Experimental validation of left ventricular transmural strain gradient with echocardiographic two-dimensional speckle tracking imaging

Abstract

A newly developed STI system can accurately assess the intramural heterogeneity of CS distribution in normal and ischaemic myocardial segments and has the potential to become a non-invasive bedside tool for characterizing myocardial strain gradient.

Subendocardial Systolic Dysfunction in Asymptomatic Normotensive Diabetic Patients

“…), who was blinded to the patients' clinical characteristics. 6 Radial and circumferential strains (RS and CS) were measured in the mid-ventricular short-axis view. RS was measured in the subendocardial and subepicardial layers and the total wall (inner RS, outer RS, and total RS, respectively).…”

“…Furthermore, newly developed layer-specific speckle tracking imaging can evaluate myocardial function layer-by-layer. 6 This technique allows the noninvasive evaluation of layer-specific myocardial damage. Accordingly, the present study aimed to identify the myocardial strain characteristics of diabetic cardiomyopathy in patients with and without hypertension using layer-specific strain analysis by 2D speckle tracking echocardiography.…”

Impaired Subendocardial Wall Thickening and Post-Systolic Shortening Are Signs of Critical Myocardial Ischemia in Patients With Flow-Limiting Coronary Stenosis

“…Tracking of mid-wall echo speckle is challenging because of the hazy speckle pattern produced in comparison to the strong echo from the myocardial contour. 11 Speckle is an inherent characteristic of ultrasound imaging, and it arises because subresolution scatter causes interference patterns in the image. 35 Therefore, the observed speckle pattern does not correspond to the underlying structure of the tissue.…”

“…36 In an open-chest animal model, intramural speckle tracking-derived strain was found to correspond with the ultrasonic crystal to the same degree as the strain derived from speckle tracking of the myocardial border. 11 Another source of measurement error for RS may be due to the small denominator in the definition of RS: strain = (Lt -L0)/L0, where L0 is the initial length at diastole. For innerRS, L0 is around 4 mm in normal left ventricle.…”

Critical Myocardial Ischemia

“…To overcome this limitation, 2D echo speckle tracking imaging (STI) has been developed and intramural strain measured by a STI system has been compared against that measured by sonomicrometry crystals. 12 In this issue of the Journal, Ishizu et al investigate inner/ outer strain, as well as PSS by STI, to detect myocardial ischemia in patients with flow-limiting coronary stenosis but visually normal LV wall motion. 13 They focused on 2 findings: heterogeneity of inner/outer myocardial strain, and the grade of PSS at rest.…”