scholarly journals 420 Vortex formation in the pre-ejection phase in the left ventricle

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A Daae ◽  
M Wigen ◽  
L Lovstakken ◽  
A Stoylen
Keyword(s):  
Left Ventricle ◽  
Speckle Tracking ◽  
Plane Waves ◽  
Vortex Formation ◽  
Left Ventricular ◽  
Frame Rate ◽  
Doppler Imaging ◽  
High Temporal Resolution ◽  
Lateral Part ◽  
Ejection Phase

Abstract Funding Acknowledgements Central Norway Regional Health Authority Background/Introduction: Vortex formation during left ventricular filling have been described since the 1980’s. We have investigated vortices in the left ventricle (LV) in healthy adults with a new technology based on high frame rate vector flow imaging (VFI) using blood speckle tracking. Purpose In this study we investigated the intraventricular flow pattern during the pre-ejection period. Material and methods We examined 21 healthy volunteers with a GE E95 ultrasound scanner, both in ordinary clinical mode and with an experimental setup. The latter was developed to achieve high frame rates by utilizing plane waves in combination with ECG-gating over multiple (5-6) heart cycles, allowing continuous acquisition of > 3500 FPS. Blood speckle tracking followed by model based regularization was used to obtain vector flow velocity measurements. Results During the pre-ejection phase we observed blood flow from the apex to the basis of the LV along the septum. At the base, the flow is deflected. A basal vortex is then created just above the mitral valve, which persists into the isovolumetric contraction (IVC). The lateral part of the vortex is then seen as an apically directed flow during IVC, as shown in the illustration. The vortex is also visible in the first phase of the ejection; the part of the blood in the LV not passing through the aortic valve is deflected and continues to conserve this vortex. These findings correspond to patterns found in colour M-Mode (CMM), showing a column of blood toward the apex in the IVC/early ejection phase. Time from peak R to the first sighting of this IVC vortex, and to the pre-ejection spike in tissue Doppler imaging (TDI), are similar, as reported in table 1. Conclusion(s): Our imaging setup allows for a very high temporal resolution (>3500 FPS), and enables VFI using blood speckle tracking, without using a contrast agent. We observed an intraventricular vortex during pre-ejection and into early ejection, with the same direction as the later vortices seen in filling. Initiation of this vortex may be conserved energy from late filling. This vortex is simultaneous with the pre-ejection spike in TDI. We postulate that this IVC vortex contributes to the closing of the anterior mitral leaflet in the IVC. As we also observe this vortex during the early ejection phase, we believe it may conserve rotational energy into early filling. Table 1 Timing of the IVC vortex and the pre-ejection spike in TDI Mean Median SD Min Max Time between R and the basal vortex during IVS (ms) 16,7 16 15,1 -13 47 Time between R and the pre-ejection spike TDI (ms) 16,3 21 14,4 -10 36 Abstract 420 Figure.

Role of speckle tracking echocardiography in the assessment of post-repair left ventricular function in patients with late presentation of anomalous origin of the left coronary artery from the pulmonary artery

2014 ◽  
Vol 25 (5) ◽  
pp. 969-975 ◽  
Author(s):  
Gholamhosein Ajami ◽  
Mohammad R. Edraki ◽  
Ali R. Moarref ◽  
Ahmad A. Amirghofran ◽  
Mohammad Borzouee ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Left Ventricle ◽  
Pulmonary Artery ◽  
Speckle Tracking ◽  
Left Coronary Artery ◽  
Speckle Tracking Echocardiography ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Anomalous Origin ◽  
Control Group

AbstractThe aim of this study was to determine the left ventricular myocardial deformation and segmental myocardial dysfunction by speckle tracking echocardiography and tissue Doppler imaging among the operated patients with anomalous origin of the left coronary artery from the pulmonary artery. The study was conducted on 12 patients diagnosed with anomalous origin of the left coronary artery from the pulmonary artery, who had been operated upon between 2001 and 2013 at the medical centres of Shiraz University of Medical Sciences, Shiraz, Iran. The mean age of the patients at the time of surgical correction was 12.6 years ranging from 6 months to 43 years, and the duration of postoperative follow-up was between 1 and 12 years. Comparison of the strain rate between the patients with acceptable ejection fraction and the control group by tissue Doppler imaging showed significant differences between the two groups regarding the lateral wall (p<0.001), but not the septal wall of the left ventricle (p=0.65). Moreover, the strain values by the speckle tracking method revealed significant differences between the patient and the control group regarding the global strain (p=0.016) and anterior, lateral, and posterior segments of the left ventricle. Although postoperative conventional echocardiography revealed normal global left ventricular function with acceptable ejection fraction, abnormal myocardial deformation of the variable segments of the left ventricle with regional and global myocardial dysfunction were well defined by speckle tracking echocardiography.

scholarly journals High frame rate speckle tracking echocardiography to assess diastolic function

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
K Papangelopoulou ◽  
M Orlowska ◽  
S Bezy ◽  
A Petrescu ◽  
A Werner ◽  
...  
Keyword(s):  
Diastolic Function ◽  
Temporal Resolution ◽  
Speckle Tracking ◽  
Reference Method ◽  
Left Ventricular ◽  
Frame Rate ◽  
Doppler Imaging ◽  
Diastolic Filling ◽  
High Frame Rate ◽  
Custom Made

Abstract Background Left ventricular (LV) strain rate (SR) during isovolumic relaxation (SRIVR) and early diastolic filling (SRe) has previously been shown to correlate with the invasive gold standard for LV diastolic function (i.e. the time constant of LV pressure decay tau). However, the translation of these biomarkers to the clinic has been hampered by technical limitations. Indeed, conventional speckle tracking (STE) is limited by its temporal resolution, whereas tissue Doppler imaging (TDI) is angle-dependent, labor-intensive and thus rarely used clinically nowadays. Purpose The aim of this study was to show that these limitations could be overcome by using a recently proposed STE algorithm operating on high frame rate (HFR) imaging data. Methods 37 subjects (age: 64±12, 81% male) were included in the study; 16 had cardiac amyloidosis, 12 were undergoing clinically indicated left and/or right heart cardiac catheterization and 9 were healthy volunteers. Since the sequence of left ventricular activation and thus the repolarization process (i.e. relaxation) starts at mid septum, we measured SRIVR and SRe in the mid septal segment in an apical 4 chamber view using a commercially available clinical system with: (1) TDI (frame rate (FR) ∼142 Hz); (2) STE (FR ∼65 Hz). Moreover, subjects were scanned with HD-PULSE, an experimental high frame ultrasound scanner (FR ∼915 Hz) and then a manually placed contour was tracked during the cardiac cycle by a custom-made 2D HFR STE algorithm, to compute and extract SRIVR and SRe from the mid septum. Since TDI is considered the reference method to assess SR, conventional as well as HFR STE values were correlated against the TDI SR values. Results In 3 subjects, SRIVR could not be reliably assessed with the clinical STE approach, which we attributed to the relatively low temporal resolution of the images; all other measurements could be made in all subjects. For both biomarkers, HFR STE values correlated better with the TDI reference measurements than the clinical STE estimates (Fig.1). The latter estimates showed a systematic underestimation (bias −0.19 1/s (p&lt;0.01) and −0.46 1/s (p&lt;0.01) for SRIVR and SRe respectively) while no significant bias was observed for the HFR STE values. Similarly, the limits of agreement of the HFR STE values were narrower (−0.45 to +0.54 1/s and −0.94 to +0.86 1/s) than those of the clinical STE measurements (−0.85 to +0.48 1/s and −1.32 to +0.41 1/s). Conclusions These results show that HFR STE offers a reliable way to assess novel biomarkers of diastolic function in a user-friendly manner and can therefore facilitate their incorporation to the clinical practice. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals Early Left Ventricular Dysfunction Detected by Speckle Tracking in Long-Term Hemodialysis Patients with Valvular Calcification

2018 ◽  
Vol 9 (1) ◽  
pp. 22-30 ◽  
Author(s):  
Jiahui Li ◽  
Aili Li ◽  
Jiali Wang ◽  
Yu Zhang ◽  
Ying Zhou
Keyword(s):  
Wall Thickness ◽  
Speckle Tracking ◽  
Heart Function ◽  
Hemodialysis Patients ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Subtle Change ◽  
Lv Mass ◽  
And Function

Purpose: Cardiac valve calcification (VC) is very common in patients on hemodialysis. However, the definite effect of VC on left ventricular (LV) geometry and function in this population is unknown, especially when LV ejection fraction (LVEF) is normal. The aim of this study was to determine the effect of VC on LV geometry and function in long-term hemodialysis patients by conventional echocardiography and two-dimensional speckle tracking echocardiography (2D-STE). Methods: A total of 47 hemodialysis patients (2–3 times weekly for 5 years or more) were enrolled in this study. Cardiac VC was defined as bright echoes of more than 1 mm on one or more cusps of the aortic valve or mitral valve or mitral annulus using echocardiography as the screening method. LV longitudinal global strain (GLS) was assessed on the apical four-chamber view and calculated as the mean strain of 6 segments. LV global circumferential strain was acquired on the LV short axis view at the level of papillary muscles. Results: Twenty-five patients with VC had higher mean values of interventricular septum thickness, LV posterior wall thickness, LV mass index, relative wall thickness, and LV mass/end-diastolic volume than 22 patients without VC (p < 0.05, respectively), indicating more obvious LV hypertrophy (LVH). VC patients had higher mitral annular E/E′ values, especially at the septal side representing increased LV filling pressure compatible with diastolic dysfunction, while only the E/E′ ratio of the septal side was significantly different between the 2 groups (16.7 ± 4.1 vs. 12.3 ± 4.4, p < 0.01). When assessed by GLS, LV longitudinal systolic function was also lower in in patients with VC compared with those without VC (–0.18 ± 0.03 vs. –0.25 ± 0.04; p < 0.01). Conclusions: Cardiac VC diagnosed by echocardiography when it occurs in long-term hemodialysis patients may indicate more severe LVH, myocardial damage, and worse heart function in comparison to those without VC. Tissue Doppler imaging and 2D-STE can detect the subtle change of heart function in this population in the early stage of LV dysfunction when LVEF is normal.

scholarly journals Speckle-Tracking Echocardiography With Novel High Frame-Rate Imaging

2021 ◽  
Author(s):  
Kana Fujikura ◽  
Mohammed Makkiya ◽  
Muhammad Farooq ◽  
Yun Xing ◽  
Wayne Humphrey ◽  
...  
Keyword(s):  
Temporal Resolution ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Myocardial Strain ◽  
Left Ventricular ◽  
Frame Rate ◽  
High Frame Rate ◽  
Echocardiographic Images ◽  
The Impact ◽  
Normal Lvef

Background: global longitudinal strain (GLS) measures myocardial deformation and is a sensitive modality for detecting subclinical myocardial dysfunction and predicting cardiac outcomes. The accuracy of speckle-tracking echocardiography (STE) is dependent on temporal resolution. A novel software enables relatively high frame rate (Hi-FR) (~200 fps) echocardiographic images acquisition which empowers us to investigate the impact of Hi-FR imaging on GLS analysis. The goal of this pilot study was to demonstrate the feasibility of Hi-FR for STE. Methods: In this prospective study, we acquired echocardiographic images using clinical scanners on patients with normal left ventricular systolic function using Hi-FR and conventional frame rate (Reg-FR) (~50 FPS). GLS values were evaluated on apical 4-, 2- and 3-chamber images acquired in both Hi-FR and Reg-FR. Inter-observer and intra-observer variabilities were assessed in Hi-FR and Reg-FR. Results: There were 143 resting echocardiograms with normal LVEF included in this study. The frame rate of Hi-FR was 190 &plusmn; 25 and Reg-FR was 50 &plusmn; 3, and the heart rate was 71 &plusmn; 13. Strain values measured in Hi-FR were significantly higher than those measured in Reg-FR (all p &lt; 0.001). Inter-observer and intra-observer correlations were strong in both Hi-FR and Reg-FR. Conclusions: We demonstrated that strain values were significantly higher using Hi-FR when compared with Reg-FR in patients with normal LVEF. It is plausible that higher temporal resolution enabled the measurement of myocardial strain at desired time point. The result of this study may inform clinical adoption of the novel technology. Further investigations are necessary to evaluate the value of Hi-FR to assess myocardial strain in stress echocardiography in the setting of tachycardia.

scholarly journals SUBCLINICAL SYSTOLIC DYSFUNCTION OF THE LEFT VENTRICLE IN PREECLAMPTIC WOMEN WITHOUT PROTEINURIA. THE POSSIBILITIES OF ECHOCARDIOGRAPHY IN EARLY DIAGNOSIS

2017 ◽  
pp. 94-97
Author(s):  
D. A. Doroshenko ◽  
A. R. Zubarev ◽  
O. B. Lapochkina
Keyword(s):  
Left Ventricle ◽  
Arterial Hypertension ◽  
Pregnant Women ◽  
Left Ventricular Dysfunction ◽  
Speckle Tracking ◽  
Ventricular Dysfunction ◽  
Speckle Tracking Echocardiography ◽  
Systolic Dysfunction ◽  
Clinical Manifestations ◽  
Left Ventricular

The article presents the main pathophysiological mechanisms associated with the development of complications of pregnancy against the background of arterial hypertension in patients without clinical manifestations of left ventricular dysfunction, the possibilities of speckle tracking of echocardiography in revealing latent systolic dysfunction of the left ventricle in pregnant women on the background of preeclampsia not accompanied by proteinuria are shown.Goal. To identify early markers of left ventricular systolic dysfunction in pregnant women with preeclampsia without proteinuria according to speckle tracking echocardiography.Material and methods. 100 pregnant women with hypertension and a gestation period of 29–40 weeks are divided into 2 groups: 1 st group – 50 patients without an arterial hypertension in the anamnesis, 2 nd group – 50 patients with an arterial hypertension in the anamnesis (without the proteinuria during pregnancy). For all patients, echocardiography with evaluation of cardiomyocyte function by speckle-tracking was performed on ultrasonic scanners Aplio ™ 500 and Aplio ™ Artida from Toshiba.Results. Ejection fraction of the left ventricle in the groups was not significantly different, while the longitudinal, radial and circular deformation parameters differed between the groups, with the lowest values characterizing the global longitudinal deformation.Conclusions. In assessing the function of the left ventricle in pregnant women with preeclampsia without diurnal proteinuria, it is not enough to focus on traditional parameters, shifting the emphasis towards derivatives of force, speed and time. Study of myocardium with the help of speckle tracking echocardiography promotes the detection of subclinical left ventricular dysfunction in patients with arterial hypertension without daily proteinuria. 

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