Normal Values for Longitudinal Tissue Velocity and Strain Rate Imaging in Individual Segments of the Left and Right Ventricles of Healthy Adult Hearts

Abstract

issue Doppler imaging has introduced different techniques, allowing regional quantification of the myocardium. This quantification is possible by measuring the velocity, total deformation, and rate of deformation in every individual segment of the myocardium. 1,2 One of these methods is tissue velocity imaging, by which the total amount of tissue movement during systole can be displayed in color to show overall systolic function in one map. 3,4 This method is influenced by overall heart motion and the myocardial tethering effect.Masoumeh Lotfi-Tokaldany, MD, MPH, Shala Majidi, MD, Farahnaz Nikdoust, MD, Zahra Savand Roomi, MD, Mahmood Sheikhfathollahi, PhD, Hakimeh Sadeghian, MD Received April 24, 2012, ORIGINAL RESEARCHObjectives-To quantify the normal peak mean systolic velocities and strain rate parameters in the left ventricle (LV) and right ventricle (RV) and define their regional differences in normal adult hearts.Methods-Sixty-nine healthy volunteers (42% male; mean age ± SD, 30.03 ± 5.35 years) underwent color tissue Doppler and strain rate imaging. The first and second peak mean systolic velocities, peak strain, and strain rate in the systolic ejection phase were determined for 16 LV segments, the apex (17th segment), and 3 RV free wall segments.Results-The first peak mean systolic velocity was measurable in less than 50% of segments in the inferior and septal (-posterior) walls and RV free wall and in greater than 70% of segments of the other LV walls. The first and second peak mean systolic velocities of all LV walls and the RV free wall decreased significantly from the basal to apical region (P < .001).The strain and strain rate in the lateral and anterior walls decreased significantly from base to apex, whereas the anteroseptal and posterior walls were homogeneous. The strain rate in the inferior wall increased remarkably from base to apex, whereas it decreased significantly from the mid level to the apex. The strain in the RV was homogeneous, whereas the strain rate decreased significantly from the mid level to the apex. The apex (17th segment) showed the lowest value for each of the study parameters.Conclusions-Longitudinal velocities decreased from base to apex, whereas deformation measurements did not show uniform patterns in LV walls and the RV free wall. In most cases, there are 1 peak systolic velocity in the inferior and septal (-posterior) walls and 2 peak systolic velocities in the other 4 LV walls.

Distribution pattern of left-ventricular myocardial strain analyzed by a cine MRI based deformation registration algorithm in healthy Chinese volunteers

“…In the present study, the Ell distribution pattern decreased from the base to the apex of the LV. This characteristic had been shown by echocardiography-based studies63132. Ecc from the base to the apex of the LV also had an increasing trend, and the apical level was the highest.…”

A new twist on an old idea: a two-dimensional speckle tracking assessment of cyclosporine as a therapeutic alternative for heart failure with preserved ejection fraction

“…Systolic longitudinal strain and strain rate values in CON animals were similar to recently reported norms reported for healthy adults (Lotfi‐Tokaldany et al. ), and we previously demonstrated torsion and untwisting rates correlate to traditional indices such as EF%, LV ESV, and Tau (Marshall et al. ) as previously observed in humans (Dong et al.…”

Strain Analysis by Tissue Doppler Imaging: Comparison of Conventional Manual Measurement with a Semiautomated Approach

“…The consistently higher frame rates in our study achieved by recording myocardial walls separately may also influence S. S was higher in females, as previously reported, but was not correlated with age . A base‐mid‐apex gradient in S as described by Kowalski et al was indicated; however, within‐wall differences may to a large extent depend on wall curvature …”

“…Reference values for S differ between methods and publications. Mean S for TDI ‐manual was −17.3% and (as calculated from reported segmental values) −17.3%, −18.0%, and −18.2%; mean S for speckle tracking was −18.4%, −19.8%, −20.3%, −20.4%, and −21.5%; and mean S by other semiautomated methods range from −16.7% to −17.4% . Differences depend, however, not only on the method, but to a large extent also on the respective patient sample, as factors such as age and gender distribution have an impact on S values.…”