2-Dimensional Strain echocardiography and early detection of myocardial ischemia

Dattilo, Giuseppe; Lamari, Annalisa; Zito, Concetta; Carerj, Scipione; Marte, Filippo; Patanè, Salvatore

doi:10.1016/j.ijcard.2008.12.100

Cited by 14 publications

(8 citation statements)

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“…In recent years, accumulative evidence has shown that strain (ε) and strain rate (SR) are powerful echocardiographic parameters to directly reflect global and regional systolic and diastolic myocardial deformation [4]–[8], and to sensitively detect dysfunction from myocardial ischemia in CAD patients [9]–[12]. The measurement of atrial deformation by strain method is a promising and useful tool, but there are few data on the ischemia-related alterations of atrial myocardial deformation.…”

Section: Introductionmentioning

confidence: 99%

Left Atrial and Right Atrial Deformation in Patients with Coronary Artery Disease: A Velocity Vector Imaging-Based Study

Yan

Sun

et al. 2012

PLoS ONE

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BackgroundImpaired left ventricular (LV) function has been shown by strain rate (SR) imaging in patients with coronary artery disease (CAD). Our aim was to investigate global and regional, systolic and diastolic left atrial (LA) and right atrial (RA) longitudinal deformation in CAD using velocity vector imaging.MethodsEchocardiographic and velocity vector imaging studies were performed in 20 patients with mild CAD, 40 patients with severe CAD and 25 controls. Maximal atrial volume, peak atrial longitudinal strain (εs) and SR during LV systole (SRs), SR during early LV filling (SRe) and late LV filling (SRa) were measured. Longitudinal strain during atrial contraction (εa) was obtained at the onset of P-wave on electrocardiography, and εa/εs was calculated.ResultsLongitudinal peak εs and SRs of LA showed decreased trend among CAD patients. The global and lateral LA SRe were prominently lower, while RA εa, SRa and εa/εs were prominently higher in 2 CAD groups than control group (P value <0.05). As compared with controls and patients with other single-vessel disease, LA SRa and εa/εs ratio were significantly increased among patients with exclusively left anterior descending coronary artery (LAD) stenosis (SRa 1.14±0.38 s−1, 1.10±0.41 s−1, 1.45±0.46 s−1, P value<0.05; εa/εs 0.44±0.11, 0.44±0.20, 0.57±0.12, P value<0.01).ConclusionsApparently decreased SRe of LA and increased εa, SRa and εa/εs of RA were found in CAD patients with preserved LVEF and E/E' in gray zone. SRa and εa/εs of LA were found to significantly increase in those with LAD stenosis.

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Section: Introductionmentioning

confidence: 99%

Left Atrial and Right Atrial Deformation in Patients with Coronary Artery Disease: A Velocity Vector Imaging-Based Study

Yan

Sun

et al. 2012

PLoS ONE

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“…Echocardiographic strain imaging enables a comprehensive assessment of myocardial function with the ability to differentiate between active and passive movement of myocardial segments, longitudinal myocardial shortening, and dyssynchrony that are not visually assessable. 43 The accuracy of 2-dimensional speckle-tracking echocardiography has been compared with delayed enhancement cardiac magnetic resonance imaging where a strain value of −15% identified myocardial fibrosis with sensitivity of 83% and specificity of 93%. 44 Our CKD subjects did not exhibit impaired global longitudinal strain assessed by 2-dimensional speckle-tracking echocardiography and none of the RT subjects had late gadolinium hyperenhancement, suggesting the impaired BOLD SI change in our cohort was not related to replacement myocardial fibrosis or scar.…”

Section: Discussionmentioning

confidence: 99%

Impaired Myocardial Oxygenation Response to Stress in Patients With Chronic Kidney Disease

Parnham

Gleadle

Bangalore

et al. 2015

JAHA

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BackgroundCoronary artery disease and left ventricular hypertrophy are prevalent in the chronic kidney disease (CKD) and renal transplant (RT) population. Advances in cardiovascular magnetic resonance (CMR) with blood oxygen level–dependent (BOLD) technique provides capability to assess myocardial oxygenation as a measure of ischemia. We hypothesized that the myocardial oxygenation response to stress would be impaired in CKD and RT patients.Methods and ResultsFifty-three subjects (23 subjects with CKD, 10 RT recipients, 10 hypertensive (HT) controls, and 10 normal controls without known coronary artery disease) underwent CMR scanning. All groups had cine and BOLD CMR at 3 T. The RT and HT groups also had late gadolinium CMR to assess infarction/replacement fibrosis. The CKD group underwent 2-dimensional echocardiography strain to assess fibrosis. Myocardial oxygenation was measured at rest and under stress with adenosine (140 μg/kg per minute) using BOLD signal intensity. A total of 2898 myocardial segments (1200 segments in CKD patients, 552 segments in RT, 480 segments in HT, and 666 segments in normal controls) were compared using linear mixed modeling. Diabetes mellitus (P=0.47) and hypertension (P=0.57) were similar between CKD, RT, and HT groups. The mean BOLD signal intensity change was significantly lower in the CKD and RT groups compared to HT controls and normal controls (−0.89±10.63% in CKD versus 5.66±7.87% in RT versus 15.54±9.58% in HT controls versus 16.19±11.11% in normal controls, P<0.0001). BOLD signal intensity change was associated with estimated glomerular filtration rate (β=0.16, 95% CI=0.10 to 0.22, P<0.0001). Left ventricular mass index and left ventricular septal wall diameter were similar between the CKD predialysis, RT, and HT groups. None of the CKD patients had impaired global longitudinal strain and none of the RT group had late gadolinium hyperenhancement.ConclusionsMyocardial oxygenation response to stress is impaired in CKD patients and RT recipients without known coronary artery disease, and unlikely to be solely accounted for by the presence of diabetes mellitus, left ventricular hypertrophy, or myocardial scarring. The impaired myocardial oxygenation in CKD patients may be associated with declining renal function. Noncontrast BOLD CMR is a promising tool for detecting myocardial ischemia in the CKD population.

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“…Dipyridamole stress echocardiography (DSE) revealed no mechanical and/or electrocardiographic alterations but the patient complained for atypical chest pain during DSE. 2-Dimensional Strain echocardiography [12] revealed a reduction of the percentage of myocardial deformation with circumferential strain at peak stress of 25% of the average total than basal, (average baseline value 33.5%, total average after stress 25%), and a reduction of the percentage of myocardial deformation with longitudinal strain of 25% of the average total than basal(baseline average value 32%, total average after stress 24%) (Fig. 1).…”

Section: Case Reportmentioning

confidence: 96%

“…Myocardial bridging [1][2][3][4][5][6][7][8][9][10][11][12] is present when a segment of a major epicardial coronary artery, the 'tunnelled artery', runs intramurally through the myocardium. With each systole, the coronary artery is compressed [8].…”

Section: Case Reportmentioning

confidence: 99%

The chance finding at multislice computed tomography coronary angiography of myocardial bridging

Dattilo¹,

Carerj²,

Lamari³

et al. 2012

International Journal of Cardiology

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2-Dimensional Strain echocardiography and early detection of myocardial ischemia

Cited by 14 publications

References 7 publications

Left Atrial and Right Atrial Deformation in Patients with Coronary Artery Disease: A Velocity Vector Imaging-Based Study

Left Atrial and Right Atrial Deformation in Patients with Coronary Artery Disease: A Velocity Vector Imaging-Based Study

Impaired Myocardial Oxygenation Response to Stress in Patients With Chronic Kidney Disease

The chance finding at multislice computed tomography coronary angiography of myocardial bridging

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