This Article Abstract Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hashimoto, I. Articles by Sahn, D. J. Search for Related Content PubMed PubMed Citation Articles by Hashimoto, I. Articles by Sahn, D. J.

Myocardial strain rate is a superior method for evaluation of left ventricular subendocardial function compared with tissue Doppler imaging

Ikuo Hashimoto, MD^*, Xiaokui Li, MD^*, Aarti Hejmadi Bhat, MD^*, Michael Jones, MD, Arthur D. Zetts and David J. Sahn, MD, FACC^*,*

^* Clinical Care Center for Congenital Heart Disease, Oregon Health and Sciences University, Portland, Oregon, USA
National Heart, Lung and Blood Institute, Bethesda, Maryland, USA

View larger version (98K): [in a new window]   Figure 1 Sampling points were determined for the left ventricular (LV) free wall (A) by dividing it into three parts: endocardial layer (End), mid-myocardial layer (Mid), and epicardial layer (Epi). Recordings of strain rate (SR) (B), strain (C), and velocity (D) sampled from the End, Mid, and Epi layers. The open arrow indicates an early diastolic wave, and the solid arrow indicates a late diastolic wave. IC = isovolumic contraction; IR = isovolumic relaxation; IVS = interventricular septum.

View larger version (48K): [in a new window]   Figure 2 Strain rate image (A and B) and tissue Doppler imaging (TDI) (C and D) during IC and IR. Left ventricular (LV) tissue was inhomogeneously colored with strain rate imaging (SRI). The solid arrows indicate the subendocardium, which was deeply colored. In contrast, TDI shows a homogeneous color distribution in the LV wall. Abbreviations as in Figure 1.

View larger version (38K): [in a new window]   Figure 3 Representative recording during baseline (A), blood loading (B), dobutamine (C), and metoprolol (D), showing SR recordings of End, Mid, and Epi along with the LV pressure and electrocardiogram (ECG). Abbreviations as in Figures 1 and 2.

View larger version (23K): [in a new window]   Figure 4 A comparison of SR (A) and TDI (B) between End, Mid, and Epi. There was a significant difference in peak SR among the three layers during both IC and IR. Abbreviations as in Figures 1 and 2.

View larger version (30K): [in a new window]   Figure 5 A comparison in SR of End, Mid, and Epi during IC (A) and IR (B) for each hemodynamic condition. There was a significant difference in peak SR during the four different conditions in both End and Mid during IC and IR. Abbreviations as in Figures 1 and 2.

View larger version (17K): [in a new window]   Figure 6 Linear regression analysis between subendocardial strain rate amplitude and peak +dP/dt (A) and –dP/dt (B). There were significant correlations between them. Abbreviations as in Figure 1.