Strain Imaging: An Everyday Tool for the Perioperative Echocardiographer

Perioperative Course of Three-Dimensional–Derived Right Ventricular Strain in Coronary Artery Bypass Surgery: A Prospective, Observational, Pilot Trial

“…STE has the advantages of being less dependent on loading conditions than Doppler and M-mode parameters, does not rely on geometric assumptions, has a smaller interobserver variability, and is largely angle-independent. 6,7 To date, most investigations on RV strain are performed using transthoracic echocardiography (TTE) in awake, spontaneously breathing patients. 7,8 Intraoperative transesophageal (TEE) two-dimensio-nalÀderived RV strain (2D-RV strain) measurement is feasible 9,10 and aids perioperative decision-making.…”

“…6,7 To date, most investigations on RV strain are performed using transthoracic echocardiography (TTE) in awake, spontaneously breathing patients. 7,8 Intraoperative transesophageal (TEE) two-dimensio-nalÀderived RV strain (2D-RV strain) measurement is feasible 9,10 and aids perioperative decision-making. 7,8 However, 2D-RV strain has limitationsÀmostly, software originally designed for the analysis of the left ventricle must be used for analysis of RV strain.…”

“…7,8 Intraoperative transesophageal (TEE) two-dimensio-nalÀderived RV strain (2D-RV strain) measurement is feasible 9,10 and aids perioperative decision-making. 7,8 However, 2D-RV strain has limitationsÀmostly, software originally designed for the analysis of the left ventricle must be used for analysis of RV strain. 7 A specific problem associated with 2D evaluation is out-of-plane motion that appears when speckles leave the evaluated 2D image plane in the complex-shaped right ventricle.…”

“…7,8 However, 2D-RV strain has limitationsÀmostly, software originally designed for the analysis of the left ventricle must be used for analysis of RV strain. 7 A specific problem associated with 2D evaluation is out-of-plane motion that appears when speckles leave the evaluated 2D image plane in the complex-shaped right ventricle. 6,11 Moreover, foreshortening can affect appropriate assessment of strain analysis.…”

Global Left Ventricular Strain: Exciting Applications In Perioperative Practice

“…1 Although left ventricular ejection fraction is a gold standard for evaluating left ventricular function, it has shortcomings, including observer variability, load dependency, and lack of sensitivity for detection of early ventricular dysfunction. [1][2][3] Newer echocardiographic modalities, such as strain analysis, can be effective in measuring systolic function for cardiac surgical patients, but still require further validation and broader implementation in the operating room setting. 2-3. Speckle tracking echocardiography is a powerful clinical tool for quantifying myocardial strain.…”