Longitudinal and Circumferential Strain in Patients with Regional LV Dysfunction

Abstract

The multilayer, helical arrangement of myofibers within the left ventricular myocardium forms the fundamental basis of the complex, multidimensional deformation of the left ventricle during the cardiac cycle. Echocardiographic characterization of the different components of this dynamic process not only provides a means to quantify the myocardial contractile function but also facilitates improved understanding of the pathophysiological mechanisms. Longitudinal deformation, which is more sensitive to the cardiac pathologies and is also easier to measure, has emerged as a reliable measure of the extent of the myocardial damage and may be helpful in the diagnosis and management of the patients with regional left ventricular dysfunction. Circumferential deformation, on the other hand, is affected relatively late in the disease process and therefore serves mainly as a marker of the transmural extent of the damage.

Time-course changes in left ventricular myocardial deformation in STZ-induced rabbits on velocity vector imaging

“…This finding was in accordance with the document published by the American Society of Echocardiography, the European Society of Echocardiography, and the Japanese Society of Echocardiography [29]. Additionally, unlike longitudinal parameters, circumferential deformation serves as a marker of more advanced myocardial damage [30] and of prognosis [31]. …”

A detailed evaluation of cardiac function in cirrhotic patients and its alteration with or without liver transplantation

“…Longitudinal direction deformation is usually the first to be affected in early diseases of the myocardium and is suggestive of subendocardial disease. Circumferential and radial strain is affected relatively late in the disease process and represents transmural damage [19]. Using this technique, a recent study has demonstrated that patients with cirrhosis have impaired LV systolic longitudinal strain compared with controls, suggestive of subendocardial dysfunction [5].…”

Investigation of Global and Regional Myocardial Mechanics With 3-Dimensional Speckle Tracking Echocardiography and Relations to Hypertrophy and Fibrosis in Hypertrophic Cardiomyopathy

“…In addition, fibrosis would alter circumferential shortening within the less involved segments (ie, where hypertrophy is absent). A possible explanation for this finding is that circumferential deformation, closely related to transmural myocardial involvement, 31 might be impaired by a particular process depending on the region analyzed. Thus, significantly increased wall thickness would lead to maximal circumferential dysfunction within hypertrophied areas, whereas fibrosis distributed through the myocardial thickness would be the factor altering circumferential shortening in nonhypertrophied regions.…”