scholarly journals Regional and temporal changes in left ventricular strain and stiffness in a porcine model of myocardial infarction

2018 ◽  
Vol 315 (4) ◽  
pp. H958-H967 ◽  
Author(s):  
William M. Torres ◽  
Julia Jacobs ◽  
Heather Doviak ◽  
Shayne C. Barlow ◽  
Michael R. Zile ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Clinical Assessment ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Myocardial Strain ◽  
Left Ventricular ◽  
Border Zone ◽  
Peak Strain ◽  
Myocardial Stiffness ◽  
Biomechanical Behavior

The aim of the present study was to serially track how myocardial infarction (MI) impacts regional myocardial strain and mechanical properties of the left ventricle (LV) in a large animal model. Post-MI remodeling has distinct regional effects throughout the LV myocardium. Regional quantification of LV biomechanical behavior could help explain changes in global function and thus advance clinical assessment of post-MI remodeling. The present study is based on a porcine MI model to characterize LV biomechanics over 28 days post-MI via speckle-tracking echocardiography (STE). Regional myocardial strain and strain rate were recorded in the circumferential, radial, and longitudinal directions at baseline and at 3, 14, and 28 days post-MI. Regional myocardial wall stress was calculated using standard echocardiographic metrics of geometry and Doppler-derived hemodynamic measurements. Regional diastolic myocardial stiffness was calculated from the resultant stress-strain relations. Peak strain and phasic strain rates were nonuniformly reduced throughout the myocardium post-MI, whereas time to peak strain was increased to a similar degree in the MI region and border zone by 28 days post-MI. Elevations in diastolic myocardial stiffness in the MI region plateaued at 14 days post-MI, after which a significant reduction in MI regional stiffness in the longitudinal direction occurred between 14 and 28 days post-MI. Post-MI biomechanical changes in the LV myocardium were initially limited to the MI region but nonuniformly extended into the neighboring border zone and remote myocardium over 28 days post-MI. STE enabled quantification of regional and temporal differences in myocardial strain and diastolic stiffness, underscoring the potential of this technique for clinical assessment of post-MI remodeling. NEW & NOTEWORTHY For the first time, speckle-tracking echocardiography was used to serially track regional biomechanical behavior and mechanical properties postmyocardial infarction (post-MI). We found that changes initially confined to the MI region extended throughout the myocardium in a nonuniform fashion over 28 days post-MI. Speckle-tracking echocardiography-based evaluation of regional changes in left ventricular biomechanics could advance both clinical assessment of left ventricular remodeling and therapeutic strategies that target aberrant biomechanical behavior post-MI.

scholarly journals Evaluation of ATP-PostC protective effect on myocardial function: A speckle tracking echocardiography study in ischemia-reperfusion injury

2020 ◽  
Author(s):  
Min Ren ◽  
Keting Li ◽  
Xuemei Liu ◽  
Hongyu Yang ◽  
Zhonghui Jiang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Strain Rate ◽  
Speckle Tracking ◽  
Myocardial Function ◽  
Speckle Tracking Echocardiography ◽  
Ischemia Reperfusion Injury ◽  
Ischemia Reperfusion ◽  
Left Ventricular ◽  
Peak Strain ◽  
Strain And Strain Rate

Abstract Background: Ischemia-reperfusion injury (IRI) seriously affects the prognosis of patients. We sought to use speckle tracking echocardiography (STE) to accurately evaluate the effect of drugs. Methods: In this study, STE was used to quantitatively evaluate the changes of myocardial function before and after reperfusion in myocardial ischemia rabbits with ischemia postconditioning (I-PostC) or ATP postconditioning. The variations of the left ventricular (LV) longitudinal, circumferential and radial myocardium were detected by STE technique. Meanwhile, a series of biochemical experiments were performed including myocardial enzymes assay, myocardial infarction size assay and TUNEL assay. Results: After ligation of coronary artery for 45 min, the strain and strain rate curves of left ventricular myocardium was disordered. The most STE parameters were significantly diminished and the time of reaching peak was delayed. After reperfusion for 120 min, the parameters (longitudinal, circumferential, radial strain and strain rate, as well as ventricular torsion function) were obvious recovery in I-PostC and ATP postconditioning groups. The sensitivity and specificity of global circumferential peak strain (GCSp), global longitudinal peak strain (GLSp), peak twist (Ptw) and peak twisting velocity (PTV) to diagnose myocardial infarction rabbits were 86.1% and 75%, 79.2% and 72.5%, 79.2% and 75%, 66.7% and 70.8%, respectively. The levels of aspartate aminotransferase (AST) and creatine phosphokinase isozyme (CKMB) were up-regulated in I/R group. AST and lactate dehydrogenase (LDH) values significantly reduced in the other three groups. The Bax expression was decreased, simultaneously, the Bcl-2 expression was increased after I-PostC and ATP postconditioning treatment. Conclusions: The application of STE in the assessment of IRI has high accuracy and reproducibility. Therefore, ATP has an important clinical value as a pharmacologic postconditioning drug.

P3548Noninvasive estimation of left ventricular diastolic function in patients with hypertension and normal ejection fraction using 3-dimensional speckle tracking echocardiography

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Minatoguchi ◽  
R Tanaka ◽  
T Yoshizane ◽  
T Deguchi ◽  
H Sato ◽  
...  
Keyword(s):  
Diastolic Function ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Diastolic Pressure ◽  
Left Ventricular Diastolic Function ◽  
Left Ventricular ◽  
Peak Strain ◽  
Myocardial Stiffness ◽  
The Impact ◽  
Lv Diastolic Function

Abstract Background Left ventricular (LV) relaxation (eTau) and pulmonary capillary wedge pressure (ePCWP) were reported to be estimated by speckle tracking echocardiography (STE). LV camber stiffness (e-c stiffness) may be estimated with the use of 2 diastolic pressure-volume coordinates. The minimum diastolic pressure (mP) is reported to have a strong correlation with Tau. Purpose We sought to examine the impact of hypertension on LV diastolic function and LA properties and to elucidate the feature of hypertensive heart failure with preserved EF (HFpEF). Methods The e', E/e', Tau, PCWP, LVEDP, LV stiffness, LAV, LA emptying function (LAEF) and LA strain were examined in 53 controls (age 66±11), 136 hypertensive patients (HTN) with normal EF (69±11) and 39 HFpEF (77±14). ePCWP and estimated EDP (eEDP) was calculated as previously reported. Tau was calculated as isovolumic relaxation time/(ln 0.9 x systolic blood pressure − ln PCWP). Myocardial stiffness (e-m stiffness) was estimated as LVED stress/LV strain. LV c-stiffness was calculated as LV pressure change (from mP to EDP) obtained by catheterization divided by LV volume change. Estimated LV c-stiffness (e-c-stiffness) was noninvasively obtained using e-mP and e-EDP. The eTau, eEDP and e-mP by STE were validated by catheterization (n=126). Results The mP had a good correlation with Tau (r=0.70, p<0.01). The eTau, eEDP and e-mP by STE had a good correlation with those by catheterization (r=0.75, 0.63 and 0.70, p<0.01). Multivariate analysis revealed that ePCWP and LA strain were independent predictors of HFpEF. LV diastoric function Variables Control HTN HFpEF LVEF, % 68±6 68±8 63±9*+ LV longitudinal strain x (s–1) 19.1±3.0 16.8±4.3* 14.5±5.1*+ E/e' 9.2±2.6 11.6±4.5* 15.9±7.9*+ eTau, ms 35±12 48±17* 59±17*+ ePCWP, mmHg 7.3±2.7 8.3±4.3 15.0±4.4*+ eLVEDP, mmHg 9.4±2.2 10.4±3.5 15.9±3.7*+ LV e-myocardial stiffness, kdynes/cm 0.56±0.25 0.69±0.56 1.27±0.71*+ LV e-chamber stiffness, mmHg/ml 0.19±0.06 0.20±0.08 0.36±0.19*+ Maximum LAVI, ml/m2 42±15 50±21* 68±17*+ Total LAEF, % 55±7 51±11 36±12*+ LA peak strain 41±15 40±17 19±8*+ *p<0.05 vs Control, +p<0.05 vs HTN. Conclusion We demonstrated that LV diastolic function in HTN may be accurately and noninvasively evaluated by STE.

Predictors of Left Ventricular Remodeling Post Acute Myocardial Infarction. Protocol for a Clinical Study

2019 ◽  
Vol 4 (3) ◽  
pp. 120-123
Author(s):  
Ioana Cîrneală ◽  
Diana Opincariu ◽  
István Kovács ◽  
Monica Chițu ◽  
Imre Benedek
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Speckle Tracking ◽  
Ventricular Remodeling ◽  
Speckle Tracking Echocardiography ◽  
Left Ventricular Remodeling ◽  
Left Ventricular ◽  
Serum Biomarkers ◽  
Remodeling Index

Abstract Heart failure is a clinical syndrome that appears as a consequence of a structural disease, and the most common cause of left ventricular systolic dysfunction results from myocardial ischemia. Cardiac remodeling and neuroendocrine activation are the major compensatory mechanisms in heart failure. The main objective of the study is to identify the association between serum biomarkers illustrating the extent of myocardial necrosis (highly sensitive troponin as-says), left ventricular dysfunction (NT-proBNP), and systemic inflammatory response (illustrated via serum levels of hsCRP and interleukins) during the acute phase of a myocardial infarction, and the left ventricular remodeling process at 6 months following the acute event, quantified via speckle tracking echocardiography. The study will include 400 patients diagnosed with acute myocardial infarction without signs and symptoms of heart failure at the time of enrollment that will undergo a complex clinical examination and speckle tracking echocardiography. Serum samples from the peripheral blood will be collected in order to determine the inflammatory serum biomarkers. After 6 months, patients will be divided into 2 groups according to the development of ventricular remodeling, quantified by speckle tracking echocardiography: group 1 will consist of patients with a remodeling index lower than 15%, and group 2 will consist of patients with a remodeling index higher than 15%. All clinical and imaging data obtained at the baseline will be compared between these two groups in order to determine the features associated with a higher risk of deleterious ventricular remodeling and heart failure.

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.

Urgent Myocardial Revascularization in Non ST-Segment Elevation Acute Myocardial Infarction Guided by Speckle Tracking Echocardiography: A Challenging Interventional Decision-Making

Cardiology ◽  
2018 ◽  
Vol 140 (4) ◽  
pp. 222-226 ◽  
Author(s):  
Fabio Capasso ◽  
Marco Pepe ◽  
Salvatore Severino ◽  
Giuseppe Valva ◽  
Pietro Landino ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Global Longitudinal Strain ◽  
Myocardial Revascularization ◽  
Invasive Procedure ◽  
Reperfusion Therapy ◽  
Left Ventricular ◽  
St Segment Elevation ◽  
Final Infarct Size

A 68-year-old man with a non-ST elevation myocardial infarction (NSTEMI) presented with a low risk profile indicating invasive revascularization within 72 h. However, left ventricular (LV) global longitudinal strain (GLS) calculated by two-dimensional speckle tracking echocardiography (2D-STE) in the Emergency Room showed substantial myocardial infarction. Therefore, urgent reperfusion therapy was decided and delivered within 30 min from hospital admission. LV GLS fully recovered after the invasive procedure and the final infarct size was 7%. This case shows that very early revascularization in NSTEMI patients can be guided by 2D-STE and might be considered for those patients with substantial LV myocardial infarction.

scholarly journals Association Between Myocardial Strain and Frailty in CHS

2021 ◽  
Author(s):  
Annabel X. Tan ◽  
Sanjiv J. Shah ◽  
Jason L. Sanders ◽  
Bruce M. Psaty ◽  
Chenkai Wu ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Myocardial Strain ◽  
Left Ventricular ◽  
Community Dwelling ◽  
Left Ventricular Ejection ◽  
Cross Sectional ◽  
Risk Of Death ◽  
Lower Strain

Background: Myocardial strain, measured by speckle-tracking echocardiography, is a novel measure of subclinical cardiovascular disease and may reflect myocardial aging. We evaluated the association between myocardial strain and frailty—a clinical syndrome of lack of physiological reserve. Methods: Frailty was defined in participants of the CHS (Cardiovascular Health Study) as having ≥3 of the following clinical criteria: weakness, slowness, weight loss, exhaustion, and inactivity. Using speckle-tracking echocardiography data, we examined the cross-sectional (n=3206) and longitudinal (n=1431) associations with frailty among participants who had at least 1 measure of myocardial strain, left ventricular longitudinal strain (LVLS), left ventricular early diastolic strain rate and left atrial reservoir strain, and no history of cardiovascular disease or heart failure at the time of echocardiography. Results: In cross-sectional analyses, lower (worse) LVLS was associated with prevalent frailty; this association was robust to adjustment for left ventricular ejection fraction (adjusted odds ratio, 1.32 [95% CI, 1.07–1.61] per 1-SD lower strain; P =0.007) and left ventricular stroke volume (adjusted OR, 1.32 [95% CI, 1.08–1.61] per 1-SD lower strain; P =0.007). In longitudinal analyses, adjusted associations of LVLS and left ventricular early diastolic strain with incident frailty were 1.35 ([95% CI, 0.96–1.89] P =0.086) and 1.58 ([95% CI, 1.11–2.27] P =0.013, respectively). Participants who were frail and had the worst LVLS had a 2.2-fold increased risk of death (hazard ratio, 2.20 [95% CI, 1.81–2.66]; P <0.0001). Conclusions: In community-dwelling older adults without prevalent cardiovascular disease, worse LVLS by speckle-tracking echocardiography, reflective of subclinical myocardial dysfunction, was associated with frailty. Frailty and LVLS have an additive effect on mortality risk.

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