler ◽

Systolic Strain ◽

Term Neonates ◽

Peak Systolic Strain ◽

Strain And Strain Rate ◽

Apical Group ◽

Fractional Shortening

AbstractThe function of the heart was studied in 20 asphyxiated term neonates by measuring the longitudinal peak systolic strain and peak systolic strain rate by tissue Doppler in 18 segments of the heart on days 1, 2, and 3 of life. The fractional shortening was assessed at each examination as well. Measurements were compared against measurements in 48 healthy term neonates examined by the same protocol. The function of the heart was lower in the asphyxiated neonates – peak systolic strain (mean (95% confidence interval) −19.4% (−20.4, −18.5), peak systolic strain rate −1.65 (−1.74, −1.56) per second) than in the healthy term neonates (peak systolic strain −21.7% (−22.3, −21.0), peak systolic strain rate −1.78 (−1.84, −1.74) per second; p < 0.001). Fractional shortening was similar in the asphyxiated (29.2% (26.8, 31.5)) and healthy term neonates (29.0% (27.9, 30.1); p = 0.874). The peak systolic strain differed significantly between the asphyxiated and healthy term neonates for the left basal and right basal groups of segments (p < 0.05) but not for the left apical, right apical, septum apical, or septum basal groups of segments. The peak systolic strain rate differed significantly only for the septum apical group of segments. The differences were largest on the second day of life. Measurements were similar in asphyxiated neonates with elevated and normal cardiac troponin T levels. The peak systolic strain and strain rate were in this study more sensitive indices than fractional shortening for assessing the reduced myocardial function in asphyxiated term neonates.

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