Download moderated poster session v - European Heart Journal

Eur J Echocardiography Abstracts Supplement, December 2008
doi:10.1093/ejechocard/jen286
MODERATED POSTER SESSION V
Myocardial velocity imaging: from normal to pathology
Saturday, 13 December 2008, 8:30–10:00
Location: Poster Area
1158
Left ventricle torsion study in normal neonates, toddlers, and young
adolescents: relation with age, twist and untwist rates.
G H. Al-Naami1
1
Pediatric Cardiology, Prince Sultan Cardiac Center-Qassim, Buraidah, Saudi Arabia
Age
BSA
Torsion
Indexed T
B sys rot
B TTP-sys
B dias rot
B TTP-dias
B T rate
B UT rate
A sys rot
A TTP-sys
A dias rot
A TTP-dias
A T rate
A UT rate
Age
Torsion
1
0.947199
20.2663
20.49339
20.36707
0.622224
0.299394
0.632172
20.43794
20.43504
20.46017
0.204877
0.428858
0.628278
20.5079
20.52159
1
0.826072
20.47883
0.133317
0.383964
20.17567
20.39601
20.41712
0.682099
0.305961
20.42258
0.267434
0.630962
0.582248
B sys rot
B TTP-sys
1160
1
20.72938
20.64724
20.19468
0.9359
0.920983
0.241627
0.160285
20.09839
20.31981
0.05695
0.269834
Left ventricular longitudinal and circumferential strain in 3 myocardial layers in
normal subjects measured with 2D strain speckle imaging
1
0.519779
0.453897
20.85359
20.79281
20.31989
20.08626
0.057585
0.433388
20.11504
20.25509
r value denotes significant correlation between different systolic parameters (p value , 0.05).
1159
Quantification of regional left and right ventricular longitudinal function:
comparison of 2 different techniques using ultrasound based strain and strain
rate imaging
E. Tsapakis1; L. De Catte2; A. Dermauw2; D. Boshoff2; B. Eyskens2; M. Gewillig2;
L. Mertens2
1
Athens, Greece; 2Leuven, Belgium
Background: Velocity vector imaging (VVI) is a novel angle-independent twodimensional imaging technique and the Software Package for Echocardiographic
Quantification LEuven (SPEQLE) is a one-dimensional angle dependent method
of analysis for Color Doppler Myocardial Imaging technique. We compare myocardial vel, 1 and SR in normal neonates aged ,7 days old calculated with these
2 techniques.
M. Leitman1; P. Lysyansky2; Z. Friedman2; R. Shmueli3; R. Krakover3; Z. Vered3
1
Cardiology Dept, Assaf Harofeh Medial Center, Heart Institute, Zerifin, Israel; 2The
Technion Institute of Science, Haifa, Israel; 3Heart Institute, Assaf Harofeh Medical
Center, Heart Institute, Zerifin, Israel
Purpose: Left ventricular wall is composed of 3 layers of fibers, that provide LV contraction and motion. TDI and 2D strain techniques have allowed measurement of transmural longitudinal and radial strain. Measurement of the different layers has not yet
been possible. Circumferential movement of the endocardial and epicardial layers in
opposite directions allows measurement of strain in 3 myocardial layers. In this
study we measured both circumferential and longitudinal strain in 3 myocardial
layers in normal subjects with 2D strain imaging.
Methods: 11 subjects with normal LV contraction underwent standard echocardiographic examination. 3 loops of short axis in the basal, mid-ventricle and apical
levels and 3 standard apical views were stored and analyzed with a novel 2D strain
based technique that allowed measurements of the longitudinal and circumferential
strain in 3 myocaridal layers.
Results: The overall longitudinal strain was higher in endocardium than in middle layer,
which in turn was higher than in the epicardium 224.2vs.-20.7 vs.-18.1 respectively
p,0.000001. In the endocardium apical longitudinal strain was higher than in mid ventricle 231 vs. 222.2 p¼0.00001, that in turn was higher than basal 222.2 vs. 219.7
p,0.0001. In the middle layer apical strain was higher than in mid ventricle 222.9
vs. 220.2 p,0.0001, and strain in mid ventricle was higher than in base 220.2 vs.
219 p¼0.03. In the epicardium there was not significant difference in the strain
between the basal and midventricle level 218.3 vs. 218.5 p¼0.7, and apical strain
was somewhat less than in mid ventricular level 217.2 vs. 218.5, p¼0.02. Circumferential strain (short axis) was higher in the apex than in the mid ventricle for all 3 layers:
endocardial 242.1 vs. 233.7 p,0.0001, middle layer 234.6 vs. 224.9 p,0.000001,
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Purpose: We study the rotational mechanics of the heart in young children. We show
the effect of age on torsion,twist and untwist rates.
Methodology: We recruited 100 normal children age between 0 and 12 years. Short
axis parasternal views were taken at the base of the heart and the apex. Offline analysis
using EchoPac focused on systolic rotation rate at apex and base to calculate the total
torsion of the left ventricle. We also calculated the twist and untwist rates. Rotational
patterns in diastole also were studied.
Results: We found no significant change of LV torsion with age (r value of 20.2).
Strong correlations were found between: systolic rotation and twist and untwist rates
at both base and apex (r value . 0.8).
Conclusion: The analysis is still ongoing. The initial results confirm some of previously
published papers for torsion and advancing age. This study is the first which focus on
neonatal heart mechanics separating them for their early time to systolic rotational peak
velocity and details the different rotational forces.
Methods: Data used from 20 healthy term neonates, mean age 1.9+1.01 days. The
acquisitions were done in supine position at rest. The apical four chamber view of
the heart was analyzed offline using Axius TM VVI software (Siemens Medical Solutions) and SPEQLE (Leuven), for the assessment of longitudinal myocardial velocities,
strain and strain rate of left and right ventricle lateral wall and the interventricular
septum. 2-3 cardiac cycles were averaged. VVI measurements were performed at
basal, mid and apical level for each wall and averaged for base-mid and mid-apical
segments in order to be comparable with the corresponding SPEQLE tracked segments. Mean values and standard deviation were calculated using 1 set of analysis
for VVI and SPEQLE. Inter- and intra-observer variability was assessed using
Bland-Altman analysis and 15% of non adequately VVI and 12,5% SPEQLE tracked
segments were discarded.
Results: Strain and strain rate values in the different segments in the neonatal heart are
lower than for children. There is a discrepancy among the results for systolic strain
quantified with VVI versus SPEQLE. VVI values show decreasing gradient towards
LV, RV and IVS apex. On the contrary, SPEQLE values are homogeneous for LVALW
and IVS systolic strain but for RVLW there is an increasing gradient towards the
apical segment. Intra-observer variability using VVI is noted higher for the systolic
strain of the left lateral basal segment whereas using SPEQLE it is higher for the
right lateral basal segment.
Conclusion: Data on myocardial deformation obtained with speqle tracking technology based on gray scale imaging (VVI) are different from those obtained by Doppler
myocardial imaging analyzed by SPEQLE. This implies that for each technique, reference values have to be established.
Abstracts
epicardium 228 vs. 218.4 p,0.00001. Circumferential strain in middle layer in the
midventricle was higher than in basal level 224.9 vs. 222.7 p¼0.046, in endocardium
there was a trend to the higher strain in the midventricle than in the base 233.7 vs.
231.5 p¼0.07, and in epicardium midventricular strain was higher than in basal
level 218.4 vs. 216.9, but it was not significant p¼0.14.
Conclusions: LV longitudinal and circumferential strain is highest in the endocardium
and lowest in the epicardium. Circumferential strain is highest in apex and lowest in the
base. Longitudinal strain is not uniform: endocardial and middle layer are highest in the
apex and lowest in the basal segments. In the epicardium there is an equilibration of
the strain, while apical strain is somewhat lower than in the mid-ventricle.
1161
Circumferential and longitudinal deformation but not radial deformation is
reduced in patients with myocarditis and normal left ventricular wall motion
G. Di Bella1; C. Zito1; A. Pingitore2; G. Dattilo1; A. Lamari1; F. Arrigo1; S. Coglitore1;
S. Carerj1
1
Department Of Medicine And Pharmacology, University Of Messina, Messina, Italy;
2
Cardiology, IFC-CNR, Pisa, Italy
Results: Average longitudinal [ was lower in the HTx group (213.86+4.36 vs.
216.05 +2.90, p¼0.05) with boirderline significance. There was no significant difference in SRs between the groups (20.84+0.26 vs. 20.88+0.18, p¼0.10). Average circumferential [ (224.64 +4.72 vs. 224.64 +5.08, p¼0.10) did not differ between the
groups. Average circumferential SRs was higher in HTx group (21.59+0.48 vs. 21.25
+0.39 vs. p¼0.007). The cumulative total rejection score correlated significantly with
decrease in longitudinal strain (r¼0.67, p¼0.021) and longitudinal SRs (r¼0.62,
p¼0.05) Increased LV mass was associated with decrease in circumferential strain
(r¼0.49, p¼0.027) and circumferential SRs (r¼0.46, p¼0.037) see TABLE.
Conclusions: Following heart transplantation strain and strain rate indices may be sensitive indicators of regional mechanical function. Significant correlations with the cumulative rejection score and LV mass were found. This might provide a new tool to better
define cardiac graft function and detect early changes due to post- HTx complications
and should be explored.
1163
3D myocardial strain estimation: first results in-vivo
A. Elen1; J. Ganame1; B. Amundsen2; J-U. Voigt1; P. Claus1; F. Maes1; FE. Rademakers1;
J. D’hooge1
1
Medical Image Computing, ESAT - PSI, KULeuven, Leuven, Belgium; 2Circulation and
Medical Imaging, Norwegian Institute of Science and Technology, Trondheim, Norway
Introduction: Deformation imaging of the heart has proven its clinical value. Despite
promising findings current methodologies remain limited in the sense that they only
assess 1 or 2 motion/deformation components of a truly 3D (moving) structure. We previously developed a methodology to measure all strain (S) components from 3D ultrasound (US) data. While our initial studies were done on simulated data, the aim of the
present study was to test the feasibility of this approach in-vivo.
Methods: 3D US images were recorded from 3 healthy volunteers using a Vivid7 (GE,
Horten, Norway) equipped with a 2.5MHz transducer. Data acquisition was gated over
6 cardiac cycles in order to achieve good spatial resolution and a large field-of-view at a
temporal resolution of 27Hz. All volunteers were scanned twice yielding a total of 6 data
sets. In addition, 3D data was collected from a patient with an apical aneurysm.
All 3 normal myocardial S components (S_R,S_C,S_L) were estimated using the proposed methodology in all LV segments according to the 17-segment LV model. Reproducibility of the measurements was verified visually and mean values for the different
strain components were determined over all LV segments and all (normal) data sets
Results: Strain curves could be obtained in all LV segments for all data sets. Average
end-systolic segmental S values were found to be respectively: 31.11+11.24%,
211.18+2.77% and 25.64+2.70% for S_R,S_L andS_C respectively. Example
traces are shown in Figure 1.
Conclusion: These preliminary findings show that the proposed methodology allows
measuring all myocardial S components in all LV segments from a single 3D data
set. Although the estimated average S values were relatively low, reproducibility was
good and dysfunctional segments could be correctly identified.
1162
Strain and strain rate: a new clinical tool to evaluate the transplanted heart
E. Raichlin1; HR. Villarraga2; AA. Shah1; SS. Kushwaha2; NL. Pereira2; JK. Oh2;
PA. Pellikka2
1
Cardiovascular Division, Mayo Clinic, Rochester, Mn, United States of America;
2
Cardiovascular Dept, Mayo Clinic, Rochester, United States of America
Background: Left ventricle remodeling occurs frequently after cardiac transplantation
resulting in exercise intolerance and reduced survival. The aim of this study were to
assess left ventricular (LV) circumferential and longitudinal strain ([) and systolic
strain rate (SRs) in patients with heart transplant (HTx) to establish the normal values
when compared with controls and to evaluate the correlation with the cumulative
total rejection score and left ventricular mass.
Methods: Twenty three stable HTx patients (age 55+16 years; 2.41+1.50 years
post-HTx) without any documented complication and 30 age- and gender- matched
healthy subjects (control group) underwent echocardiographic study. S and SRs
were determined from apical 4-chamber, 2-chamber, and long-axis views using
vector velocity imaging (VVI). The cumulative rejection score was calculated based
on ISHLT R grading (1R ¼ 1, 2R ¼ 2; 3R ¼ 3) and was normalized by dividing for the
total number of biopsies. Left ventricular mass (LVM) was calculated according the
formula 0.8 x (1.04 [(LVDD þ EDPWT þ EDST)3] –(LVDD) 3 þ 0.6g
variables
Longitudinal ]
Longitudinal SRs
TRS
LV mass (Htx)
r ¼-0.67
r ¼0.62
Circumferential]
Circumferential SRs
r ¼ 0.49
r ¼ 0.46
Figure 1
1164
Better longitudinal function in endurance-trained athletes in comparison with
strength-trained athletes, related to optimized ventriculo-arterial interaction
M. Florescu1; I. Petcu2; M. Radu2; C. Palombo3; M. Cinteza2; D. Vinereanu2
1
University Hospital of BucharestBucharest, Romania; 2University of Medicine Carol
Davila, Bucharest, Romania; 3University of Pisa, Pisa, Italy
Cardiac adaptation differs according to the type of sport. Thus, endurance training is
associated with eccentric LVH and better cardiac function, whereas strength training
induces concentric LVH, and no difference in cardiac performance. Type of LVH
alone can not explain these differences, therefore, other mechanisms, such as different
ventriculo-arterial interaction might be involved.
Aims: 1) To assess differences in cardiac function, induced by endurance- and
strength- athletic training; 2) to identify mechanisms of ventriculo-arterial interaction,
and their effects on cardiac function in both types of athletes.
Methods: 70 male (21+4 yrs) subjects were enrolled: 26 endurance-trained athletes
(EA), 10 strength-trained athletes (SA), and a control group (C) of 34 age-matched
sedentary subjects. Cardiac function was assessed by conventional and tissue
Eur J Echocardiography Abstracts Supplement, December 2008
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Purpose: Focal acute myocarditis is characterized by myocardial damage and normal
wall motion of left ventricle (LV). Two-dimensional strain echocardiography (SE)
imaging uses standard B-mode images for analysis and quantification of circumferential and longitudinal deformation of LV. Delayed enhancement (DE) cardiac magnetic
resonance (CMR) is accurate in identifying myocardial damage due to myocarditis.
The aim of the study was to correlate myocardial deformation in patients with and
without focal myocarditis.
Methods: Twenty-one male subjects were enrolled in the study. Of these, 11 (26+6
years) had a diagnosis of focal myocarditis (myocarditis-group) and 10 normal subjects (26+7 years) with no risk factors or previous history of heart disease served as
controls. CMR protocol consisted of cine images to evaluate systolic wall thickening
(SWT) representing radial deformation, and DE to determine location of myocardial
damage. SE was performed using a commercial ultrasound system (MyLab50CV,
Esaote Florence). Echocardiographic recordings were done from apical views (4,2
and 3 chambers views) for the evaluation of longitudinal strain, and for short axis
views at basal, middle and apical level of LV for the evaluation of circumferential
strain. To quantify longitudinal and circumferential strain, the images were analysed
offline by “track”LV endocardial borders in an operator driven automatic approach
(“XStrain Imaging”).
Results: Myocarditis-group have showed a significant reduction of global circumferential strain (25+7 vs 27+7, p¼0.02) and global longitudinal strain (20,5+6 vs 25+7;
p¼ ,0.0001) respect of controls. No difference of SWT was found in MG and controls
(78+35% vs 76+35%). Considering myocarditis-group, DE-CMR showed a DE
located in the epicardial layer of inferior (N¼2), inferolateral (N¼3), anterolateral wall
(N¼4) and both anterolateral and inferolateral (N¼3) walls suggestive for myocarditis
. Considering together all segments of myocarditis-group and controls, circumferential
strain was analysed in 244 of the 336 total segments, those with DE (29 segments;
24+6%) had showed a significant lower circumferential deformation (p¼0.05) in comparison with segments without DE (216 segments; 27+7%). Similarly, longitudinal
strain was analysed in 303 of the 336 total segments, those with DE (50 segments;
219+4%) showed a significant lower longitudinal strain (p¼0.002) in comparison
with segments without DE (253 segments; 223+7%).
Conclusion: Circumferential and longitudinal deformation but not radial deformation is
reduced in patients with focal myocarditis.
S155
S156
Abstracts
Abstract 1164 table
EA
SA
C
p (ANOVA)
p (EA vs. SA)
STDE(cm/s)
ETDE(cm/s)
AIx(%)
PWV (m/s)
FMD(%)
12.0 + 0.9
10.0 + 0.8
10.1 + 1.0
,0.0001
,0.0001
17.4 + 0.3
13.7 + 0.4
15.8 + 0.2
,0.0001
,0.0001
210.9 + 7
0.079 + 6
22.2 + 11
,0.001
,0.009
7.1 + 2.4
8.5 + 2.0
8.8 + 1.1
,0.0001
,0.0001
16.7 + 6.9
12.5 + 4.5
14.0 + 4.1
,0.009
,0.025
CW (mmHg.m.s3 103)
OS (nmol/mg)
37.1 + 21.5
17.1 + 14.5
17.6 + 13.4
,0.0001
,0.01
0.259 + 0.71
0.549 + 0.90
0.428 + 0.88
,0.0001
,0.0001
see text
Doppler echo: global systolic function from EF, short-axis function from PW velocities,
and long-axis systolic (STDE) and diastolic (ETDE) function from mean 6 basal segments velocities; arterial stiffness from augmentation index (AIx) and carotido-femural
pulse wave velocity (PWV); endothelial function from flow mediated dilatation (FMD);
and ventriculo-arterial interaction from amplitude of the compression wave (CW) from
the carotid wave intensity recordings. NT-proBNP, markers of myocardial fibrosis, and
markers of oxidative stress (OS) were measured
Results: Both groups of athletes had significant, but similar LVH; however, EA had
better longitudinal function (table), whereas short-axis function was similar, associated
with augmented arterial and endothelial function and lower OS, with improved
ventriculo-arterial interaction. NT-proBNP and markers of myocardial fibrosis were not
different between groups.
Conclusions: Although both EA and SA have physiological LVH, endurance exercise is
associated with better longitudinal function, due to optimized ventriculo-arterial
interaction.
1165
Cardiac involvement in patients with ankylosing spondylitis, dermatomyositis,
polymyositis and Wegeners granulomatosis
Introduction: Cardiac lesions found in non-invasive studies in the course of ankylosing
spondylitis(AS), dermatomyositis (DM) and polymyositis (PM) are considered as an
adverse prognostic factors. The aim of the study was to evaluate the anatomical and
functional abnormalities in patients with AS, DM, PM and Wegener’s granulomatosis
(WG).
Material and methods: The study enrolled 42 patients (pts) with AS, aged 51+11
years. The mean duration of the disease was 16+9 years. The group with DM and
PM involved 25 pts aged 53+8 years. The duration of the disease was 8+4 years.
The group with WG included 11 pts (mean age 52+7years, mean duration of the
disease 8+7years). Echocardiographic evaluation (ECHO) included: left atrial diameter (LA), aortic width (Ao), valvular insufficiency (scored 0-4þ), left ventricular contractility, left ventricular ejection fraction (LVEF), right ventricular dimensions, mitral valve
prolapse (MVP), interiatrial septum mobility (IAS), pericardium, and morphology of leaflets and cusps of valves. Examination of diastolic function was performed. A peak of
E-wave velocity (E), a peak of A wave velocity (A), E/A ratio, and isovolumetric relaxation time (IVRT) were measured.
Results: Echocardiographic abnormalities were found in 73% pts with AS. Mitral valve
regurgitation (MR) up to 2þ occurred in 15/42 (35.7%) pts, aortic incompetence (AI) up
to 2þ in 8/42 (19%) pts.
The increased aortic width was found in 9/42(21.4%). In 1 pt LVEF was diminished to
40%. Small amount of pericardiac fluid was found in 13/42 (30.9%) pts. MVP was
found in 3 pts. LV diastolic dysfunction was found in 48% pts with AS. Clinical evidence
of cardiac abnormalities has been observed, in as many as 42% of cases with positive
ECHO findings. In pts with DM and PM echocardiographic abnormalities were found in
74%. MR (up to 2þ) occurred in 16 pts (66%), and AI was found in 2 pts (8.3%). Interatrial septal aneurysm, MVP and pericardiac fluid was found in 3 pts. Hypokinesis was
found in 4 pts, in 3 pts LVEF was diminished to 45%. Abnormal diastolic function was
found in 58% pts. Clinical evidence were observed in 51% pts. In pts with WG mitral
regurgitation occurred in 5/10 (50%) pts, hemodynamically significant in 1 pt (4þ).
Small amount of pericardiac fluid was found in 1/10 (10%) pt. Abnormal diastolic function in form of relaxation disorders was found in 49% pts.
Conclusions: 1. Subclinical cardiac abnormalities are frequent in patients with AS, DM,
PM and Wegener’s granulomatosis.
2. Abnormal diastolic function dominates in the studied group of patients.
1166
Peaksystolic strain in comparison to wall motion score in predicting flow
limiting coronary artery disease
R. MEERA1; G. Vijayaraghavan1; V. Ramakrishnapillai1; RACHEL. Daniel1
1
Cardiology, Kerala Institute of Medical Sciences, Trivandrum, India
Purpose: The study was done with the following objectives
a. To assess the feasibility of 2D peak systolic strain (2DPSS) to demonstrate regional
systolic dysfunction
b. To find if this method was superior to 2Dwall motion score (2DWMS)
c. To use this method for predicting flow limiting coronary lesion (FLCL)
d. To demonstrate the benefits of revascularisation
Eur J Echocardiography Abstracts Supplement, December 2008
CAG
WMS(no)
WMS(%)
2DPSS(no)
2DPSS(%)
PVALE
LAD
LCX
RCA
69
69
59
63.8
63.8
54.6
91
88
87
84.2
81.4
80.5
0.001
0.012
0.001
2DPSS predicted FLCL correctly in more number of patients compared to WMS in all the three
territories
1167
Assessment of left ventricular twist in patients with secundum atrial septal
defect using speckle tracking imaging
L. Dong1; X. Shu2; L. Guan2; H. Chen2; C. Pan2; H. Chen2
1
Department Of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai,
People’s Republic of China; 2Shanghai, China, People’s Republic of
Background: Left ventricular (LV) torsional deformation plays an important role with
respect to LV ejection and filling. A novel ultrasound speckle tracking imaging (STI)
allows the noninvasive assessment of LV torsion. However, there is no data available
on the impact of right ventricular (RV) volume overload on LV twist and untwisting in
patients with secundum atrial setpal defect (ASD). This study sought to evaluate LV torsional deformation using STI method in patients with ASD.
Methods: Forty-five asymptomatic adults with isolated secundum ASD were enrolled in
this study. Using commercially available 2-dimensional strain software, we analyzed
basal and apical LV short-axis images in these patients and 45 age- and sex-matched
normal subjects. LV twist and twist rate were defined as apical LV rotation and rotational
velocity relative to the base.
Results: Patients with ASD had significantly smaller LV end-diastolic volume
(62.0+11.1 ml vs. 69.9+10.1 ml, P¼0.001) and lower LV ejection fraction (EF)
values (65.4+5.1% vs. 69.4+5.6%, P¼0.001) in comparison with the controls. The
apical rotation parameters including peak counterclockwise rotation and time to the
peak were similar between two groups. However, the peak basal clockwise rotation
was significantly depressed (25.4+2.88 vs. 26.9+2.68, P,0.001) and time to the
peak was significantly delayed (118.3+18.8% vs. 96.1+12.6% of systolic period,
P,0.001) in patients with ASD. The peak basal initial counterclockwise rotation in
ASD group was significantly higher (5.1+3.38 vs. 1.8+1.48, P,0.001) and its duration
was longer (75.4+26.7% vs. 42.5+24.4% of systolic period, P,0.001) than that in
control group. LV peak twist was also reduced significantly in patients with ASD
(11.9+5.98 vs. 14.6+3.58, P,0.05) in comparison with the controls while the LV
untwisting parameters including peak untwisting rate and time to the peak were not significantly different between the two groups.
Conclusions: LV systolic twist was reduced but diastolic untwisting remained
unchanged in patients with ASD. The depressed LV twist was mainly due to the heterogenous basal rotation which was characterized by a reduced and delayed clockwise
rotation following an abnormally enhanced and extended initial counterclockwise
rotation during early systole.
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M. Peregud-Pogorzelska1; J. Kazmierczak1; A. Wojtarowicz1; H. Przepiera1; I. Brzosko1;
M. Brzosko1; Z. Kornacewicz-Jach1
1
Department of Cardiology, Pomeranian Medical Academy, Szczecin, Poland
Subjects and methods
Echo Doppler study was done on 120 patients. 2D WMS analysed by ACC criteria. 112
patients had 2D PSS imaging done by speckle tracking. Data from 108 patients who
had coronary artery disease were analysed. Coronary arteries were scored as Score
0 for nonflow limiting coronary artery lesion (NFLCL) and score 1 for FLCL. 19 patients
who had single vessel angioplasty had 2DWMS and 2D PSS imaging done after 4
weeks. Data analysed by Least Square Error regression algorithms to find individual
correlation for coronary angiogram with 2DPSS.WMS and 2DPSS were analysed in
similar manner.
Results: 2-D PSS in LAD territory predicted FLCL correctly in 91patients (84.2%), 2D
WMS in 69 patients (63.8%). In LCX territory 2DPSS predicted FLCL in 88 patients
(81.48%), 2DWMS in 59 patients. In RCA territory, the predictions by 2D PSS and
2DWMS were 87(80.5%) and 69 (63.8%) respectively. Following angioplasty, 12
patients out of the 19(63.2%) showed improvement in deformation in LAD territory,
15 out of 19(78.9%) in LCX and16 (84.2%) in RCA territories, whereas the improvement
in wall motion score in the corresponding territories were 5(26.3%), 8(42.1%),9 (47.4%)
,respectively.
Conclusions: 1. 2DPSS demonstrated the abnormality in regional LV Systolic function
2. 2DPSS is superior to 2DWMS in predicting FLCL.
3. 2DPSS is superior to 2 DWMS in demonstrating the results of revascularization
4. 2DPSS is demonstrable as objective result, while 2DWMS is a subjective impression.