Usefulness of New Diastolic Strain and Strain Rate Indexes for the Estimation of Left Ventricular Filling Pressure

Dokainish, Hisham; Sengupta, Ranjita; Pillai, Manu; Bobek, Jaromir; Lakkis, Nasser

doi:10.1016/j.amjcard.2008.01.037

Cited by 142 publications

(104 citation statements)

References 18 publications

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“…Moreover, the parallel behavior between global strain and EF has been confirmed by the previous study by Brown et al 28 Fourth, although the frame rates of 2DST were comparable to those used in a previous report of the 2DST-derived SR, 29 those of the TDI were considerably low, which could reduce the accuracy of the TDI-SD. Fifth, contrary to previously reported results, 16,30,31 none of the radial indexes correlated with the changes in LV systolic function after CRT in the present study.…”

Section: Iwano H Et Almentioning

confidence: 61%

Novel Strain Rate Index of Contractility Loss Caused by Mechanical Dyssynchrony - A Predictor of Response to Cardiac Resynchronization Therapy -

Iwano

Yamada

Watanabe

et al. 2011

Circ J

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Background: Time-delay indexes are limited in predicting the response to cardiac resynchronization therapy (CRT), partly because they do not reflect the residual left ventricular (LV) contractility. We computed a novel index of LV contractility loss due to dyssynchrony (the strain rate (SR) dispersion index: SRDI) by using the speckletracking SR and compared the efficacy of the SRDI, time-delay indexes, and strain delay index (SDI), the previously reported index of wasted energy due to dyssynchrony, for predicting the acute response to CRT. Methods and Results:Echocardiography was performed in 19 heart failure patients (LV ejection fraction (EF) 25±6%) before and 2 weeks after CRT. The standard deviation of time to peak velocity, or strain, was calculated as time-delay indexes. The SRDI was calculated as the average of segmental peak systolic SR minus global peak systolic SR. Longitudinal SDI (L-SDI), longitudinal SRDI (L-SRDI), and circumferential SRDI (C-SRDI) significantly correlated with the change in global longitudinal strain (∆global LSt), whereas the time-delay indexes did not. Although the time-delay indexes were comparable between responders (∆global LSt ≥0.3%) and nonresponders, the L-SDI, L-SRDI, and C-SRDI were greater in responders. The area under the receiver operating characteristic curve of the L-SRDI, L-SDI, and C-SRDI for predicting responders was 0.89, 0.81, and 0.78, respectively. Conclusions:The SRDI correlated fairly well with an improvement in global LV systolic function after CRT. (Circ J 2011; 75: 2167 - 2175

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Section: Iwano H Et Almentioning

confidence: 61%

Novel Strain Rate Index of Contractility Loss Caused by Mechanical Dyssynchrony - A Predictor of Response to Cardiac Resynchronization Therapy -

Iwano

Yamada

Watanabe

et al. 2011

Circ J

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“…12 The τ with the zero-asymptote method may be less sensitive for the detection of impaired LV which are well-known limitations of tissue Doppler imaging. 5 Because e´ reflects the rate of longitudinal LV wall expansion in early diastole, a deformation parameter for the entire LV wall could be an alternative or even more useful marker of LV relaxation. Based on this hypothesis, myocardial strain and strain rate measured by 2-dimensional (2D) speckle-tracking echocardiography (STE) have been tested as estimates of LV relaxation and filling pressure.…”

Section: Pressure Measurementmentioning

confidence: 99%

Left Ventricular Global Strain for Estimating Relaxation and Filling Pressure　– A Multicenter Study –

Hayashi

Yamada

Iwano

et al. 2016

Circ J

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Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp that these parameters do not necessarily correlate with invasively measured LV filling pressure in patients with hypertrophic cardiomyopathy, 2 severely reduced LV systolic function, 3 and heart failure with preserved ejection fraction (EF). 4 Editorial p 1104Reasons for inaccuracies with tissue Doppler-derived parameters could include angle dependency and myocardial tethering, levated left ventricular (LV) filling pressure results in shortness of breath, which is both a major symptom and a prognostic predictor for heart failure. Therefore, noninvasive estimation of LV filling pressure is considered a goal of routine echocardiography. Recent recommendations encourage using tissue Doppler-derived early-diastolic mitral annular velocity (e´) as a parameter of LV relaxation and the ratio of early-diastolic LV inflow velocity (E) to e´ (E/e´) to indicate LV filling pressure. Background: Speckle-tracking echocardiography (STE)-derived parameters may have better correlation with left ventricular (LV) relaxation and filling pressure than tissue Doppler-derived parameters. However, it has not been elucidated which parameter -strain or strain rate -and which direction of myocardial deformation -longitudinal or circumferential -is the most useful marker of LV relaxation and filling pressure.

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“…75 A similar result also was observed, however, for diastolic strain rates measured during early diastolic filling. 76 Prospective studies in a wide variety of patients are needed to validate these promising novel techniques to estimate LV filling pressures noninvasively.…”

Section: Tschöpe and Paulus Value Of Echo Diastolic Evaluation 815mentioning

confidence: 99%

Echocardiographic Evaluation of Diastolic Function Can Be Used to Guide Clinical Care

2009

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For normal cardiac performance, the left ventricle (LV) must be able to eject an adequate stroke volume at arterial pressure (systolic function) and fill without requiring an elevated left atrial (LA) pressure (diastolic function). These systolic and diastolic functions must be adequate to meet the needs of the body both at rest and during stress. Response by Tschöpe and Paulus on p 809Systolic function is conveniently (although not always accurately) measured as the ejection fraction (EF), calculated as stroke volume divided by end-diastolic volume. 1 The LV EF is easily interpreted. The lower limit of normal is Ϸ50%. The lower the EF is, the greater the reduction in systolic function. Diastolic function has been more difficult to evaluate. 2 Traditionally, invasive measures of LV diastolic pressure-volume relations and the rate of LV pressure fall during isovolumetric relaxation have been used. However, these methods are not practical for routine clinical use and do not adequately evaluate all aspects of diastolic filling. 3 Comprehensive echocardiographic evaluation of the dynamics of LV filling using blood pool and tissue Doppler has now progressed so that it provides clinically important information that can be used to direct patient care. We present data that support the use of echocardiographic evaluation of diastolic function to recognize cardiac dysfunction in patients with heart failure, especially those with preserved EF; to guide the management of patients by identifying those with and without elevated left filling pressures regardless of underlying EF; and to determine prognosis in a wide variety of patient populations. LV FillingAlthough the LV end-diastolic pressure-volume relation describes the passive properties of the LV, LV filling is not a passive or slow process. 3 In fact, the peak flow rate across the mitral valve is equal to or greater than the peak flow rate across the aortic valve. Understanding the physiological basis of LV filling provides the basis for the interpretation of the information available from a comprehensive echocardiographic evaluation of LV filling dynamics.During LV ejection, energy is stored as the myocytes are compressed and the elastic elements in the myocardial wall are compressed and twisted. 4 Relaxation of myocardial contraction allows this energy to be released as the elastic elements recoil. This causes LV pressure to fall rapidly during isovolumetric relaxation. Furthermore, for the first 30 to 40 milliseconds after mitral valve opening, relaxation of LV wall tension is normally rapid enough to cause the LV pressure to continue to decline despite an increase in LV volume. 5 This fall in LV pressure produces an early diastolic pressure gradient from the LA that extends to the LV apex (Figure 1). 6 This accelerates blood out of the LA andThe opinions expressed in this article are not necessarily those of the editors or of the American Heart Association.

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Usefulness of New Diastolic Strain and Strain Rate Indexes for the Estimation of Left Ventricular Filling Pressure

Cited by 142 publications

References 18 publications

Novel Strain Rate Index of Contractility Loss Caused by Mechanical Dyssynchrony - A Predictor of Response to Cardiac Resynchronization Therapy -

Novel Strain Rate Index of Contractility Loss Caused by Mechanical Dyssynchrony - A Predictor of Response to Cardiac Resynchronization Therapy -

Left Ventricular Global Strain for Estimating Relaxation and Filling Pressure　– A Multicenter Study –

Echocardiographic Evaluation of Diastolic Function Can Be Used to Guide Clinical Care

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Usefulness of New Diastolic Strain and Strain Rate Indexes for the Estimation of Left Ventricular Filling Pressure

Cited by 142 publications

References 18 publications

Novel Strain Rate Index of Contractility Loss Caused by Mechanical Dyssynchrony - A Predictor of Response to Cardiac Resynchronization Therapy -

Novel Strain Rate Index of Contractility Loss Caused by Mechanical Dyssynchrony - A Predictor of Response to Cardiac Resynchronization Therapy -

Left Ventricular Global Strain for Estimating Relaxation and Filling Pressure – A Multicenter Study –

Echocardiographic Evaluation of Diastolic Function Can Be Used to Guide Clinical Care

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Left Ventricular Global Strain for Estimating Relaxation and Filling Pressure　– A Multicenter Study –