Impact of Loading Condition on the 2D Speckle Tracking–Derived Left Ventricular Dyssynchrony Index in Nonischemic Dilated Cardiomyopathy

Park, Hyo Eun; Chang, Sung‐A; Kim, Yong Jin; Shin, Dong‐Ho; Kim, Jihyun; Seo, Mi Hae; Kim, Yong-Jin; Cho, Goo-Yeong; Sohn, Dae‐Won; Oh, Byung‐Hee; Park, Young-Bae

doi:10.1161/circimaging.109.890848

Cited by 52 publications

(23 citation statements)

References 42 publications

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“…A U G U S T 1 1 , 2 0 1 5 : 6 3 1 -4 1 changes in regional loading conditions, may manifest time-to-peak differences that are not due to a true electrical activation delay (31). In the present study, dyssynchrony by time-to-peak indexes was significantly associated with outcome, with HRs similar to those previously reported (19) STUDY LIMITATIONS.…”

Section: Lbbb Contraction Patterns and Long-term Crt Outcomesupporting

confidence: 84%

Identification of Typical Left Bundle Branch Block Contraction by Strain Echocardiography Is Additive to Electrocardiography in Prediction of Long-Term Outcome After Cardiac Resynchronization Therapy

Risum

Tayal

Hansen

et al. 2015

Journal of the American College of Cardiology

140

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Section: Lbbb Contraction Patterns and Long-term Crt Outcomesupporting

confidence: 84%

Identification of Typical Left Bundle Branch Block Contraction by Strain Echocardiography Is Additive to Electrocardiography in Prediction of Long-Term Outcome After Cardiac Resynchronization Therapy

Risum

Tayal

Hansen

et al. 2015

Journal of the American College of Cardiology

140

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“…Studies on CRT have demonstrated that LV systolic dysfunction is related to increased radial dyssynchrony18, 19. Additionally, changes in loading conditions can result in significant LV dyssynchrony28. Similarly, the slight LV dyssynchrony observed in this study after attenuation of PDA flow was a reflection of transient myocardial dysfunction caused bydecreased preload.…”

Section: Discussionsupporting

confidence: 53%

Echocardiographic Evaluation of Myocardial Changes Observed After Closure of Patent Ductus Arteriosus in Dogs

Hamabe

Kim

Yoshiyuki

et al. 2015

Veterinary Internal Medicne

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BackgroundClosure of PDA can be associated with echocardiographic changes including deterioration of LV systolic function. Although PDA is commonly encountered in dogs, few comprehensive reports of echocardiographic changes in dogs with PDA closure are available.ObjectivesTo evaluate the short‐term echocardiographic changes observed after PDA closure in dogs using strain analysis.AnimalsSeventeen client‐owned dogs with left‐to‐right PDA.MethodsEchocardiographic evaluations, including standard echocardiography and two‐dimensional tissue tracking (2DTT), were performed before and within 3 days of PDA closure.ResultsPreclosure examination showed LV and left atrial dilatation indicating volume overload as a result of PDA. Closure of PDA resulted in significant reduction of LVIDd (<.0001) and LA/Ao (0.01) without change in LVIDs, suggestive of decreased preload. Postclosure LV systolic dysfunction was observed with significant decreased in FS (<.0001) and strain values (P = .0039 for radial strains, P = .0005 for circumferential strains). Additionally, significant LV dyssynchrony (P = .0162) was observed after closure of PDA.Conclusions and Clinical ImportanceClosure of PDA resulted in decreased preload as a result of alleviation of LV volume overload, which in turn caused transient deterioration of LV systolic function. Additionally, this study demonstrated that strain analysis is load dependent. Therefore, care should be taken when interpreting strain measurements as an indicator of LV systolic function.

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“…39 The ability of strain imaging to quantify the regional timing of deformation has led to its widespread application in the assessment of ventricular synchrony. Quantifying the temporal dispersion in contractility has provided important insights into the load dependency of ventricular dyssynchrony, 40 the linkage between dyssynchrony and impaired contractile function, 41 and the prognostic relevance of dyssynchrony in select groups of patients with QRS duration Ͻ120 ms. 42 These measures have also been used to assess the relationship between dyssynchrony measures and response after resynchronization therapy. Using both the magnitude and timing of regional deformation, Delgado et al 43 demonstrated the importance of both lead positioning and contractile function, as they relate to the most delayed myocardial segment, in predicting response to cardiac resynchronization therapy.…”

Section: Quantification Of Regional Functionmentioning

confidence: 99%

Myocardial Deformation Imaging

2012

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M yocardial deformation imaging is a novel echocardiographic method for assessment of global and regional myocardial function. As this technology has evolved, it has been applied to an increasing number of research questions, and the number of publications incorporating deformation imaging has grown in parallel.Although not yet sufficiently vetted for routine clinical use, these methods offer the long-term potential for more complete, accurate, and reproducible assessment of myocardial function. What Is Myocardial Deformation Imaging?Evaluation of contractile function with echocardiography has traditionally been limited to volume-based assessment of ejection fraction (EF) and assessment of regional wall motion or visual estimation of regional thickening. These methods have suffered from lack of reproducibility and standardization and are generally considered to be extremely sensitive to loading conditions. These limitations have led to an interest in techniques that provide more objective and reproducible measures of contractile function.During systole, the ventricular myocardium simultaneously shortens in the longitudinal and circumferential planes and thickens in the radial plane, with reciprocal changes in diastole ( Figure). Deformation imaging, in the broadest sense, allows for more direct assessment of myocardial muscle shortening and lengthening throughout the cardiac cycle by assessing regional myocardial strain and strain rate. Strain is defined as the change in length of a segment of myocardium relative to its resting length and is expressed as a percentage; strain rate is the rate of this deformation. Longitudinal and circumferential shortening results in negative strain values, whereas radial thickening results in a positive strain value. Previously, assessment of myocardial strain could be performed with the use of sonomicrometry crystals, which can only be performed experimentally 1 or with magnetic resonance imaging-based myocardial tagging, 2,3 which is limited by relatively low temporal resolution and the limited availability and expense of cardiac magnetic resonance imaging. Extension of these techniques to echocardiography has allowed for substantially greater utility in a broader range of patients.Myocardial deformation imaging with echocardiography can be performed with the use of either tissue Doppler-based or 2-dimensional speckle tracking-based methods. Doppler methods, developed initially, utilize the velocity gradient present along the length of the left ventricle (LV) to calculate strain rate, which is then integrated to derive strain. This technique suffers from limitations similar to those of traditional Doppler because it can only accurately assess deformation in the plane incident with the ultrasound beam and requires prospective acquisition of dedicated images at high frame rate. B-mode speckle tracking, sometimes referred to as feature tracking, utilizes the movement of the coherent ultrasound backscatter speckle pattern within B-mode echocardiographic images to assess myocardial...

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Impact of Loading Condition on the 2D Speckle Tracking–Derived Left Ventricular Dyssynchrony Index in Nonischemic Dilated Cardiomyopathy

Cited by 52 publications

References 42 publications

Identification of Typical Left Bundle Branch Block Contraction by Strain Echocardiography Is Additive to Electrocardiography in Prediction of Long-Term Outcome After Cardiac Resynchronization Therapy

Identification of Typical Left Bundle Branch Block Contraction by Strain Echocardiography Is Additive to Electrocardiography in Prediction of Long-Term Outcome After Cardiac Resynchronization Therapy

Echocardiographic Evaluation of Myocardial Changes Observed After Closure of Patent Ductus Arteriosus in Dogs

Myocardial Deformation Imaging

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