Echocardiography (Mount Kisco, N.Y.) · 2011
Transmural myocardial strain gradient: a new and robust quantitative index of left ventricular wall motion based on myocardial strain imaging.
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Chen Xin, Nakatani Satoshi
Аннотация
BACKGROUND: Peak strain has been promising as an index of wall motion but it is sometimes susceptible to the image quality.
OBJECTIVE: We investigated the feasibility of a novel index, transmural myocardial strain gradient (TMSG), derived from myocardial strain M-mode imaging (TDI-Q, Toshiba) for quantifying regional systolic wall motion.
METHOD: We measured transmural myocardial strain distribution at the left ventricular lateral, posterior, inferior, septal, anteroseptal and anterior walls in the basal and midventricular short-axis images using TDI-Q. Twenty normals (35 ± 3 years) and 35 consecutive patients (63 ± 9 years) with coronary artery disease (CAD, 19 patients with old myocardial infarction, 4 patients with acute myocardial infarction, 12 patients with angina pectoris) were studied. Peak strain, endocardial- and epicardial-half strain and TMSG ((peak strain, - epicardial strain)/distance between peak and epicardial points) were obtained. Coefficient of variation (CV) of each index was calculated.
RESULTS: In control subjects, the best reproducibility of the variables was obtained for TMSG with the smallest CV (11.6%) (27.8%, 28.1%, and 35.5%, respectively for CV of peak strain, endocardial- and epicardial-half strain). All segments in control subjects and normal segments in CAD patients showed no significant difference in TMSG (15.1 ± 1.8 vs. 15.1 ± 1.6%/mm, P = ns). TMSG was the lowest for akinetic segments and highest for the normal segments (P < 0.001).
CONCLUSION: TMSG was more robust than simple strain values to quantitatively assess wall motion. This could successfully identify subtle regional differences in wall function.
OBJECTIVE: We investigated the feasibility of a novel index, transmural myocardial strain gradient (TMSG), derived from myocardial strain M-mode imaging (TDI-Q, Toshiba) for quantifying regional systolic wall motion.
METHOD: We measured transmural myocardial strain distribution at the left ventricular lateral, posterior, inferior, septal, anteroseptal and anterior walls in the basal and midventricular short-axis images using TDI-Q. Twenty normals (35 ± 3 years) and 35 consecutive patients (63 ± 9 years) with coronary artery disease (CAD, 19 patients with old myocardial infarction, 4 patients with acute myocardial infarction, 12 patients with angina pectoris) were studied. Peak strain, endocardial- and epicardial-half strain and TMSG ((peak strain, - epicardial strain)/distance between peak and epicardial points) were obtained. Coefficient of variation (CV) of each index was calculated.
RESULTS: In control subjects, the best reproducibility of the variables was obtained for TMSG with the smallest CV (11.6%) (27.8%, 28.1%, and 35.5%, respectively for CV of peak strain, endocardial- and epicardial-half strain). All segments in control subjects and normal segments in CAD patients showed no significant difference in TMSG (15.1 ± 1.8 vs. 15.1 ± 1.6%/mm, P = ns). TMSG was the lowest for akinetic segments and highest for the normal segments (P < 0.001).
CONCLUSION: TMSG was more robust than simple strain values to quantitatively assess wall motion. This could successfully identify subtle regional differences in wall function.