Role of Radial Strain and Displacement Imaging to Quantify Wall Motion Dyssynchrony in Patients With Left Ventricular Mechanical Dyssynchrony and Chronic Right Ventricular Pressure Overload
- 27 February 2008
- journal article
- other
- Published by Elsevier BV in The American Journal of Cardiology
- Vol. 101 (8), 1206-1212
- https://doi.org/10.1016/j.amjcard.2007.11.077
Abstract
Left ventricular (LV) deformation with ventricular septal shift is one of the most distinctive echocardiographic observations in patients with chronic right ventricular (RV) pressure overload (PO). However, little is known about the effects of RVPO on LV performance and regional synchrony. Accordingly, our objective was to test the hypothesis that chronic RVPO affects regional wall motion, synchronicity, and global LV function using a novel speckle-tracking approach to quantify and characterize regional LV wall motion dyssynchrony. Displacement and strain imaging echocardiographic studies were performed in 20 patients with RVPO from pulmonary arterial hypertension or pulmonic stenosis (mean age 53 ± 16 years, New York Heart Association class 2.6 ± 0.7, and peak RV systolic pressure 73 ± 28 mm Hg) and 20 age-matched normal subjects (mean age 47 ± 16 years). Segmental signals from 6 segments around the mid-LV short axis were defined as dyssynchronous if their changes were opposite to that of the global LV signal at each time frame, and overall LV dyssynchrony was calculated as the percentage of dyssynchrony in all 6 segments within the specified time interval from onset of QRS to the end of isovolumic relaxation. RVPO was associated with a large degree of regional dyssynchrony with paradoxical ventricular septal motion observed by displacement imaging (21 ± 6%, p <0.05 vs control group), which was closely associated with LV eccentricity index (r = 0.79, p <0.05) and LV myocardial performance index with linear regression (r = 0.76, p <0.05). In contrast, strain imaging showed uniform segmental radial thickening in the RVPO group, which was similar to the control group, and suggests that there was no intrinsic LV contractile dyssynchrony. In conclusion, LV wall motion dyssynchrony assessed by displacement imaging, not intrinsic contractile dyssynchrony by strain imaging, coexists with LV chamber deformation with ventricular septal shift and is closely associated with impairment of LV performance.Keywords
Funding Information
- Ministry of Education, Culture, Sports, Science and Technology
This publication has 21 references indexed in Scilit:
- Novel Speckle-Tracking Radial Strain From Routine Black-and-White Echocardiographic Images to Quantify Dyssynchrony and Predict Response to Cardiac Resynchronization TherapyCirculation, 2006
- Relation of Right Ventricular Free Wall Mechanical Delay to Right Ventricular Dysfunction as Determined by Tissue Doppler ImagingThe American Journal of Cardiology, 2005
- Utility of Echocardiographic Radial Strain Imaging to Quantify Left Ventricular Dyssynchrony and Predict Acute Response to Cardiac Resynchronization TherapyThe American Journal of Cardiology, 2005
- Usefulness of echocardiographic tissue synchronization imaging to predict acute response to cardiac resynchronization therapyThe American Journal of Cardiology, 2004
- Quantification of left ventricular mechanical dyssynchrony by conductance catheter in heart failure patientsAmerican Journal of Physiology-Heart and Circulatory Physiology, 2004
- Sequential Versus Simultaneous Biventricular Resynchronization for Severe Heart FailureCirculation, 2002
- Assessment of Nonuniformity of Transmural Myocardial Velocities by Color-Coded Tissue Doppler ImagingCirculation, 2000
- Effect of Preload Alternations on a New Doppler Echocardiographic Index of Combined Systolic and Diastolic PerformanceJournal of the American Society of Echocardiography, 1999
- Nongeometric quantitative assessment of right and left ventricular function: Myocardial performance index in normal children and patients with Ebstein anomaly☆☆☆★Journal of the American Society of Echocardiography, 1998
- Immediate effects of lung transplantation on right ventricular morphology and function in patients with variable degrees of pulmonary hypertensionJournal of the American College of Cardiology, 1996