Original ArticlesStrain rate imaging for the assessment of preload-dependent changes in regional left ventricular diastolic longitudinal function*
Section snippets
Study population
We studied 20 young, healthy volunteers (16 males, 4 females, mean age 24.2 years) with no evidence of cardiac disease in either their history or electrocardiographic (ECG) or standard echocardiographic examination. The study was performed according to the ethical regulations of Erlangen University, and all participants had given prior informed consent.
Protocol
Ultrasound images were acquired from the apical view. This allowed equal access to imaging all parts of the left ventricular wall. Cine loops of
Results
Reconstruction and analysis of useful strain rate data were successful in most cine loops from our volunteers. The typical data acquisition frame rate was 178 fps, which resulted in a minimal measurable period of 5.6 ms.
Localized “blue lines” of short duration were frequently seen in the mid part of the walls at the beginning of the isovolumic relaxation period and propagating toward the apex, suggesting a local myocardial extension before mitral valve opening. (Fig. 3, Fig. 4).
During diastole,
Discussion
It can be assumed from intraventricular measurements that a pressure difference between ventricular base and apex is one of the driving forces of diastolic filling.10 On the basis of such invasive measurements, Courtois and other authors11 have proposed an early diastolic suction effect because of elastic recoil of the relaxing apical myocardium. Recently, Steine et al12 and others13, 14 compared simultaneously acquired pressure tracings with peak mitral inflow velocity propagation measured
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2020, Ultrasound in Medicine and BiologyCitation Excerpt :Strain imaging is widely used to measure myocardial deformation and allow early detection of subclinical LV dysfunction, but it cannot measure the myocardial stiffness directly and quantitatively (Grondin et al. 2017). Voigt et al. (2002) described that the base-to-apex time delay in diastolic lengthening could be observed in both early diastole and atrial contraction. Kanai (2005) found that the pulsive wave spontaneously activated because of the aortic valve closure at the beginning of the isovolumic relaxation period and propagated along the interventricular septum from the base to the apex.
Myocardial Stretch Post-atrial Contraction in Healthy Volunteers and Hypertrophic Cardiomyopathy Patients
2019, Ultrasound in Medicine and BiologyCitation Excerpt :We denote this pattern as myocardial stretch propagation post-atrial contraction (MSPa), in line with a similar definition by Pislaru et al. We started this study with the hypothesis of a wave propagating with constant velocity over the first 4 to 5 cm of the interventricular septum, as previously described in normal and pathologic hearts after atrial contraction (Pislaru et al. 2014, 2017; Voigt et al. 2002). This prospective study was conducted in 2016–2017 according to the principles of the Declaration of Helsinki and approved by the Institutional Medical Ethical Committee (MEC-2014-611, MEC-2017-209).
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Reprint requests: Dr med Jens-Uwe Voigt, Medical Clinic II, University Erlangen-Nuernberg, Oestliche Stadtmauerstrasse 29, 91054 Erlangen, Germany (E-mail: [email protected]).