Assessment of Left Ventricular Function by Cardiac Ultrasound

Thomas, James D.; Popović, Zoran B.

doi:10.1016/j.jacc.2006.06.071

Cited by 176 publications

(136 citation statements)

References 123 publications

(86 reference statements)

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“…[14][15][16] It has been shown that delayed and reduced diastolic untwisting during the diastolic phase may be an early indicator of an LV relaxation abnormality for hypertensive patients with LV hypertrophy. 17 Bansal et al 5 found that resting global LVrot and regional LVrot were significantly reduced in patients with myocardial infarction compared to those without previous myocardial infarction, and LVrot was most impaired in patients with multiple areas of infarction.…”

Section: Left Ventricular Rotation and Clinical Implicationsmentioning

confidence: 99%

“…Therefore, LVrot assessment represents an interesting approach for quantifying LV function and may provide important clinical information about cardiac function. 6,15 Current Clinical Techniques for Measuring LVrot Left ventricular rotation can be measured noninvasively using both MRI and echocardiography. Tagged MRI has been considered the reference standard for noninvasive LVrot assessment.…”

Section: Left Ventricular Rotation and Clinical Implicationsmentioning

confidence: 99%

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Three-Dimensional Speckle-Tracking Imaging for Left Ventricular Rotation Measurement

Zhou

Ashraf

et al. 2010

Journal of Ultrasound in Medicine

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Objective. Left ventricular (LV) twist is manifested in oppositely directed apical and basal rotation. We studied a new 3-dimensional (3D) echocardiography program (wall motion tracking; Toshiba America Medical Systems, Inc, Tustin, CA) for left ventricular rotation. Methods. We used a rotation model with a variable-speed motor to rotate hearts in a water bath. We studied 10 freshly harvested pig hearts, which were mounted on the rotary actuator of our twist phantom with the heart base rotating and the apex held fixed to avoid translational motion, at rotations of 0°, 15°, 20°, and 25°. Full-volume 3D image loops were acquired on a Toshiba Aplio Artida ultrasound system at a maximized frame rate. Results. As the actual heart rotation increased, computed segmental and global rotation also increased accordingly, with the measured rotations of the basal and middle segments greater than that of the apex (both P < .001). Segmental and global rotation at all 3 levels correlated well with the actual rotation (base: r = 0.93; middle: r = 0.92; apex: r = 0.82; global: r = 0.95; all P < .001). Conclusions. The new 3D program tracked LV rotation accurately. Key words: left ventricular rotation; speckle tracking; 3-dimensional imaging. esearch in clinical deformation cardiac mechanics has recently been focused on 2-dimensional (2D) left ventricular (LV) deformation studies, including LV twist and LV rotation (LVrot). 1 Left ventricular twist may be related to the helical fiber orientation of the LV, which results in opposing rotational directions of the apex and the base and which determines the magnitude of this torsional deformation. 2,3 It has been proposed that LV twist is a sensitive marker of changes in both regional and global LV function. [4][5][6] Recently, efforts have focused on 2D speckle-tracking imaging (STI) to assess LVrot. [7][8][9] Several studies have shown that 2D STI gives equivalent results when compared to magnetic resonance imaging (MRI) or Doppler tissue imaging (DTI) for measuring LVrot. 9 However, because of the 3-dimensional (3D) nature of cardiac deformation, 2D STI based on 2D imaging may not be robust enough for LVrot measurement because of speckle decorrelation or the loss of some speckles due to elevational

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Section: Left Ventricular Rotation and Clinical Implicationsmentioning

confidence: 99%

Section: Left Ventricular Rotation and Clinical Implicationsmentioning

confidence: 99%

Three-Dimensional Speckle-Tracking Imaging for Left Ventricular Rotation Measurement

Zhou

Ashraf

et al. 2010

Journal of Ultrasound in Medicine

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“…Tissue Doppler imaging (TDI) is one of the more recent technological advances that allows quantitative characterization of regional wall motion velocities 3, 4. Both in people and in small animals, the clinical applicability of TDI has been established and the modality has been successfully applied for the assessment of systolic and diastolic LV function and estimation of ventricular filling pressures 4, 5, 6, 7.…”

mentioning

confidence: 99%

Echocardiographic Assessment of Left Ventricular Function in Healthy Horses and in Horses with Heart Disease Using Pulsed‐Wave Tissue Doppler Imaging

Koenig

Mitchell

Schwarzwald

2017

Veterinary Internal Medicne

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BackgroundAssessment of left ventricular (LV) function by tissue Doppler imaging (TDI) is not well established in horses with heart disease.ObjectivesTo describe the use of pulsed‐wave (PW) TDI for the assessment of LV function, establish reference intervals, investigate effects of mitral regurgitation (MR), aortic regurgitation (AR), and primary myocardial disease (MD), and provide proof of concept for the use of PW TDI in Warmblood horses with heart disease.AnimalsThirty healthy horses, 38 horses with MR, 25 with AR, 8 with MD.MethodsEchocardiograms were retrospectively analyzed. Reference intervals were calculated. PW TDI indices of healthy horses and horses with MR, AR, and MD were compared by one‐way ANOVA and Dunnett's test.ResultsA complete set of PW TDI variables could be obtained in 94 of 101 horses. Variables corresponding to isovolumic intervals were most difficult to measure. Valvular regurgitation influenced variables describing isovolumic contraction and ejection. Horses with MD had significantly shortened ETm (−118.5 [−154.1 to −82.9] ms; mean difference [95% CI of difference of means]), increased PEPm/ETm (0.11 [0.05 to 0.17]), prolonged IMPm (0.28 [0.18 to 0.37]), increased S 1 (8.9 [5.2 to 12.6] cm/s), and decreased E 1 (−2.6 [−4.7 to −0.5] cm/s), E m (−14.2 [−19.9 to −8.5] cm/s), and E m/A m ratio (−1.6 [−2.6 to −0.6]).Conclusions and Clinical ImportancePulsed‐wave TDI might be useful for detection of LV dysfunction in horses with primary MD. The clinical value of TDI in horses with MR and AR remains uncertain.

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“…Thomas and Popovic have reviewed the clinical application of LV strain imaging using tissue Doppler derived and speckle tracked derived strain imaging for evaluation of regional myocardial function. 8 Abnormal LV strain (> -20) can be used to determine subclinical systolic dysfunction. Left ventricular strain imaging with 2-D speckle tracking is done frequently in many labs to evaluate patients for subclinical LV systolic dysfunction when overall LV ejection fraction is preserved, especially in condition like amyloidosis and hypertrophic cardiomyopathy.…”

Section: Aliakbar Arvandi MDmentioning

confidence: 99%

Left Atrial Function

Arvandi

2017

SWRCCC

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The left atrium (LA) The left atrium (LA) is anatomically located as a left posterior cardiac chamber that serves as a conduit between the pulmonary veins and the left ventricle (LV). Although anatomical variation is not uncommon, usually four pulmonary veins (left upper and lower and right upper and lower) are connected to the posterior wall of the LA. The connection between the LA and LV is through the mitral valve apparatus. The interatrial septum separates the two atria, but communication between the left and right atria by a patent foramen ovale occurs in up to 25% of the population.The LA is filled during systole and reaches its maximum volume at the end of isovolumetric relaxation right before the opening of the mitral valve. Subsequently its volume starts to decrease by the opening of the mitral valve and reaches its smallest diameter at the end of diastole after atrial contraction. Normal phasic emptying during diastole has an important role in determining LV stroke volume, meaning that most of the LV preload and the final stroke volume depend on passive filling during the earlier part of diastole. In normal conditions, atrial contraction contributes 15-30% of the LV stroke volume. The LA appendage has an important role in the contraction phase of LA. It is trabeculated compared to the rest of the atrium, and in conditions like atrial fibrillation when the atrium loses effective contraction, it is the main site for thrombus formation. Due to the close proximity of the LA to the esophagus, transesophageal echocardiography (TEE) has proven to be an excellent method to detect LA thrombus. The changes in LA size during the cardiac cycle can be measured by M-Mode and two dimensional (2-D) echocardiography (see Figures1-A and 1-B).

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Assessment of Left Ventricular Function by Cardiac Ultrasound

Cited by 176 publications

References 123 publications

Three-Dimensional Speckle-Tracking Imaging for Left Ventricular Rotation Measurement

Three-Dimensional Speckle-Tracking Imaging for Left Ventricular Rotation Measurement

Echocardiographic Assessment of Left Ventricular Function in Healthy Horses and in Horses with Heart Disease Using Pulsed‐Wave Tissue Doppler Imaging

Left Atrial Function

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