scholarly journals Speckle-Tracking and Tissue-Doppler Stress Echocardiography in Arterial Hypertension: A Sensitive Tool for Detection of Subclinical LV Impairment

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Kai O. Hensel ◽  
Andreas Jenke ◽  
Roman Leischik
Keyword(s):  
Early Diagnosis ◽  
Arterial Hypertension ◽  
Strain Rate ◽  
Speckle Tracking ◽  
Stress Echocardiography ◽  
Longitudinal Strain ◽  
Tissue Doppler ◽  
Systolic Strain ◽  
Hypertensive Patients ◽  
Cardiac Alterations

Early diagnosis of cardiac alterations in hypertensive heart disease is still challenging. Since such patients might have depressed global LV systolic strain or strain rate when EF is still normal, speckle-tracking echocardiography (STE) and tissue-Doppler imaging (TDI) combined with stress echocardiography might improve early diagnosis of cardiac alterations. In this prospective study standard 2D Doppler echocardiography, STE, and TDI were performed at rest and during bicycle exercise in 92 consecutive patients—46 hypertensive subjects with normal ejection fraction and 46 healthy controls. STE and TDI were used to measure global peak systolic LV circumferential strain (CS), longitudinal strain (LS), and longitudinal strain rate (SR). Mean arterial blood pressure was significantly higher in hypertensive patients at rest (100.8 mmHg SD 13.5 mmHg;P=0.002) and during physical exercise testing (124.2 mmHg SD 13.4 mmHg;P=0.003). Hypertensive patients had significantly reduced values of systolic CS (P=0.001), LS (P=0.014), and SR (P<0.001) at rest as well as during physical exercise—CS (P<0.001), LS (P<0.001), and SR (P<0.001). Using STE and TDI, reduced LV systolic strain and strain rate consistent with early cardiac alterations can be detected in patients with arterial hypertension. These findings were evident at rest and markedly pronounced during exercise echocardiography.

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 ◽  
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.

scholarly journals 1025 Global strain rate do not reduce biological variability compared to S", and do not normalize for body size

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A Stoylen ◽  
H E Molmen ◽  
H E Dalen
Keyword(s):  
Body Size ◽  
Strain Rate ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Tissue Doppler ◽  
Biological Variability ◽  
Systolic Strain ◽  
Global Strain ◽  
Standard Deviations ◽  
Global Strain Rate

Abstract Background As the Left ventricular (LV) apex is stationary, and maximum velocities are in the mitral plane, peak systolic annular velocity (S") normalized for wall length (WL) is a measure of peak systolic strain rate (Fig. 1), as is strain rate measured by tissue Doppler. As the normalization presumably corrects for the size of the heart (and thus body), this should reduce biological variability, but this assumption has previously been shown to be faulty for annular displacement (MAPSE) vs global longitudinal strain. Methods The HUNT study examined 1266 subjects without evidence of heart disease, from a mixed urban / rural population of North Tøndelag county in Norway. Annular systolic velocity was measured by pulsed-wave Tissue Doppler in the septal, lateral, anterior and inferior points, and averaged. Wall lengths was measured in a straight line in the same points, and S" was normalized (S"/WL) and averaged. Segmental systolic strain rate was also measured by combined speckle tracking / Tissue Doppler and averaged to a global value (GLSR). Results are given in table 1. All three measures declined with increasing age (R was -0.23, -0.29 and -0.29, respectively, all p &lt; 0.001) The over-all relative standard deviations were similar for S", normalized S" and global strain rate. Both S"/WL and GLSR correlated negatively with BSA, R was - 0.22 and 0.17, respectively (p &lt; 0.001), while S" showed a modest positive correlation; R = 0.13, (p &lt; 0.001) Conclusion Normalizing peak systolic mitral annular velocity for length do not reduce biological variability, and introduces a systematic error in the body size relation, due to the one-dimensional nature of the normalisation, and the three-dimensional nature of LV deformation. This is in accordance with what has previously been shown for global longitudinal strain vs. annular plane displacement. Table 1 Age (years) S" (cm/s) S"/WL (/s) GLSR (/s) &lt; 40 9.1 (1.2) 0.93 (0.13) 1.08 (0.12) 40 - 60 8.3 (1.3) 0.86 (0.13) 1.03 (0.12) &gt; 60 7.7 (1.3) 0.81 (0.14) 0.98 (0.14) All 8.4 (1.4) 0.87 (0.14) 1.03 (0.13) Relative SD (%) 16.7 16.1 12.6 Mitral annular velocity (S"), normalised velocity (S"/WL) and Global strain by age groups. (Standard deviations in parentheses) Abstract 1025 Figure. Fig. 1

scholarly journals Reduced myocardial reserve in cirrhotic patients: an evaluation by dobutamine stress speckle tracking and tissue Doppler imaging (TDI) echocardiography

2019 ◽  
Vol 11 (2) ◽  
pp. 127-131 ◽  
Author(s):  
Mahmood Zamirian ◽  
Forough Afsharizadeh ◽  
Alireza Moaref ◽  
Firoozeh Abtahi ◽  
Fatemeh Amirmoezi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Strain Rate ◽  
Speckle Tracking ◽  
Systolic Function ◽  
Peak Stress ◽  
Tissue Doppler ◽  
Doppler Imaging ◽  
Control Group ◽  
Basal Segment ◽  
Cirrhotic Patients

Introduction: Despite the normal systolic function at rest, cirrhotic patients often suffer from volume overload and symptoms of heart failure as they face stressful situations. This study investigated the myocardial reserve in cirrhotic patients at resting condition and peak stress by dobutamine speckle tracking echocardiography (STE) and tissue Doppler imaging (TDI). Methods: Twenty cirrhotic patients and 10 normal individuals aged 30-50 were selected randomly. For all of the participants, complete echocardiographic study of 2D, STE and TDI was done at rest and peak stress status with dobutamine. The following parameters were assessed: ejection fraction (EF), global longitudinal LV strain (GLS), strain rate in the septal basal segment and lateral wall and E’ in the septal basal segment by color-coded method. Results: At baseline, EF was higher than 55% in both groups. GLS was higher (-22.6±2.4%) in the case group than the control group (-19.2±1.9%) at resting condition. After stress, it showed a greater increase (-22.5±1.7%) in the controls compared to cirrhotic patients (-22.6±3.3%; mean difference = 2.6 ± 2.03, P = 0.02). In cirrhotic patients, the average strain rate in the basal septal segment decreased after stress (-1.2 ± 0.3/s to-1.1 ± 0.3/s), but it increased in the control group (-1.1 ± 0.2/s to -1.8 ± 0.2/s). Conclusion: Despite the presence of normal resting systolic function in cirrhotic patients, there was insufficient increase or even a decrease in myocardial function with stress; this may indicate the absence of sufficient myocardial reserve in cirrhotic patients. These findings would help to explain the reason for occurrence of heart failure or hemodynamic changes in cirrhotic patients.

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