Global Longitudinal Cardiac Strain and Strain Rate for Assessment of Fetal Cardiac Function: Novel Experience with Velocity Vector Imaging

Background: Strain and strain rate has been shown to identify subtle contraction abnormalities of left ventricle. Objectives: We hypothesized that S and SR derived from velocity vector imaging (VVI) will allow early identification of global and regional RV systolic function in patients with pulmonary hypertension (PHT) compared to conventional echo parameters. Methods: 96 patients, 35 normal RV Systolic Pressure (RVSP < 30 mmHg) and 61 with PHT, {24 mild-moderate (RVSP > 60 mmHg) and 37 severe (RVSP < 60 mmHg)} underwent echo-Doppler assessment of RV. Apical 4 chamber images at end expiration were used for RV lateral wall (LW) and ventricular septal (VS) segment analysis for systolic tangential velocity (Ta V), S and SR. In addition RV end systolic and diastolic area, RV fractional area change (RV FAC), RV performance index (RIMP) and tricuspid annulus systolic excursion were measured. Results: Peak S, systolic SR and Ta V at the basal, mid and apical segments of the RV LW and VS were depressed in patients with PHT compared with controls, Table 1 , P 0.001. Similarly, significant decrease in RIMP was seen in patients with PHT compared to controls, p <0.001. Significant correlation (p<0.001, r >0.6) was noted between the 2D FAC and S, SR. The time to peak systolic S indexed to end diastolic area (EDA) is significantly prolonged, p<0.01 in all segments in patients with PHT indicating dyssynchrony. Conclusion: S and SR allows assesment of Regional RV systolic function otherwise difficult to assess from conventional echo-Doppler technique. PHTN is associated with not only regional RV systolic dysfunction but also with dyssynchrony. Thus, this new tool can offer new insights in the functioning of right ventricular global and regional function. mean±SD of strain

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Quantitative Assessment of Strain and Strain Rate by Velocity Vector Imaging During Dobutamine Stress Echocardiography to Predict Outcome in Patients With Left Bundle Branch Block

Journal of the American Society of Echocardiography ◽

10.1016/j.echo.2009.07.011 ◽

2009 ◽

Vol 22 (11) ◽

pp. 1212-1219 ◽

Cited By ~ 11

Author(s):

Ying Shan ◽

Hector R. Villarraga ◽

Cristina Pislaru ◽

Aijaz A. Shah ◽

Stephen S. Cha ◽

...

Keyword(s):

Strain Rate ◽

Left Bundle Branch Block ◽

Velocity Vector ◽

Quantitative Assessment ◽

Stress Echocardiography ◽

Dobutamine Stress Echocardiography ◽

Dobutamine Stress ◽

Bundle Branch Block ◽

Velocity Vector Imaging ◽

Strain And Strain Rate

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In vivo velocity vector imaging and time-resolved strain rate measurements in the wall of blood vessels using MRI

Journal of Biomechanics ◽

10.1016/j.jbiomech.2010.12.010 ◽

2011 ◽

Vol 44 (5) ◽

pp. 979-983 ◽

Cited By ~ 6

Author(s):

Stéphane Avril ◽

Fabien Schneider ◽

Christian Boissier ◽

Zhi-Yong Li

Keyword(s):

Strain Rate ◽

Blood Vessels ◽

Velocity Vector ◽

Time Resolved ◽

Velocity Vector Imaging

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Cardiopulmonary Function in Thoracic Wall Deformities: What Do We Really Know?

European Journal of Pediatric Surgery ◽

10.1055/s-0038-1668130 ◽

2018 ◽

Vol 28 (04) ◽

pp. 327-346 ◽

Cited By ~ 9

Author(s):

Cristine Velazco ◽

Venkata Pulivarthi ◽

Reza Arsanjani ◽

Robert Obermeyer ◽

Dawn Jaroszewski

Keyword(s):

Strain Rate ◽

Pectus Excavatum ◽

Surgical Repair ◽

Exercise Intolerance ◽

Thoracic Wall ◽

Cardiac Chamber ◽

Chest Wall Mechanics ◽

Strain And Strain Rate ◽

Cardiac Strain ◽

Chamber Size

AbstractPatients with pectus excavatum (PE) frequently present with complaints of exercise intolerance and cardiopulmonary symptoms. There continues to be controversy regarding the physiologic benefits of repair. The aim of this review is to summarize and discuss recent data regarding the cardiopulmonary effects of PE deformity and the evidence for improvement obtained after surgical repair including (1) a greater efficiency of breathing (chest wall mechanics), (2) improvement in pulmonary restrictive deficits, (3) an increase in cardiac chamber size and output, with improved cardiac strain and strain rate, and (4) improvement in exercise capacity.

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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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