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Strain and strain rate imaging by echocardiography - basic concepts and clinical applicability.

Dandel M, Lehmkuhl H, Knosalla C, Suramelashvili N, Hetzer R - Curr Cardiol Rev (2009)

Bottom Line: Echocardiographic strain and strain-rate imaging (deformation imaging) is a new non-invasive method for assessment of myocardial function.Due to its ability to differentiate between active and passive movement of myocardial segments, to quantify intraventricular dyssynchrony and to evaluate components of myocardial function, such as longitudinal myocardial shortening, that are not visually assessable, it allows comprehensive assessment of myocardial function and the spectrum of potential clinical applications is very wide.Strain and strain rate data also provide valuable prognostic information, especially prediction of future reverse remodelling after left ventricular restoration surgery or after cardiac resynchronization therapy and prediction of short and median-term outcome without transplantation or ventricular assist device implantation of patients referred for heart transplantation.The Review explains the fundamental concepts of deformation imaging, describes in a comparative manner the two major deformation imaging methods (TDI-derived and speckle tracking 2D-strain derived) and discusses the clinical applicability of these new echocardiographic tools, which recently have become a subject of great interest for clinicians.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Germany.

ABSTRACT
Echocardiographic strain and strain-rate imaging (deformation imaging) is a new non-invasive method for assessment of myocardial function. Due to its ability to differentiate between active and passive movement of myocardial segments, to quantify intraventricular dyssynchrony and to evaluate components of myocardial function, such as longitudinal myocardial shortening, that are not visually assessable, it allows comprehensive assessment of myocardial function and the spectrum of potential clinical applications is very wide. The high sensitivity of both tissue Doppler imaging (TDI) derived and two dimensional (2D) speckle tracking derived myocardial deformation (strain and strain rate) data for the early detection of myocardial dysfunction recommend these new non-invasive diagnostic methods for extensive clinical use. In addition to early detection and quantification of myocardial dysfunction of different etiologies, assessment of myocardial viability, detection of acute allograft rejection and early detection of allograft vasculopathy after heart transplantation, strain and strain rate data are helpful for therapeutic decisions and also useful for follow-up evaluations of therapeutic results in cardiology and cardiac surgery. Strain and strain rate data also provide valuable prognostic information, especially prediction of future reverse remodelling after left ventricular restoration surgery or after cardiac resynchronization therapy and prediction of short and median-term outcome without transplantation or ventricular assist device implantation of patients referred for heart transplantation.The Review explains the fundamental concepts of deformation imaging, describes in a comparative manner the two major deformation imaging methods (TDI-derived and speckle tracking 2D-strain derived) and discusses the clinical applicability of these new echocardiographic tools, which recently have become a subject of great interest for clinicians.

No MeSH data available.


Related in: MedlinePlus

Left ventricular longitudinal strain images obtained from the 4-chamber view of a patient with LV apical aneurysma after myocardial infarction before (panel A) and after (panel B) surgical LV restoration. Less systolic asynchrony (more uniform contraction), more uniform relaxation and improvement of contractile function in apical and basal lateral regions were the most evident postoperative changes detectable by 2D strain imaging. [Knosalla C, Dandel M, et al. Journal of Heart Lung Transplant 2008; 27: S186].
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Figure 5: Left ventricular longitudinal strain images obtained from the 4-chamber view of a patient with LV apical aneurysma after myocardial infarction before (panel A) and after (panel B) surgical LV restoration. Less systolic asynchrony (more uniform contraction), more uniform relaxation and improvement of contractile function in apical and basal lateral regions were the most evident postoperative changes detectable by 2D strain imaging. [Knosalla C, Dandel M, et al. Journal of Heart Lung Transplant 2008; 27: S186].

Mentions: In our department, 2D-strain imaging is also the method of choice for patient selection for surgical ventricular restoration (SVR) to improve the LV function after severe myocardial infarction. We also found that systolic dyssynchrony and the end-systolic dyssynergy indexes, calculated from regional strain values, are highly sensitive for evaluations of myocardial functional changes during the postoperative reverse remodeling processes after SVR [40,75]. Figs. (5) and (6) show examples of 2D-strain and strain-rate recordings obtained before and after SVR.


Strain and strain rate imaging by echocardiography - basic concepts and clinical applicability.

Dandel M, Lehmkuhl H, Knosalla C, Suramelashvili N, Hetzer R - Curr Cardiol Rev (2009)

Left ventricular longitudinal strain images obtained from the 4-chamber view of a patient with LV apical aneurysma after myocardial infarction before (panel A) and after (panel B) surgical LV restoration. Less systolic asynchrony (more uniform contraction), more uniform relaxation and improvement of contractile function in apical and basal lateral regions were the most evident postoperative changes detectable by 2D strain imaging. [Knosalla C, Dandel M, et al. Journal of Heart Lung Transplant 2008; 27: S186].
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2805816&req=5

Figure 5: Left ventricular longitudinal strain images obtained from the 4-chamber view of a patient with LV apical aneurysma after myocardial infarction before (panel A) and after (panel B) surgical LV restoration. Less systolic asynchrony (more uniform contraction), more uniform relaxation and improvement of contractile function in apical and basal lateral regions were the most evident postoperative changes detectable by 2D strain imaging. [Knosalla C, Dandel M, et al. Journal of Heart Lung Transplant 2008; 27: S186].
Mentions: In our department, 2D-strain imaging is also the method of choice for patient selection for surgical ventricular restoration (SVR) to improve the LV function after severe myocardial infarction. We also found that systolic dyssynchrony and the end-systolic dyssynergy indexes, calculated from regional strain values, are highly sensitive for evaluations of myocardial functional changes during the postoperative reverse remodeling processes after SVR [40,75]. Figs. (5) and (6) show examples of 2D-strain and strain-rate recordings obtained before and after SVR.

Bottom Line: Echocardiographic strain and strain-rate imaging (deformation imaging) is a new non-invasive method for assessment of myocardial function.Due to its ability to differentiate between active and passive movement of myocardial segments, to quantify intraventricular dyssynchrony and to evaluate components of myocardial function, such as longitudinal myocardial shortening, that are not visually assessable, it allows comprehensive assessment of myocardial function and the spectrum of potential clinical applications is very wide.Strain and strain rate data also provide valuable prognostic information, especially prediction of future reverse remodelling after left ventricular restoration surgery or after cardiac resynchronization therapy and prediction of short and median-term outcome without transplantation or ventricular assist device implantation of patients referred for heart transplantation.The Review explains the fundamental concepts of deformation imaging, describes in a comparative manner the two major deformation imaging methods (TDI-derived and speckle tracking 2D-strain derived) and discusses the clinical applicability of these new echocardiographic tools, which recently have become a subject of great interest for clinicians.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Germany.

ABSTRACT
Echocardiographic strain and strain-rate imaging (deformation imaging) is a new non-invasive method for assessment of myocardial function. Due to its ability to differentiate between active and passive movement of myocardial segments, to quantify intraventricular dyssynchrony and to evaluate components of myocardial function, such as longitudinal myocardial shortening, that are not visually assessable, it allows comprehensive assessment of myocardial function and the spectrum of potential clinical applications is very wide. The high sensitivity of both tissue Doppler imaging (TDI) derived and two dimensional (2D) speckle tracking derived myocardial deformation (strain and strain rate) data for the early detection of myocardial dysfunction recommend these new non-invasive diagnostic methods for extensive clinical use. In addition to early detection and quantification of myocardial dysfunction of different etiologies, assessment of myocardial viability, detection of acute allograft rejection and early detection of allograft vasculopathy after heart transplantation, strain and strain rate data are helpful for therapeutic decisions and also useful for follow-up evaluations of therapeutic results in cardiology and cardiac surgery. Strain and strain rate data also provide valuable prognostic information, especially prediction of future reverse remodelling after left ventricular restoration surgery or after cardiac resynchronization therapy and prediction of short and median-term outcome without transplantation or ventricular assist device implantation of patients referred for heart transplantation.The Review explains the fundamental concepts of deformation imaging, describes in a comparative manner the two major deformation imaging methods (TDI-derived and speckle tracking 2D-strain derived) and discusses the clinical applicability of these new echocardiographic tools, which recently have become a subject of great interest for clinicians.

No MeSH data available.


Related in: MedlinePlus