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Assessment of left ventricular torsion in patients with anterior wall myocardial infarction before and after revascularization using speckle tracking imaging

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Chinese Medical Journal 2008年第16期121卷 1543-1548页

作者： HAN Wei XIE Ming-xing WANG Xin-fang LU Qing WANG Jing ZHANG li ZHANG Jing Department of Ultrasonography Union Hospital of Tongji Medical College Huazhong University of Science and Technology Hubei Provincial Key Laboratory of Molecular imaging Wuhan Hubei 430022 China

Background Rotation of the left ventricular （LV） apex to the base, or LV torsion, is related to myocardial contractility and structure and has recently been recognized as a sensitive indicator of cardiac performance, but it has been difficult to measure. The recent development of 2-dimensional （2D） speckle tracking imaging （STI） may provide a powerful means of assessing LV torsion. This study was conducted to evaluate the global and regional LV twist in patients with anterior wall myocardial infarction （AMI） disease before and after revascularization by STI. Methods 2D STI was performed in 35 AMI patients before and one month after revascularization, as well as in 32 normal controls. Left ventricular global and regional rotations were obtained at basal and apical short-axis levels; LV torsion was defined as apical rotation relative to the base. The time sequences were normalized to the percentage of systolic and diastolic duration. Results Before revascularization, LV peak regional and global torsion in patients with AMI were significantly reduced as the result of reduced apical and basal rotation relative to those of normal control group （all P〈0.001）; most significantly in the anterior and anterior-septal regions （P 〈0.001）; one month after revascularization, there were significant changes in peak rotation at either the base or apex relative to pre-revascularization values （all P 〈0.001）. Similarly, peak regional and global LV torsion were increased significantly （all P 〈0.001）. Global torsion inversely correlated with EDV （r=-0.605, P=0.028） and ESV （r=-0.638, P=0.019）; and positively correlated with LVEF （r=0.630, P=-0.021）. Tight relations were also found between torsion and LV longitudinal and short axis function. Conclusions Systolic torsion was decreased in AMI patients. Revascularization therapy can improve the LV function of the AMI patients. STI has a potential to quantify left ventricular global and segment torsion in patients with AMI, and may make the

关键词： echocardiography torsion speckle tracking imaging coronary artery disease revascularization

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Evaluation of Ventricular-vascular Coupling in Patients with Type 2 Diabetes Mellitus Using 2-Dimensional speckle tracking imaging

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2014年第6期34卷 929-934页

作者：李朝军杜联芳罗向红 Department of Ultrasound First People’s Hospital Affiliated to Shanghai Jiaotong University Department of Echocardiography First People’s Hospital Affiliated to Shanghai Jiaotong University

The elastic and functional coupling of heart and vessels makes the stroke work （SW） of the heart optimal. speckle tracking imaging （STI） can evaluate the myocardial strain and function. We studied ventricular-vascular coupling in 80 diabetic patients with different systolic function using STI. The patients were divided into two groups according to ejection fraction （EF）： the diabetes mel- litus with normal EF （DMN） group and the diabetes mellitus with abnormal EF （DMA） group. Forty-two volunteers served as control group. The relative wall thickness （RWT）, left ventricular mass index （LVMI）, stroke volume （SV）, SW, rate-pressure product （RPP）, systemic vascular resis- tance index （SVRI）, left ventricular end-systolic elastance （Ees）, effective arterial elasticity （Ea） and ventricular-vascular coupling index （VVI） were measured and calculated by conventional echocardi- ography. The longitudinal strain （LS） at basement （LSBA）, papillary muscle （LSvM） and cardiac apex （LSAv） was assessed with STI. It was found：（A） compared with control group, in DMN and DMA groups, LSBA, LSvM and LSAp decreased, and they were lower in DMA group. （B） VVI, RPP and SVRI increased, and they were higher in DMN group; Ees decreased, and it was lower in DMA group. （C） LSBA, LSpM, and LSAv had negative correlation with VVI. LSAp, RWT, LVMI and SW were independent predictors for VVI. The area under the receiver operating characteristic （ROC） curves was used for identification of DMA and DMN with LSBA, LSpM, and LSAp, and the area under the ROC of LSAp was the largest. This study supports that myocardial LS could reflect the ventricu- lar-vascular coupling. Different segments had an order to “respond to” the state of the coupling, and the cardiac apex might be the earliest.

关键词： ventricular-vascular coupling type 2 diabetes myocardial dysfunction echocardiography speckle tracking imaging

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Assessment of Right Ventricular Free Wall Longitudinal Myocardial Deformation Using speckle tracking imaging in Normal Subjects

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2008年第2期28卷 194-196页

作者：童春黎春雷宋家琳刘红云邓又斌 Department of Medical Ultrasound Tongji HospitalTongji Medical CollegeHuazhong University of Science and Technology Wuhan 430030China

To assess fight ventficular free wall longitudinal myocardium deformation and examine the changes with normal age by speckle tracking imaging （STI）, myocardial systolic peak strain （ε）, systolic peak strain rate （SRs）, early diastolic peak strain rate （SRe）, late diastolic peak strain rate （SRa）, the ratio of SRe/SRa were measured in the basal, middle and apical segments of right ventficular free wall in 75 healthy volunteers （age range： 21-71 y） by STI from the apical 4-chamber view. RV longitudinal strain and strain rate were highest in the basal segment of the free wall. Older subjects had lower early diastolic strain rate （SRe） than younger subjects, but they had higher late diastolic strain rate （SRa）. A negative correlation between age and the ratio of SRe/SRa was found in all RV free wall segments （r=-4）.466 - -0.614, P〈0.01）. It is concluded that RV diastolic strain rate changes with age and STI can be used for the study of RV myocardial deformation.

关键词： right ventficular function strain strain rate speckle tracking imaging

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Ultrasound speckle tracking imaging Contributes to Early Diagnosis of Impaired Left Ventricular Systolic Function in Patients with Type 2 Diabetes Mellitus

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2008年第6期28卷 719-723页

作者：马红谢明星王静吕清王新房卢晓芳杨亚利胡莉君 Department of Ultrasound Union HospitalTongji Medical CollegeHuazhong University of Science and Technology Hubei Provincial Key Laboratory of Molecular imaging Department of Special Diagnosis Henan Provincial Corps HospitalChinese People's Armed Police Force

To investigate the value of ultrasound speckle tracking imaging （STI） in the assessment of the short-axis and long-axis systolic function of the left ventricle （LV） in patients with type 2 diabetes mellitus （DM）, 100 subjects with normal ejection fraction were studied, including 41 patients with DM only （DM group）, 22 patients with both DM and left ventricular hypertrophy （DH group）, and 37 healthy subjects （control group）. Left ventricle systolic function in the long axis defined as longitudinal strain, and that in the short axis defined as radial strain, apical and basal LV rotations, and LV twist were assessed respectively. The results showed that average peak strain in the long axis at basal, middle and apical levels, and global peak strain were significantly decreased in the patient groups when compared with the control group （P〈0.001 for each）. The parameters in DH group were significantly lower than those in DM group （P〈0.01 for each）. There were no significant differences in average radial peak strain in the short axis at different levels, and global peak strain among the three groups （P〉0.05）. Apical and basal LV rotations, and LV twist were greater in the patient groups than in the control group （P〈0.01 for each）. Basal LV rotation and LV twist were greater in DH group than those in DM group （P〈0.01）. It was concluded that STI may be used to identify early abnormalities in patients with type 2 DM that have normal left ventricular systolic function.

关键词： echocardiography diabetes mellitus ventricular function, left speckle tracking imaging

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Assessment of Left Ventricular Radial Deformation by speckle tracking imaging

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2009年第5期29卷 669-672页

作者：潘敏罗浩 Ashraf Muhammad Schultheis Judy 李小葵 David J. Sahn Department of Ultrasound Peking University Shenzhen Hospital Tongji Medical College Huazhong University of Science and Technology The Cardiac Fluid Dynamics and imaging Lab Oregon Health & Science University

The left ventricular radial strain in the inner and outer layers was evaluated by using two-dimensional speckle tracking imaging （2DS）. Twenty-five piglets were studied. The short axis views were acquired. Peak systolic radial strain was measured from 6 circumferential points related to 6 standard segments in the inner and outer layers respectively using 2DS methods. The peak positive first derivative （dp/dt） of left ventricular pressure was compared to the radial strain from 2DS. The inner band showed higher peak radial strain values as compared to the outer band at all of the segments （P〈0.0001）, but the differences had significance just in anteroseptal, posterior, inferior and septal segments （P〈0.05）. Good correlation could be found between radial strain of inner and outer layers and peak dp/dt （P〈0.001）. These preliminary results showed that the degree of local deformation or wall thickening of the ventricular wall in its inner layer was more obvious than its outer layer. It is suggested that the 2DS technique is useful and sensitive for better understanding the regional and global myocar- dial motion and its relationship to the complex architecture of myocardium.

关键词： echocardiography speckle tracking imaging strain, radial

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Assessment of Age-related Changes in Left Ventricular Twist by Two-dimensional Ultrasound speckle tracking imaging

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2007年第6期27卷 691-695页

作者：张丽谢明星付曼丽王新房吕清韩伟张静刘莹莹王静项飞翔 Department of Ultrasound Union Hospital Tongji Medical College Huazhong University of Science and Technology Hubei Provincial Key Laboratory of molecular Imaging

To assess the normal value of left ventricular twist （LVtw） and examine the changes with normal aging by 2-dimensional ultrasound speckle-tracking imaging （STI）, 121 healthy volunteers were divided into three age groups： a youth group （19-45 y old）, a middle-age group （46-64 y old ） and an old-age group （≥65 y old）. Basal and apical short-axis images of left ventricular were acquired to analyse LV rotation （LVrot） and LVrot velocity. LVtw and LVtw velocity was defined as apical LVrot and LVrot velocity relative to the base. Peak twist （Ptw）, twist at aortic valve closure （AVCtw）, twist at mitral valve opening （MVOtw）, untwisting rate （UntwR）, half time of untwisting （HTU）, peak twist velocity （PTV）, time to peak twist velocity （TPTV）, peak untwisting velocity （PUV）, time to peak untwisting velocity （TPUV） were separately measured. The results showed that the normal LV performs a wringing motion with a clockwise rotation at the base and a counterclock- wise rotation at the apex （as seen from the apex）. The LVtw velocity showed a systolic counterclockwise twist followed by a diastolic clockwise twist. Peak twist develops near the end of systole （96%±4.2% of systole）. With aging, Ptw, AVCtw, MVOtw, HTU and PUV increased significantly （P〈0.05） and UntwR decreased significantly （P〈0.05）. However, no significant differences in TPUV, PTV and TPTV were noted among the 3 groups （P〉0.05）. It is concluded that LV twist can be measured non-invasively by 2-dimensional ultrasound STI imaging. The age-related changes of LVtw should be fully taken into consideration in the assessment of LV function.

关键词： echocardiography speckle tracking imaging left ventricular twist rotation

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Assessment of Left Ventricular Global Twist in Essential Hypertensive Heart by speckle tracking imaging

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2008年第1期28卷 114-117页

作者：韩伟谢明星王新房吕清 Department of Ultrasonography Union Hospital Tongji Medical College Huazhong University of Science and Technology

The left ventricular twist was evaluated by 2-dimensional ultrasound speckle-tracking imaging （STI） in 50 patients with hypertension with normal geometric left ventricle （LV） and 45 normal subjects as control group. The mean value of LV rotation was obtained at each plane Using STI. LV twist and twist velocity were defined as apical rotation/rotation rate relative to the base respectively. To adjust the intersubject differences in heart rates, the time sequence were normalized. The results showed that peak twist developed near the end of systole. Peak LV twist was significantly higher in patients with hypertension than normal controls （P〈0.001）. The diastolic untwisting mainly occurred in early diastole （=38%）. Compared with normal controls, untwisting rate （Untw R） in patients with hypertension was significantly reduced （P〈0.001）, and untwisting half-time （UHT） was significantly delayed （P〈0.05）. This study demonstrated that STI has a potential ability to evaluate the early change of heart function in patients with hypertension by measuring the twist of LV.

关键词： echocardiography twist, rotation, left speckle tracking imaging hypertension

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Three-Dimensional Rotation,Twist and Torsion Analyses by Real-time 3-D speckle tracking imaging:Feasibility,Reproducibility,and Normal Ranges in Pediatric Population

Three-Dimensional Rotation,Twist and Torsion Analyses by Rea...

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中国超声医学工程学会第三届全国介入超声医学学术会议

作者：张丽 Zhenxing Sun MingxingXie Department of Ultrasonography Union Hospital of Tongji Medical CollegeHuazhong University of Science and TechnologyHubei Province Key Laboratary of Molecular Imaging

Background:Although 2-D analysis of left ventricular(LV) rotation,twist and torsion has been validated in adults and children;these measures are highly dependent on 2-D planes with limited robustness and *** aims of this study were to evaluate the feasibility and reproducibility of LV rotation,twist and torsion by real-time 3 D speckle-tracking echocardiography(STE)in children and to establish their normal ***:A prospective study was conducted in 347 consecutive healthy subjects(181 male/156 female,mean age 7.12 ± S.3 years,and range from birth to 18 years)using RT 3-D echocardiography(3 DE).The LV rotation,twist and torsion measurements were made off-line using new TomTec software(4 D LV-Analysis 3.0,TomTec imaging Systems,Munich,Germany).Manual landmark selection and endocardial border editing were performed in 3 planes(apical 2-,4-,and " 3-" chamber views) and semi-automated border identification and tracking yielded LV rotation,twist and torsion ***;LV rotation,twist and torsion analysis by RT 3 D-SIT was feasible in 307 of 347 subjects(88.5%),excluding 40 subjects secondary to the low frame rates or incomplete 3-D *** is no correlation between rotational or twist and age,height,weight,BSA or HR,respectively,using canonical correlation ***,there is a negative correlation between age and LV torsion(P < 0.001).The normal ranges were defined in this cohort for rotation and twist,and for each age group for *** intraobserver and interobserver variabilities for apical and basal rotation,twist and torsion ranged from 7.3%± 3.8%to 12.3%± 8.8%and from 8.8%± 4.6%to 15.7%± 10.1%,*** correlation coefficients ranged from 0.78 to 0.89 and from 0.76 to 0.83 for intraobserver and interobserver measurements for rotation,twist and torsion,***;Analyses of LV rotation,twist and torsion by this new RT3 D STI methodology are feasible and reproducible in pediatric populat

关键词： Left ventricular speckle tracking imaging Three-dimension echocardiography

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Evaluation of left ventricular systolic dyssynchrony by two-dimensional speckle tracking imaging and real-time three-dimensional echocardiography

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South China Journal of Cardiology 2015年第2期16卷 80-87页

作者：吕函璐刘英梅韦育林邱琼 Department of Cardiology Sun Yat-sen Memorial Hospital Sun Yat-sen University

Background Two-dimensional speckle tracking imaging （2D-STI） and real-time three-dimensional echocardiography （RT-3DE） have more advantages in evaluating left ventricular （LV） systolic dyssynchrony than traditional echocardiographic techniques. The study aimed to evaluate LV dyssynchrony parameters by both 2D-STI and RT-3DE, and the correlation between these two techniques. Methods A total of 43 chronic heart failure （CHF） patients and 27 healthy volunteers were enrolled. There were 23 dyssynchrony parameters selected to evaluate left ventricular systolic synchronization, involving 15 from 2D-STI and 8 from RT-3DE. Results Few of the dyssynchrony parametersshowednegative correlations with LV ejection fraction （LVEF） in the CHF group. The difference between time to peak-systolic radial strain of the anteroseptal and posterior segments at the level of papillary muscles [AS-P（RS）] from 2D-STI showed positive correlations with parts of the parameters from RT-3DE （P 〈 0.05）. Conclusions LV systolic dysfunction does not correlate with dyssynchrony. Moreover, there is a weak association between 2D-STI and RT-3DE in assessment of left ventricular dyssynchrony.

关键词： heart failure speckle tracking imaging real-time three-dimensional echocardiography dyssynchrony

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Two-dimension speckle tracking imaging assessment of right ventricular function in patients with acute inferior and anterior myocardial infarction

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South China Journal of Cardiology 2015年第2期16卷 88-94页

作者：吴国祥王志兰陈小丽徐伟罗顺祥 Department of Cardiology the First Hospital of Nanping Affiliated to Fujian Medical University Department of Ultrasound the First Hospital of Nanping Affiliated to Fujian Medical University

Background Acute inferior and anterior myocardial infarction often leads to right ventricular （RV） function decrease. Estimation of RV function is challenging due to the complex RV geometry. Few studies have been conducted to investiogate the effects of acute myocardial infarction （AMI）on right ventricular functions （RVFs）. Two-dimension speckle tracking imaging （STI） is a novel method that allows for a segment based measurement of myocardial deformation and may have the potential to quantify RV dysfunction more precisely than the conventional parameters of RV function. Therefore, in this study we analyzed the RV function in AMI patients by using this novel technique. Methods Thirty-four patients with acute inferior myocardial infarction （AIMI）, 31 patients with acute anterior myocardial infarction （AAMI and 30 agematched healthy individuals were enrolled for the study. 2D speckle tracking imaging （STI） was used to obtain 2D imaging at the apical fourchamber view under rest condition. Peak systolic strains and strain rates of all segments in right ventricular free wall were analyzed. Results Compared to the normal control group, longitudinal peak systolic strain （e）, strain rate （SRs）, early diastolic strain rate （SRe） and late diastolic strain rate （SRa） in all segments of right ventricular free wall were significantly lower in AMI patients, e, SRs, SRe and SRa of each segment of RV in the AIMI group were decreased significantly than those of the normal control group （P 〈 0.05）. e, SRs, SRe and SRa of each segment of RV in the AAMI group were lower than these in the control group. Except for basal segmental SRa, there were significant differences among other parameters （P 〈 0.05）. Conclusions RVFs are impaired in AMI patients. RVFs could be accurately and sensitively assessed with STI.

关键词： speckle tracking imaging right ventricular myocardial infarction

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