Higher myocardial strain rates duringisovolumic relaxation phase than duringejection characterize acutely ischemic myocardium

Pislaru, Cristina; Anagnostopoulos, Peter C.; Seward, James B.; Greenleaf, James F.; Bělohlávek, Marek

doi:10.1016/s0735-1097(02)02171-4

Cited by 40 publications

(25 citation statements)

References 37 publications

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“…This (passive) mechanism was also suggested by Skulstad et al 28 To be able to discriminate ischemic PST from other forms, it was suggested that changes in strain rate during isovolumic relaxation could be used. 67,68 It was Figure 9. A, The influence of the amplitude of the contractile force on the deformation pattern.…”

Section: Postsystolic Thickening: What Is It and Why Does It Occur?mentioning

confidence: 99%

“…suggested that, in ischemia, the ratio between maximal strain rate during isovolumic relaxation and systole is larger than unity 67 and that, in the radial direction, maximal strain-rate during isovolumic relaxation is positive in ischemia but negative in other forms of PST. 68 In summary, PST will be present in all cases where an imbalance exists at the moment left ventricular pressure drops (aortic valve closure), between deformation of neighboring segments, regardless whether this imbalance is caused by reduced contractility as a result of ischemia, high regional wall stress in some segments (mainly basal septum and in the presence of increased afterload), or regionally delayed contraction.…”

Section: Postsystolic Thickening: What Is It and Why Does It Occur?mentioning

confidence: 99%

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Investigating Cardiac Function Using Motion and Deformation Analysis in the Setting of Coronary Artery Disease

et al. 2007

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Section: Postsystolic Thickening: What Is It and Why Does It Occur?mentioning

confidence: 99%

Section: Postsystolic Thickening: What Is It and Why Does It Occur?mentioning

confidence: 99%

Investigating Cardiac Function Using Motion and Deformation Analysis in the Setting of Coronary Artery Disease

et al. 2007

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“…Fourth, we did not investigate the relationship between the selected parameters and the degree of stenosis of the coronary artery. Fifth, PSS is not specific for ischemia because it can occur in hypertensive heart disease, hypertrophic cardiomyopathy, dilated cardiomyopathy, left bundle branch block, and normal hearts (20,29,30). Sixth, this study excluded patients with prior myocardial infarction because the QGS method has limited ability to evaluate LV thickening in areas of low perfusion.…”

Section: Discussionmentioning

confidence: 99%

Presence of Postsystolic Shortening Increases the Likelihood of Coronary Artery Disease: A Rest Electrocardiography-Gated Myocardial Perfusion SPECT Study

et al. 2015

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Postsystolic shortening (PSS), which is a delayed myocardial contraction that occurs after end-systole, has been considered an important diagnostic index of myocardial ischemia. Recent technological advancements in quantitative gated SPECT (QGS) software enables the left ventricular (LV) regional analysis and may be useful for PSS measurement. The purpose of this study was to evaluate whether PSS at the resting condition determined by QGS is useful to identify patients with coronary artery disease. Methods: The study comprised 146 patients (mean age ± SD, 71 ± 8 y; 98 men) with normal LV wall motion (mean LV ejection fraction ± SD, 72% ± 9%) who underwent both coronary angiography and resting 99m Tctetrofosmin myocardial perfusion SPECT. The sum of the difference between post-end-systolic maximal LV thickening and end-systolic LV thickening, designated PSS index, was calculated from 17 LV myocardial segments using QGS. Results: The PSS index was significantly higher in patients with significant stenosis of the coronary artery than in the other patients (9.8 ± 10.2 vs. 5.6 ± 5.1; P , 0.01). A cutoff point of 6.0 of the PSS index had sensitivity, specificity, positive predictive value, and negative predictive values of 55%, 70%, 76%, and 47%, respectively, for the diagnosis of coronary artery disease. Multivariate logistic regression analysis demonstrated that a PSS index greater than 6.0 was an independent predictor for the presence of coronary artery disease (odds ratio, 2.46; 95% confidence interval, 1.1-5.4; P , 0.05). Conclusion: Among subjects with normal LV function, PSS index even in the resting condition determined using QGS may help to identify patients with coronary artery disease. Quant itative electrocardiography-gated SPECT myocardial perfusion imaging (quantitative gated SPECT [QGS]) can be used to acquire the left ventricular (LV) time volume curve at several phases of the cardiac cycle and, therefore, to assess LV wall motion (1-5). Advances in QGS software have enabled the analysis of the LV regional wall motion (6-8). Several previous studies have used this method to investigate the diagnostic and prognostic values of LV dyssynchrony in patients with heart failure (9-13) and ischemic heart disease (14-17). Postsystolic shortening (PSS), defined as delayed myocardial contraction occurring after end-systole, is observed in patients with flow-limiting coronary stenosis and has also been proposed as a marker of myocardial ischemic memory (18-26).The LV wall motion can be analyzed by QGS using an automated procedure with high reproducibility. In the present study, we used QGS to investigate whether the presence of PSS at rest is associated with an increased likelihood of coronary artery stenosis in subjects with normal global LV systolic function. MATERIALS AND METHODS Study PatientsWe retrospectively analyzed data from 146 consecutive patients (98 men, 48 women; mean age 6 SD, 71 6 8 y) who underwent myocardial perfusion SPECT for the diagnosis of active myocardial ischemia because of the presence o...

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“…Therefore, it is important to compare local measurements to global measurement for analyzing regional wall motion. In this situation, myocardial thickening or shortening, i.e., postsystolic shortening, occurs after aortic valve closure [41]. Timing of aortic and mitral valve closure is important to recognize presence of postsystolic shortening.…”

Section: Strain Rate Imagingmentioning

confidence: 99%

Assessment of Ventricular-Vascular Function by Echocardiography

Toyono

2014

Congenital Heart Disease

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Reliable assessment of ventricular function is an essential for management of patients with heart disease. Noninvasive echocardiographic evaluation is indispensable for repeated assessment of ventricular function in the clinical setting. Alterations of left and right ventricular geometry and loading conditions are the property of congenital heart disease; therefore, quantitative assessment of ventricular function is technically challenging. Systolic ventricular function is pump activity for the generation of an adequate cardiac output with filling pressure as low as possible. A wide variety of different echocardiographic parameters and indices are developed for the assessment of systolic ventricular function; however, no single parameter adequately provides all the necessary information. One should integrate information from different parameters to comprehensively describe systolic function. Echocardiographic assessment of diastolic function is based on Doppler method of mitral inflow and the pulmonary veins with supplemental assessment by tissue Doppler, strain, and strain rate. Although several indices are available, no single indices adequately evaluate diastolic function. Therefore, a comprehensive examination is mandatory as well as in systolic ventricular function. This chapter will discuss traditional and newer echocardiographic techniques for the evaluation of ventricular function and, in addition, vascular function in patients with congenital heart disease.

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Higher myocardial strain rates duringisovolumic relaxation phase than duringejection characterize acutely ischemic myocardium

Abstract: In the presence of reduced regional systolic deformation, a higher rate of PSS than systolic shortening identifies acutely ischemic myocardium.

Cited by 40 publications

References 37 publications

Investigating Cardiac Function Using Motion and Deformation Analysis in the Setting of Coronary Artery Disease

Investigating Cardiac Function Using Motion and Deformation Analysis in the Setting of Coronary Artery Disease

Presence of Postsystolic Shortening Increases the Likelihood of Coronary Artery Disease: A Rest Electrocardiography-Gated Myocardial Perfusion SPECT Study

Assessment of Ventricular-Vascular Function by Echocardiography

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