Left Atrial Strain: Is it a Paragon, Which We Cardiac Anesthesiologists Misconstrue? (original) (raw)
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Automated LV motion analysis from 3D echocardiography
MIUA, Oxford, UK, 1999
3D-cardiac analysis methods based on MRI, CT and nuclear imaging techniques are being developed which begin to elucidate the relationship between 3D shape deformation and heart malfunction. However, recent advances in 3D+T cardiac ultrasound (US) acquisition technology potentially offer now a near-real-time, noninvasive alternative to these methods, at a moderate cost. In this paper we describe an approach to left ventricular (LV) reconstruction and motion analysis, as a first step towards rapid quantification of regional heart performance based on 3D-US. We outline an automated approach that combines state-of-the-art 2D-echogram feature detection with 3D-reconstruction and shape-modelling methods that are being developed for tagged-MRI and SPECT cardiac imagery. We evaluate our approach on 3D+T dense and simulated free-hand sparse images. Results on real cardiac and phantom data are presented in a qualitative and quantitative manner.
European Heart Journal – Cardiovascular Imaging, 2016
Background: To evaluate the interventricular cardiac relationship, Doppler measurement of Qp/Qs by transthoracic echocardiography (TTE) has been used. It is complicated to do, however, and cannot evaluate interventricular relationship in the same cardiac phase. In recent echocardiographic examination, TAPSE (tricuspid annular plane of systolic excursion) and MAPSE (mitral annular plane of systolic excursion) have become widely used to assessment and quantification of the ventricular function. TAPSE and MAPSE can be evaluated using single echocardiographic view of four chamber view, but could not be evaluate in same cardiac cycle until the speckle tracking method introduce. To conquer this problem, we suppose to use the speckle tracking method. Speckle tracking method is an image analyzing technique to trace the local speckle pattern in B-mode of TTE. In practice, on simply placing ROI (region of interesting) to both the lateral tricuspid annulus and the lateral mitral annulus, based to apex, we will be able to evaluate TAPSE and MAPSE in the same cardiac cycle. We have hypothesized these; 1) the relationship of TAPSE and MAPSE in the same cardiac cycle could be a new surrogate indicator of interventricular functional relationship or dyssynchrony. 2) In AS patients, this relation could be different from healthy individuals. Purpose: This study was conducted to evaluate whether the relationship of TAPSE and MAPSE on the same cardiac cycle using the speckle tracking method could be a indicator of interventricular relationship in the patients with severe aortic stenosis. Methods: This study has been approved by our institutional review board. We prospectively recruited 20 healthy adult volunteers and 20 patients with severe AS that were indicated for TAVI. Using TTE, we measured TAPSE and MAPSE with speckle tracking method under a resting condition in addition to standard measurements. We analyzed maximum distance and duration time of tricuspid and mitral annular displacement in trans-apical 4ch view by Q-LABV R (Phillips electronicsV C) and a2DQ (auto 2D quantification) software in EPIQ 7G(Phillips electronicsV C). Statistical analysis was made with ANOVA and the Pearson's correlation analysis, and p < 0.05 was considered significant. Result: Healthy adult volunteers have no difference in TAPSE and MAPSE time phase (p ¼ 0.1516). Severe AS patients have restricted MAPSE (p ¼ 4.331*10-10) and retracted time phase (p ¼ 0.0014). (Figure) Conclusion: This study showed that the large interventricular mismatch in cardiac time phase has occurred in severe AS patients whereas not in healthy volunteers. The time phase deviation between TAPSE and MAPSE might become one of the possible indicators of the severity in a reduced ventricular function.
Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography, 2017
Although left ventricular global longitudinal strain (GLS) is an index of systolic function recommended by the guidelines, poor image quality may hamper strain measurements. While contrast agents are commonly used to improve endocardial visualization, no commercial speckle-tracking software is able to measure strain in contrast-enhanced images. This study aimed to test the accuracy of speckle-tracking software when applied to contrast-enhanced images in patients with suboptimal image quality. We studied patients with a wide range of GLS values who underwent transthoracic echocardiography. Protocol 1 included 44 patients whose images justified use of contrast but still allowed noncontrast speckle-tracking echocardiography (STE), which was judged as accurate and used as a reference. Protocol 2 included 20 patients with poor image quality that precluded noncontrast STE; cardiac magnetic resonance- (CMR-) derived strain was used as the reference instead. Half the manufacturer recommende...
BioMed Research International, 2013
Background. Left ventricular (LV) longitudinal deformation can be assessed with new echocardiographic techniques like triplane echocardiography (3PE) and four-dimensional echocardiography (4DE). We aimed to assess the feasibility, reproducibility, and agreement between these different speckle-tracking techniques for the assessment of longitudinal deformation. Methods. 101 consecutive subjects underwent echocardiographic examination. 2D cine loops from the apical views, a triplane view, and an LV 4D full volume were acquired in all subjects. LV longitudinal strain was obtained for each imaging modality. Results. 2DE analysis of LV strain was feasible in 90/101 subjects, 3PE strain in 89/101, and 4DE strain in 90/101. The mean value of 2DE and 3PE longitudinal strains was significantly higher with respect to 4DE. The relationship between 2DE and 3PE derived strains ( = 0.782) was significantly higher ( = 3.72, < 0.001) than that between 2DE and 4DE ( = 0.429) and that between 3PE and 4DE ( = 0.510; = 3.09, = 0.001). The mean bias between 2DE and 4DE strains was −6.61 ± 7.31% while −6.42 ± 6.81% between 3PE and 4DE strains; the bias between 2DE and 3PE strain was of 0.21 ± 4.16%. Intraobserver and interobserver variabilities were acceptable among the techniques. Conclusions. Echocardiographic techniques for the assessment of longitudinal deformation are not interchangeable, and further studies are needed to assess specific reference values.