A novel multi-layer approach of measuring myocardial strain and torsion by 2D speckle tracking imaging in normal subjects and patients with heart diseases

Zhang, Qing; Fang, Fang; Liang, Yuanying; Xie, Jun-Min; Wen, Yue-Yi; Yip, Gabriel Wai-Kwok; Lam, Yat‐Yin; Chan, Joseph Yat‐Sun; Fung, Jeffrey Wing‐Hong; Yu, Cheuk‐Man

doi:10.1016/j.ijcard.2009.07.041

Cited by 34 publications

(22 citation statements)

References 25 publications

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“…The left anterior descending branch mainly supplies the anterior wall, the inferior wall, and the anterior septum wall [4], which contributes to ischemic injury and a decrease in LS of the corresponding myocardium in the 2-chamber view. Our study also proved that the LS decreased gradually from the endocardium to epicardium, with the most significant decrease in LSendo, exactly as in previous studies [15]. Due to the uneven thickness of the LV wall in the 3 layers of myocardium, compared with the epicardial layer, the systolic intensity of the endocardium was obviously higher, and the endocardial layer needed greater oxygen consumption; therefore, when perfusion was compromised, the endocardial layer was more vulnerable to ischemia [16].…”

Section: D-sti and Layer-specific Strain Analysissupporting

confidence: 88%

Left Ventricular Strain and Dyssynchrony in Young and Middle-Aged Peritoneal Dialysis Patients and Healthy Controls: A Case-Matched Study

et al. 2018

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Background: This study aimed to evaluate the role of two-dimensional speckle-tracking imaging (2D-STI) and myocardial layer-specific analysis in evaluating early left ventricular (LV) myocardial function and systolic dyssynchrony in young and middle-aged uremic patients undergoing peritoneal dialysis (PD). Methods: We enrolled 31 PD patients aged ≤65 years with preserved LV ejection fraction (LVEF, ≥54%) as the PD group and 49 age-matched healthy people as the control group. Echocardiography was used to assess the left atrial diameter index (LADI, LAD/BSA), LV mass index (LVMI), LVEF, peak early diastolic velocity/late diastolic velocity (E/A) (measured by pulsed Doppler), and peak early diastolic velocity (by pulsed Doppler)/peak velocity of the early diastolic wave (by pulsed-wave tissue Doppler) (E/e′). Next, we used 2D-STI and myocardial layer-specific analysis to obtain longitudinal strains (LS) of the endocardium (LSendo), the myocardium (LSmyo), the epicardium (LSepi), and the global myocardium (GLS). Then, we measured the postsystolic index (PSI) to evaluate LV myocardial function. Time to peak LS (TTP) and peak strain dispersion (PSD) from 17 consecutive segments were assessed to quantify LV dyssynchrony. Results: Compared with the controls, PD patients had significantly increased LADI (p = 0.041), LVMI (p = 0.000), and E/e′ (p = 0.009), but reduced LVEF (p = 0.000) and E/A (p = 0.000). The average values of GLS (GLS avg) (p = 0.01) and GLS of the apical 2-chamber view (p = 0.003), including the LSendo (p = 0.024), LSmyo (p = 0.024), and LSepi (p = 0.032), were significantly decreased in patients with PD compared with controls. In PSI, segments of LS were markedly delayed in the anterior septum (p = 0.047), anterior (p = 0.000) and septum wall (p = 0.024) from basal segments, anterior wall (p = 0.001) from middle segments, and anterior (p = 0.024) and inferior (p = 0.024) wall from apical segments. Moreover, PSD was significantly increased in PD patients (p = 0.015), while TTP was evidently delayed in the anterior septum (p = 0.004), anterior (p = 0.000) and posterior (p = 0.042) wall from basal segments, and inferior wall (p = 0.048) from apical segments. Conclusions: Despite preserved LVEF, young and middle-aged PD patients developed LV dysfunction and myocardial systolic dyssynchrony earlier compared with controls.

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Section: D-sti and Layer-specific Strain Analysissupporting

confidence: 88%

Left Ventricular Strain and Dyssynchrony in Young and Middle-Aged Peritoneal Dialysis Patients and Healthy Controls: A Case-Matched Study

et al. 2018

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“…Zhang uses Qlab (Philips) to demonstrate that a transmural gradient exists in CS in normal controls, acute coronary syndrome subjects with an LV EF N 45%, right ventricular apical pacing with EF N45%, and systolic heart failure with EF b 45%, with the highest values in the endocardial layer [12]. Therefore, a 2D, speckle tracking, multi-layer imaging approach may provide further useful information for the assessment of myocardial diseases.…”

Section: Discussionmentioning

confidence: 99%

Characteristic myocardial strain identified in hypertrophic cardiomyopathy subjects with preserved left ventricular ejection fraction using a novel multi-layer transthoracic echocardiography technique

Ozawa

Funabashi

Takaoka

et al. 2015

International Journal of Cardiology

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“…Nottin et al 2008;Zhang et al 2009;Goffinet et al 2009;Hasegawa et al 2009). Comparison of circumferential strain data from our subjects, at baseline, with sedentary but healthy subjects (Zhang et al 2009) revealed a degree of similarity in both sub-endocardial (current: -26.9 vs. Zhang: -25.7) and sub-epicardial (current: -13.8 vs. Zhang: -18.7) peak circumferential strain. The slightly lower sub-epicardial circumferential strain in the runners, and a greater transmural gradient, may be partly related to their elevated training status.…”

Section: Baseline Datamentioning

confidence: 99%

Left ventricular myocardial strain and strain rates in sub-endocardial and sub-epicardial layers before and after a marathon

et al. 2010

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We assessed myocardial deformation in sub-endocardial and sub-epicardial layers of the left ventricle (LV) wall before and after running a marathon. Echocardiography scans were performed on 14 male, non-elite runners (mean +/- SD; age 32 +/- 10 years) who completed the 42.2-km London marathon. Para-sternal short axis and apical four-chamber views were recorded for off-line analysis. Peak longitudinal, radial and circumferential strains, peak systolic and early diastolic strain rates were recorded. Circumferential rotation in basal and apical LV scans was used to calculate torsion. Pre-race strain and strain rates were generally greater in the sub-endocardial layer of the LV wall. After race completion, a mixed pattern of change was observed with a reduction in sub-epicardial radial strain (32.6 +/- 12.5 to 20.3 +/- 9.6%; P < 0.01) and sub-endocardial circumferential strain (-26.9 +/- 3.6 to -23.7 +/- 4.1%; P < 0.01) at the apex. Rotation was not altered at either the apical or basal levels and thus torsion was not changed in either the sub-endocardium (6.72 +/- 3.46 degrees to 5.67 +/- 4.98 degrees) or the sub-epicardium (3.48 +/- 2.68 degrees to 3.01 +/- 3.23 degrees). Strain rates and rotation rates were only sporadically altered post-race. There are differences in deformation characteristics between the sub-endocardium and sub-epicardium at baseline, and the limited changes observed post-race were not specific to any region or depth of the LV wall.

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A novel multi-layer approach of measuring myocardial strain and torsion by 2D speckle tracking imaging in normal subjects and patients with heart diseases

Cited by 34 publications

References 25 publications

Left Ventricular Strain and Dyssynchrony in Young and Middle-Aged Peritoneal Dialysis Patients and Healthy Controls: A Case-Matched Study

Left Ventricular Strain and Dyssynchrony in Young and Middle-Aged Peritoneal Dialysis Patients and Healthy Controls: A Case-Matched Study

Characteristic myocardial strain identified in hypertrophic cardiomyopathy subjects with preserved left ventricular ejection fraction using a novel multi-layer transthoracic echocardiography technique

Left ventricular myocardial strain and strain rates in sub-endocardial and sub-epicardial layers before and after a marathon

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