Fizjologiczne podstawy oceny mechaniki mięśnia serca przy użyciu techniki śledzenia markerów akustycznych 2D. Część I

Abstract

In this paper, the authors attempt to concisely present the anatomical and pathophysiological bases as well as the principles for echocardiographic evaluation of mechanical aspects of cardiac function based on speckle tracking method. This technique uses a phenomenon involving the formation of characteristic image units, referred to as speckles or acoustic markers, which are stable during cardiac cycle, on a two-dimensional echocardiographic picture. Changes in the position of these speckles throughout the cardiac cycle, which are monitored and analyzed semi-automatically by a computer system, reflect deformation of both, cardiac ventricle as a whole as well as its individual anatomical segments. The values of strain and the strain rate, as well as the range and velocity of the movement of these markers, which are in close relationship with multiple hemodynamic parameters, can be visualized as various types of charts – linear, two- and three-dimensional – as well as numerical values, enabling deeper insight into the mechanical and hemodynamic aspects of cardiac function in health and disease. The use of information obtained based on speckle tracking echocardiography allows to understand previously unclear mechanisms of physiological and pathophysiological processes. The first part of the study discusses the formation of a two-dimensional ultrasound image and the speckles, as well as the technical aspects of tracking their movement. The second part presents in more detail the methodology of speckle-tracking echocardiography, the characteristic abnormalities of cardiac mechanics presenting in different clinical entities, and the limitations related to given clinical and technical issues.

Myocardial tissue characterisation using echocardiographic deformation imaging

“…Deformation of a particular myocardial segment is dependent on cardiomyocyte function, myofibre architecture, tissue elasticity and fibrosis, as well as being affected by intracavity pressure and the function of neighboring segments [5]. In this narrative review, we examine the utility of STE deformation imaging for tissue characterisation, focusing on studies comparing imaging with the gold standard of ex-vivo tissue analysis, rather than on comparison with other imaging modalities.…”

Timing and Magnitude of Regional Right Ventricular Function and Their Relationship with Early Hospital Mortality in Patients with Acute Pulmonary Embolism

“…They recorded three consecutive cardiac cycles in DICOM format for each view with a frame rate >50/s, which appears to be the best compromise between appropriate temporal resolution and acceptable spatial definition of the LV lateral wall and RV free wall. In post-processing analysis, the region of interest (ROI) was obtained by tracing the RV endocardial borders at the level of the interventricular septum and the free wall in a still frame at end-systole (12). The ROI was adjusted to cover at least 90% of the myocardial wall thickness.…”

Clinical Capabilities and Limitations in the Use of Modern Technologies in Echocardiography

“…Интерпретация данного исследования практически не зависит от угла, под которым лоцируется тот или иной сегмент ЛЖ. Технология speckle tracking лишена ограничений, возникающих при измерении деформации миокарда с помощью тканевой допплерографии [13].…”