Abstract 2477: Ventricular Synchrony can be Preserved by Right Ventricular Septal Pacing Compared with Right Ventricular Apical Pacing: Evaluation by Ultrasound Speckle-Tracking Imaging and Tissue Doppler Imaging

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Chisato Izumi ◽  
Shuichi Takahashi ◽  
Sumiyo Hashiwada ◽  
Hidetaka Hayashi ◽  
Jiro Sakamoto ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Speckle Tracking ◽  
Circumferential Strain ◽  
Radial Strain ◽  
Lateral Wall ◽  
Tissue Doppler ◽  
Doppler Imaging ◽  
Speckle Tracking Imaging ◽  
Myocardial Velocity ◽  
Time To Peak

Objectives: Traditional right ventricular apical (RVA) pacing may induce ventricular dyssynchrony in patients with normal left ventricular (LV) function. The purpose of this study is to elucidate the influence of pacing sites on the ventricular dyssynchrony, using ultrasound speckle-tracking imaging and tissue Doppler imaging. Methods: We investigated 24 patients with normal LV function who underwent DDD pacemaker implantation. Right ventricular lead position was apex in 18 patients and septum in 6 patients. Radial strain and circumferential strain were measured using ultrasound speckle-tracking imaging (Vivid 7, GE) from short axis view at papillary muscle level. Myocardial velocity was measured by tissue Doppler imaging in mid-segments from apical 4-chamber view. The difference of time to peak radial strain, circumferential strain, and systolic myocardial velocity between septal and lateral wall were compared between during patients’ intrinsic rhythm and pacing rhythm, and between patients with RVA pacing and right ventricular septal (RVS) pacing. Results: In 18 patients with RVA pacing, difference of time to peak circumferential strain and systolic myocardial velocity between septal and lateral wall were larger during pacing rhythm than during patients’ intrinsic rhythm (circumferential strain: 118±57 vs 59±48msec, p<0.01, myocardial velocity: 75±47 vs 52±40msec, p<0.05). On the other hand, in 6 patients with RVS pacing, difference of time to peak radial strain, circumferential strain and systolic myocardial velocity during pacing rhythm were the same as those during patients’ intrinsic rhythm. Difference of time to peak circumferential strain between septal and lateral wall was smaller in patients with RVS pacing than patients with RVA pacing (37±50 vs 118±57msec, p<0.005). Conclusions: Ventricular synchrony can be preserved by RVS pacing compared with RVA pacing.

Abstract 3286: Prediction for Long-term Effect Of Cardiac Resynchronization Therapy: Comparison Between Tissue Doppler Imaging And Speckle Tracking Imaging

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Azusa Furugen ◽  
Naoki Matsuda ◽  
Kyomi Ashihara ◽  
Asako Mochida ◽  
Morio Shoda ◽  
...  
Keyword(s):  
Cardiac Resynchronization Therapy ◽  
Tissue Doppler Imaging ◽  
Speckle Tracking ◽  
Tissue Doppler ◽  
Doppler Imaging ◽  
Cardiac Resynchronization ◽  
Speckle Tracking Imaging ◽  
Resynchronization Therapy ◽  
Time To Peak ◽  
Qrs Duration

Recent studies have demonstrated that the septal-to-posterior motion delay (SPWMD) assessed by M-mode echo and the longitudinal intra-LV dyssynchrony assessed by tissue Doppler imaging (TDI) can predict chronic effects of cardiac resynchronization therapy (CRT). A newly developed 2D speckle tracking imaging (STI) has enabled assessment of not only longitudinal but circumferential regional strain of LV. We investigated the usefulness of STI in selecting patients for CRT. Methods: Fifty-one patients with heart failure symptoms and QRS duration>120 ms underwent standard echocardiography, TDI and STI before CRT. Time to peak systolic velocity was measured in 12 basal and mid LV segments in apical views by TDI. The time difference between the basal septal and the basal lateral segments was calculated (TDI-SLPVD).The standard deviation of those among 12 segments was calculated (TDI-SD). Time to peak circumferential strain, radial strain and longitudinal strain were measured in basal segments in parasternal short axis and apical views by STI. The time difference between the septal and the lateral segments was calculated (CS-SL, RS-SL and LS-SL). A responder to CRT was defined as a patient whose NYHA class improved by >1 class and whose LVESV reduced by >10% at 6 months after CRT. Results: Thirty-six patients (71%) responded to CRT. CS-SL showed high sensitivity and specificity for predicting the responders at a cut-off point of 124 ms (Table ). The area under the ROC curve (AUC) of CS-SL was larger than that of QRS duration, SPWMD, TDI-SLPVD, TDI-SD, RS-SL and LS-SL. Conclusion: Assessment of circumferential dyssynchrony using STI seems useful in selecting patients for CRT.

Studying of morphology and left ventricular function by conventional and speckle tracking echocardiography in football players

2019 ◽  
pp. 36-40
Author(s):  
Kien Duoc Vang ◽  
Anh Vu Nguyen
Keyword(s):  
Tissue Doppler Imaging ◽  
Speckle Tracking ◽  
Circumferential Strain ◽  
Speckle Tracking Echocardiography ◽  
Early Stage ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Control Group ◽  
Cross Sectional

Objective: Recent studies have showed that Tissue Doppler Imaging and Speckle Tracking Echocardiography can discover these changes at functional and structural cardiac in athletes at early stage, especially at the footballers. The purpose of this research was evaluated the structural and functional adaption of left ventricular in footballer by conventional and advanced echocardiography. Materials and methods: We performed a cross-sectional study of 30 footballers who have been trained over 2 years compared to 30 healthy candidate with the same ages. We carried out TM, 2D, STE. Echo machine was Philips Affinity 50CV with QLAB version 10.04 which can analyze online or offline. Result: In comparison with control group, IVSd, LVEDd, PWTd, LVM, LVMI (p = 0.001) was different from athlete group. Left ventricular adaption trended to eccentric hypertrophy and increased left ventricular mass index. A wave was decrease velocity and increased E/A, E/El’, E/E’s ratio. Base circumferential strain, apex circumferential strain, rotation and twist (10.12 ± 1.2) (°) athletes (7.42 ± 2.6) (°) control group with (p = 0.05), were more than control group. Conclusion: Conventional and advanced echocardiography can evaluate structural and functional left ventricular adaption in athletes. Especially, STE provided more data in myocardial deformation, rotation and twist so that it can discover these changes at athlete heart in early stages Key words: Athletes heart, Speckle Tracking Echocardiography, Tissue Doppler Imaging

scholarly journals Acute right ventricular pressure overload compromises left ventricular function by altering septal strain and rotation

2013 ◽  
Vol 115 (2) ◽  
pp. 186-193 ◽  
Author(s):  
Jason Chua ◽  
Wei Zhou ◽  
Jonathan K. Ho ◽  
Nikhil A. Patel ◽  
G. Burkhard Mackensen ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Circumferential Strain ◽  
Median Sternotomy ◽  
Radial Strain ◽  
Pressure Overload ◽  
Left Ventricular ◽  
Rotational Dynamics ◽  
Time To Peak ◽  
End Diastolic Volume ◽  
Apical Rotation

While right ventricular (RV) dysfunction has long been known to affect the performance of left ventricle (LV), the mechanisms remain poorly defined. Recently, speckle-tracking echocardiography has demonstrated that preservation of strain and rotational dynamics is crucial to both LV systolic and diastolic function. We hypothesized that alteration in septal strain and rotational dynamics of the LV occurs during acute RV pressure overload (RVPO) and leads to decreased cardiac performance. Seven anesthetized pigs underwent median sternotomy and placement of intraventricular pressure-volume conductance catheters. Two-dimensional echocardiographic images and LV pressure-volume loops were acquired for offline analysis at baseline and after banding of the pulmonary artery to achieve RVPO (>50 mmHg) induced RV dysfunction. RVPO resulted in a significant decrease ( P < 0.05) in LV end-systolic elastance (50%), systolic change in pressure over change in time (19%), end-diastolic volume (22%), and cardiac output (37%) that correlated with decrease in LV global circumferential strain (58%), LV apical rotation (28%), peak untwisting (reverse rotation) rate (27%), and prolonged time to peak rotation (17%), while basal rotation was not significantly altered. RVPO reduced septal radial and circumferential strain, while no other segment of the LV midpapillary wall was affected. RVPO decreased septal radial strain on LV side by 27% and induced a negative radial strain from 28 ± 5 to −16 ± 2% on the RV side of the septum. The septal circumferential strain on both LV and RV side decreased by 46 and 50%, respectively, following RVPO ( P < 0.05). Our results suggest that acute RVPO impairs LV performance by primarily altering septal strain and apical rotation.

scholarly journals Cardioprotective effect of Trimetazidine in patients with early breast cancer receiving anthracycline-based chemotherapy

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M.G Delle Donne ◽  
A Iannielli ◽  
P Capozza ◽  
R De Caterina ◽  
M Marzilli
Keyword(s):  
Breast Cancer ◽  
Diastolic Dysfunction ◽  
Speckle Tracking ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Cardiac Biomarkers ◽  
Doppler Imaging ◽  
Control Group ◽  
Speckle Tracking Imaging ◽  
Lv Diastolic Dysfunction

Abstract Background Anthracyclines, alone or in combination with other drugs, are among the most effective chemotherapeutic agents to treat breast cancer both in the adjuvant and neoadjuvant settings. Unfortunately, anthracycline-associated dose-dependent cardiotoxicity is a limiting factor in clinical use. Extensive efforts have been devoted to identifying strategies to prevent anthracycline-induced cardiotoxicity. However, most cardioprotective agents have shown little efficacy in clinical trials. We hypothesized that myocardial damage by anthracyclines could be rationally prevented by using trimetazidine (TMZ), previously reported to interfere with anthracycline- and trastuzumab-induced cardiotoxicity. Therefore, we planned a randomized, controlled, open trial to determine whether TMZ may prevent the development of left ventricular (LV) dysfunction in patients receiving standard treatment for breast cancer. Methods The trial included 73 patients (41.2±8.1 years) undergoing surgery for breast cancer, who were scheduled for adjuvant epirubicin-containing chemotherapy and, if indicated, trastuzumab. Patients were randomly allocated in a 1:1 ratio to receive TMZ or baseline therapy only (control group). The main study endpoint was a reduction in the deterioration of left ventricular ejection fraction (LVEF), as evaluated by serial echocardiography performed at randomization and then every 3 months after the start of chemotherapy and for 1 year after its completion. Secondary outcome measures included echocardiographic indices of LV diastolic dysfunction, structural myocardial alterations, as assessed by speckle tracking echocardiography, and changes in cardiac biomarkers (troponin and brain natriuretic peptide). Results We found no significant differences between the two groups regarding baseline clinical and echocardiographic parameters. The two groups reached a similar cumulative dose of doxorubicin. No patient died during the study and no patients withdrew from chemotherapy. Three months after the start of chemotherapy, nonsignificant changes were observed in LVEF, shortening fraction, and LV diameters. No significant changes in cardiac biomarkers were observed in either group. Tissue Doppler imaging detected a significant decrease in myocardial velocities (P=0.001) in the control group, indicating LV diastolic dysfunction. In the same group, speckle tracking imaging revealed a statistically significant alteration in ventricular deformation (P=0.01), which means a decrease in LV systolic function. In the TMZ group, no significant alterations in LV diastolic function were observed. Conclusions Tissue Doppler imaging and speckle tracking imaging are more sensitive than conventional echocardiograms in the early diagnosis of cardiac dysfunction and TMZ seems to have an important role in the prevention of cardiotoxicity. Funding Acknowledgement Type of funding source: None

scholarly journals Early detection of myocardial dysfunction in a cat that gradually progressed to endomyocardial form of restrictive cardiomyopathy

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Takahiro Saito ◽  
Ryohei Suzuki ◽  
Yunosuke Yuchi ◽  
Takahiro Teshima ◽  
Hirotaka Matsumoto ◽  
...  
Keyword(s):  
Early Detection ◽  
Circumferential Strain ◽  
Myocardial Dysfunction ◽  
Interventricular Septum ◽  
Restrictive Cardiomyopathy ◽  
Tissue Doppler ◽  
Doppler Imaging ◽  
Free Wall ◽  
Myocardial Velocity ◽  
Atrial Enlargement

Abstract Background Restrictive cardiomyopathy (RCM) is a common myocardial disease in cats, characterized by diastolic dysfunction and atrial enlargement without myocardial hypertrophy. Especially, endomyocardial form of RCM, one of the subtypes in RCM, is characterized by endocardial fibrosis, endocardial scar bridging the interventricular septum and left ventricular (LV) free wall, and deformation and distortion of the LV. However, it is unclear how the myocardial dysfunction and the endocardial scar contribute to the pathophysiology of RCM disease progression. Case presentation A 3 years and 2 months old, intact male, Domestic shorthaired cat was presented for consultation of cardiac murmur. At the first visit (day 0), the notable abnormal finding was echocardiography-derived chordae tendineae-like structure bridging the interventricular septum and the LV free wall, resulting high-speed blood flow in the left ventricle. Electrocardiography, thoracic radiography and noninvasive blood pressure measurements were normal. No left atrial enlargement was observed, and LV inflow velocity showed an abnormal relaxation pattern. Although there was no abnormality in tissue Doppler imaging-derived myocardial velocity, two-dimensional speckle tracking echocardiography (2D-STE) revealed a decrease in the LV longitudinal strain and an increase in endocardial to epicardial ratio of the LV circumferential strain on day 0. On day 468, obvious left atrium enlargement and smoke like echo in the left atrium were observed. The LV inflow velocity was fused, and the tissue Doppler imaging-derived early-diastolic myocardial velocity of the septal mitral annulus decreased. Regarding 2D-STE, LV circumferential strain was further decreased, and right ventricular strain was additionally decreased. Although the general condition was good, we made a clinical diagnosis of endomyocardial RCM based on the above findings. On day 503, the cat showed the radiographic evidence of pulmonary edema and congestive heart failure signs. Conclusions Cats with abnormal LV structure and associated myocardial dysfunction like this case needs careful observation. Additionally, 2D-STE indices may be useful for early detection of myocardial dysfunction in feline RCM.

Deformation echocardiography

2016 ◽  
Author(s):  
Matteo Cameli ◽  
Partho Sengupta ◽  
Thor Edvardsen
Keyword(s):  
Strain Rate ◽  
Tissue Doppler Imaging ◽  
Speckle Tracking ◽  
Radial Strain ◽  
Tissue Doppler ◽  
Strain Imaging ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Deformation Imaging ◽  
Strain And Strain Rate

Echocardiographic strain imaging, also known as deformation imaging, has been developed as a means to objectively quantify regional and global myocardial function. First introduced as a post-processing feature of tissue Doppler imaging velocity converted to strain and strain rate, strain imaging has more recently also been derived from speckle tracking analysis. Tissue Doppler imaging yields velocity information from which strain and strain rate are mathematically derived whereas two-dimensional speckle tracking yields strain information from which strain rate and velocity data are derived. Data obtained from these two different techniques may not be equivalent due to limitations inherent with each technique. Speckle tracking analysis can generate longitudinal, circumferential, and radial strain measurements and left ventricular twist. Although potentially useful, these measurements are also complicated and frequently displayed as difficult-to-interpret waveforms. Strain imaging is now considered a robust research tool and has great potential to play many roles in routine clinical practice. This chapter explains the fundamental concepts of deformation imaging, the technical features of strain imaging using tissue Doppler imaging and speckle tracking, and the strengths and weaknesses of these methods.

scholarly journals Speckle-tracking strain echocardiography for detecting cardiac dyssynchrony in a canine model of dyssynchrony and heart failure

2007 ◽  
Vol 293 (1) ◽  
pp. H735-H742 ◽  
Author(s):  
Takeshi Arita ◽  
George P. Sorescu ◽  
Brian T. Schuler ◽  
Laura S. Schmarkey ◽  
John D. Merlino ◽  
...  
Keyword(s):  
Heart Failure ◽  
Speckle Tracking ◽  
Radial Strain ◽  
Peak Systolic Velocity ◽  
Posterior Wall ◽  
Canine Model ◽  
Doppler Imaging ◽  
S Wave ◽  
Cardiac Dyssynchrony ◽  
Time To Peak

Multiple echocardiographic criteria have been proposed to diagnose mechanical dyssynchrony in patients with heart failure without being validated against a model of cardiac dyssynchrony with heart failure. This study examines which of these methods can detect dyssynchrony in a canine model. Adult mongrel dogs underwent His-bundle ablation and right-ventricular pacing for 4 wk at either 110 bpm to induce dyssynchrony without heart failure (D group, n = 12) or 170 bpm to induce dyssynchrony with heart failure (DHF group, n = 9). To induce heart failure with narrow QRS, atria were paced at 190 bpm for 4 wk (HF group, n = 8). Tissue Doppler imaging (TDI) and two-dimensional echocardiography were performed at baseline and at end of study. Standard deviation of time to peak systolic velocity (color-coded TDI), time to peak S wave on pulse-wave TDI, time to peak radial and circumferential strain by speckle-tracking analysis ( Err and Ecc, respectively), and septal-to-posterior wall motion delay on M mode were obtained. In D group, only Err and Ecc were increased by dyssynchrony. In contrast, all the echocardiographic parameters of dyssynchrony appeared significantly augmented in the DHF group. Receiver-operator curve analysis showed good sensitivity of Err (90%) and Ecc (100%) to detected dyssynchrony without heart failure and excellent sensitivity and specificity of Err and Ecc to detect dyssynchrony with heart failure. Radial strain by speckle tracking is more accurate than TDI velocity to detect cardiac dyssynchrony in a canine model of dyssynchrony with or without heart failure.

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