Assessment of ischemic myocardium by strain-rate imaging during adenosine stress echocardiography.

@article{citeulike:2453949, abstract = {OBJECTIVE: Strain rate (SR) provides a quantitative segmental analysis of myocardial function. However, the use of SR with stress echocardiography to determine the ischemic myocardium has not been completely investigated. The present study aimed to determine the changes in systolic function of the ischemic myocardium by strain-rate imaging (SRI) with adenosine stress echocardiography. METHODS: Stenosis and complete occlusion of coronary arteries were produced in 11 canine models by constricting the left anterior descending coronary artery (LAD). Myocardial longitudinal strain with adenosine was measured at baseline and during ischemia and infarction. RESULTS: Strain and SR did not differ during ischemia and infarction as compared with that at baseline in non-LAD segments or after adenosine treatment. As compared with baseline, during ischemia, LAD segments showed significantly decreased peak systolic SR (SR(peak sys)) (P < 0.05) and significantly increased ratio of postsystolic strain (varepsilon(ps)) to strain during ejection time (varepsilon(et)) (varepsilon(ps)/varepsilon(et)) (P < 0.05); varepsilon(max) and varepsilon(et) were reduced slightly, varepsilon(ps) and the ratio of varepsilon(ps) to maximal systolic strain (varepsilon(max))(varepsilon(ps)/varepsilon(max)) were increased minimally, but had no significance(P > 0.05). During infarction, the varepsilon(ps) and the ratios of varepsilon(ps)/varepsilon(max) and varepsilon(ps)/varepsilon(et) were increased markedly (P < 0.01) and varepsilon(et) and SR(peak sys) decreased as compared with that at baseline and during ischemia, whereas varepsilon(max) was reduced only with at baseline (P < 0.01). After adenosine treatment, in the non-LAD segments, the values of strain and SR did not change at baseline or during ischemia and infarction and in LAD segments, values did not change at baseline and during infarction. However, during ischemia, SR(peak sys) and varepsilon(et) were significantly reduced (P < 0.05), whereas varepsilon(ps), varepsilon(ps)/varepsilon(max) and varepsilon(ps)/varepsilon(et) were increased (P < 0.05 and < 0.01, respectively). CONCLUSION: Combined with adenosine stress echocardiography, SRI can quantitatively differentiate the ischemic from non-ischemic myocardium. varepsilon(ps)/varepsilon(max) and varepsilon(ps)/varepsilon(et) can be used as objective indices to identify the ischemic myocardium.}, address = {Department of Cardiology, Shandong Provincial Chest Hospital, Jinan, China.}, author = {Qu, H. Y. and Yao, G. H. and Sun, W. Y. and Chen, L. and Li, X. N. and Zhang, P. F. and Ding, S. F. and Wang, X. and Zhang, Y. and Zhang, M. }, citeulike-article-id = {2453949}, doi = {http://dx.doi.org/10.1007/s10554-006-9183-7}, issn = {1569-5794}, journal = {Int J Cardiovasc Imaging}, keywords = {adenosine, echocardiography, imaging, ischemic, myocardium, strain-rate, stress, ultrasound}, month = {December}, number = {6}, pages = {725--732}, posted-at = {2008-03-01 22:57:34}, priority = {2}, title = {Assessment of ischemic myocardium by strain-rate imaging during adenosine stress echocardiography.}, url = {http://dx.doi.org/10.1007/s10554-006-9183-7}, volume = {23}, year = {2007} }

TY - JOUR ID - citeulike:2453949 L3 - citeulike-article-id:2453949 TI - Assessment of ischemic myocardium by strain-rate imaging during adenosine stress echocardiography. JF - Int J Cardiovasc Imaging VL - 23 IS - 6 SP - 725 EP - 732 AD - Department of Cardiology, Shandong Provincial Chest Hospital, Jinan, China. SN - 1569-5794 N2 - OBJECTIVE: Strain rate (SR) provides a quantitative segmental analysis of myocardial function. However, the use of SR with stress echocardiography to determine the ischemic myocardium has not been completely investigated. The present study aimed to determine the changes in systolic function of the ischemic myocardium by strain-rate imaging (SRI) with adenosine stress echocardiography. METHODS: Stenosis and complete occlusion of coronary arteries were produced in 11 canine models by constricting the left anterior descending coronary artery (LAD). Myocardial longitudinal strain with adenosine was measured at baseline and during ischemia and infarction. RESULTS: Strain and SR did not differ during ischemia and infarction as compared with that at baseline in non-LAD segments or after adenosine treatment. As compared with baseline, during ischemia, LAD segments showed significantly decreased peak systolic SR (SR(peak sys)) (P < 0.05) and significantly increased ratio of postsystolic strain (varepsilon(ps)) to strain during ejection time (varepsilon(et)) (varepsilon(ps)/varepsilon(et)) (P < 0.05); varepsilon(max) and varepsilon(et) were reduced slightly, varepsilon(ps) and the ratio of varepsilon(ps) to maximal systolic strain (varepsilon(max))(varepsilon(ps)/varepsilon(max)) were increased minimally, but had no significance(P > 0.05). During infarction, the varepsilon(ps) and the ratios of varepsilon(ps)/varepsilon(max) and varepsilon(ps)/varepsilon(et) were increased markedly (P < 0.01) and varepsilon(et) and SR(peak sys) decreased as compared with that at baseline and during ischemia, whereas varepsilon(max) was reduced only with at baseline (P < 0.01). After adenosine treatment, in the non-LAD segments, the values of strain and SR did not change at baseline or during ischemia and infarction and in LAD segments, values did not change at baseline and during infarction. However, during ischemia, SR(peak sys) and varepsilon(et) were significantly reduced (P < 0.05), whereas varepsilon(ps), varepsilon(ps)/varepsilon(max) and varepsilon(ps)/varepsilon(et) were increased (P < 0.05 and < 0.01, respectively). CONCLUSION: Combined with adenosine stress echocardiography, SRI can quantitatively differentiate the ischemic from non-ischemic myocardium. varepsilon(ps)/varepsilon(max) and varepsilon(ps)/varepsilon(et) can be used as objective indices to identify the ischemic myocardium. KW - adenosine KW - echocardiography KW - imaging KW - ischemic KW - myocardium KW - strain-rate KW - stress KW - ultrasound AU - Qu, HY AU - Yao, GH AU - Sun, WY AU - Chen, L AU - Li, XN AU - Zhang, PF AU - Ding, SF AU - Wang, X AU - Zhang, Y AU - Zhang, M PY - 2007/12// UR - http://dx.doi.org/10.1007/s10554-006-9183-7 ER -