Echocardiographic Assessment of Myocardial Strain

Gorcsan, John; Tanaka, Hidekazu

doi:10.1016/j.jacc.2011.06.038

Cited by 404 publications

(317 citation statements)

References 70 publications

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“…Global longitudinal strain has proved more accurate than LVEF in quantifying LV function, and it is known to possess prognostic impact (10) . Alterations in regional myocardial deformation can be quantifi ed by strain echocardiography, and these may represent electromechanical interactions.…”

Section: Imaging Techniquesmentioning

confidence: 99%

New predictors of malignant ventricular arrhythmias in Chagas disease: searching for the holy grail

Barros

2015

Rev. Soc. Bras. Med. Trop.

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(Carlos Chagas, 1916) (1) Since the fi rst descriptions of Chagas disease (ChD), sudden death is considered one of the characteristics and responsible for >50% of the mortality in chagasic patients with heart failure. In this issue of RSBMT, Barbosa et al (2) . highlight several important aspects of the pathogenesis, prognosis, and treatment of ventricular arrhythmias in ChD (2) . Chagas disease has an essentially arrhythmogenic nature characterized by dense and complex ventricular arrhythmias; therefore, ventricular fi brillation likely constitutes the terminal event in most cases of sudden death, which accounts for the majority of deaths in ChD. Chagas cardiomyopathy gives rise to the most intense fi brous reaction amongst all causes of myocarditis, leading to severe disorganization of the myocardial architecture and structure. In addition to the fi brotic substrate, electrical dispersion plays an important role in arrhythmogenesis, and it is caused by areas of slow conduction leading to electrical instability. Myocardial fi brosis and areas of slow electrical conduction result in mechanical alterations in both timing and function. With the development of therapeutic strategies to prevent death from ventricular fi brillation, particularly the use of implantable cardioverter-defi brillators (ICDs), accurate patient stratifi cation based on the future risk of arrhythmic events has become very relevant in ChD (3) .A major therapeutic goal in the management of Chagas cardiomyopathy is prevention of sudden cardiac death. While ICD therapy is the standard treatment for secondary prevention of cardiac arrest, the strategy for primary prevention of cardiac arrest in Chagas cardiomyopathy is much more controversial. Although several clinical features have been assessed as possible risk factors for the development of fatal arrhythmias, the sensitivity and specifi city of any single test to predict fatal arrhythmias are limited. For example, left ventricular dysfunction is recognized as a strong general risk predictor, particularly for arrhythmic death in ChD (4) ; however, the mere presence of a depressed left ventricular ejection fraction (LVEF) is not sensitive or specifi c enough to stratify the risk of sudden death. Most patients with ChD that have an ICD for secondary prevention and thus have experienced a potentially fatal arrhythmic event have an LVEF >30%. Electrocardiographic techniquesIn the last few years, several new electrocardiographic methods have been used to predict mortality in ChD including measurement of the length of the QRS and QT intervals from a standard 12-lead ECG, which is a simple and inexpensive method of risk assessment in ChD. QT dispersion is associated with left ventricular (LV) systolic dysfunction, and both increased QT dispersion and QT interval are related to a higher risk of death in ChD patients (5) . Moreover, in another study performed in the same study sample, T-wave axis deviation was a strong and independent predictor of mortality risk. Furthermore,

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Section: Imaging Techniquesmentioning

confidence: 99%

New predictors of malignant ventricular arrhythmias in Chagas disease: searching for the holy grail

Barros

2015

Rev. Soc. Bras. Med. Trop.

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“…Dedicated software allows calculation of the velocity in the myocardial tissue due to the geometric shift of the speckles. With this new technique it is possible to quantify myocardial strain and strain rate in longitudinal, radial, and circumferential directions [11]. Strain parameters are thereby suggested to be more sensitive regarding their diagnostic and potentially prognostic potential compared to conventional functional parameters, e. g. LV ejection fraction.…”

Section: Speckle Trackingmentioning

confidence: 99%

“…1. However, TTE ST depends on a high image quality with a sufficient echocardiographic window to reproduce valid measurements and is limited due to the rather time-consuming acquisition and post-processing [11]. In a study by Hsiao et al, LV circumferential as well as longitudinal strain and strain rate were significantly lower in MC patients compared to healthy controls, and longitudinal strain was shown to exhibit the best diagnostic potential [12].…”

Section: Speckle Trackingmentioning

confidence: 99%

Modern Imaging of Myocarditis: Possibilities and Challenges

Baeßler

Schmidt

Lücke

et al. 2016

Fortschr Röntgenstr

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▼Myocarditis is known as the chameleon of cardiac diseases. The symptoms and the course of disease vary greatly so that it is often challenging to establish a diagnosis. Early and accurate diagnosis is of utmost importance, since myocarditis is one of the leading causes of sudden cardiac death in young adults and represents an important precursor to dilated cardiomyopathy. Due to the constraints of the routinely used diagnostic approach, including clinical history and examination, laboratory testing, and electrocardiogram, different imaging modalities have emerged over the last decades as contributors to the noninvasive diagnosis of myocarditis. With this interdisciplinary review we would like to present the current state-of-the-art imaging of myocarditis across all available imaging modalities (i. e., echocardiography, cardiac magnetic resonance, cardiac computed tomography, and nuclear medicine). Furthermore, we present novel imaging techniques that might become useful in the near future for easier and more accurate diagnosis of this highly relevant disease.

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“…Imaging myocardial strain is of growing importance for the clinical assessment of heart disease (3,(32)(33)(34). MRI myocardial tagging, a long-established method, has been considered the gold standard as compared to strain imaging using echocardiography (34,35).…”

Section: Cine Displacement Encoding With Stimulated Echoes (Dense)mentioning

confidence: 99%

“…Compressed sensing (32), an acceleration technique of growing importance, is making a major impact on MRI (10). Using CS, high-quality images can be recovered from data sampled well below the Nyquist rate provided that the sampling pattern is incoherent, the images are sparse in a transform domain, and a sparsity-promoting iterative reconstruction is used (10).…”

Section: Introductionmentioning

confidence: 99%

Accelerated Dynamic Cardiac MRI Using Motion-Guided Compressed Sensing with Regional Sparsity

Chen

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All rights reserved AbstractDynamic cardiac Magnetic Resonance Imaging (CMR) demands fast imaging techniques to obtain high spatial-resolution, large spatial-coverage and high temporal-resolution images for accurate prognosis and diagnosis. Compressed sensing (CS), a fast imaging technique of growing importance, is making a major impact on MRI. Using CS, high-quality images can be recovered from data sampled well below the Nyquist rate. Because of the high temporal and spatial redundancy inherent to dynamic images, these data are well-suited for acceleration by CS.However, the complex dynamics which include both object motions and image contrast variations encountered in dynamic CMR pose challenging tasks for CS techniques. The complexity, if not handled correctly, leads to largely degraded reconstruction quality.This dissertation presents a novel CS method to accelerate dynamic CMR imaging, especially those with complex dynamics, with a motion-compensated CS method that exploits regional spatiotemporal sparsity: Block LOw-rank Sparsity with Motion-guidance (BLOSM). In one iteration of the BLOSM calculation, blocks of image pixels are motion-tracked through time and low-rank sparsity is exploited within the tracked blocks. The de-noised blocks are merged back into complete images and compensated for data fidelity.The BLOSM method was first developed and validated using retrospectively accelerated first-pass cardiac perfusion images with prominent respiratory motion and computer simulated motion phantoms. Systematic experiments were conducted to compare BLOSM to several other II competing CS methods. The BLOSM showed great quality improvement for the images presenting complex dynamics.Two CMR applications of great clinical importance, both of which present distinct and extremely challenging tasks for CS, were prospectively accelerated using BLOSM.First-pass cardiac perfusion imaging was accelerated on patients with suspected heart disease. With prospective rate 4 acceleration, multi-slice high spatial resolution perfusion images were acquired. A Poisson-disc-distributed sampling pattern was implemented. BLOSM was extended to incorporate parallel imaging. The image quality offered by BLOSM showed significant improvement over the other CS methods when respiratory motion occurred.2D cine DENSE imaging was accelerated using BLOSM. The scan time was shortened from two separate breathholds of total 28 heartbeats to one single breathhold of 8 heartbeats.Variable-density spiral trajectory with golden angle rotation was designed for accelerated data sampling. Both retrospective and prospective studies were conducted in healthy volunteers and BLOSM provided high image quality and the cardiac function assessed from BLOSM reconstructed images matched well with the fully-sampled reference data.III

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Echocardiographic Assessment of Myocardial Strain

Cited by 404 publications

References 70 publications

New predictors of malignant ventricular arrhythmias in Chagas disease: searching for the holy grail

New predictors of malignant ventricular arrhythmias in Chagas disease: searching for the holy grail

Modern Imaging of Myocarditis: Possibilities and Challenges

Accelerated Dynamic Cardiac MRI Using Motion-Guided Compressed Sensing with Regional Sparsity

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