Therese Fuchs

Circumferential and Longitudinal Strain in 3 Myocardial Layers in Normal Subjects and in Patients with Regional Left Ventricular Dysfunction

BACKGROUND The left ventricle is not homogenous and is composed of 3 myocardial layers. Until recently, magnetic resonance imaging has been the only noninvasive technique for detailed evaluation of the left ventricular (LV) wall. The aim of this study was to analyze strain in 3 myocardial layers using speckle-tracking echocardiography. METHODS Twenty normal subjects and 21 patients with LV dysfunction underwent echocardiography. Short-axis (for circumferential) and apical (for longitudinal strain) views were analyzed using modified speckle-tracking software enabling the analysis of strain in 3 myocardial layers. RESULTS In normal subjects, longitudinal and circumferential strain was highest in the endocardium and lowest in the epicardium. Longitudinal endocardial and mid layer strain was highest in the apex and lowest in the base. Epicardial longitudinal strain was homogenous over the left ventricle. Circumferential 3-layer strain was highest in the apex and lowest in the base. In patients with LV dysfunction, strain was lower, with late diastolic or double peak. CONCLUSIONS Three-layer analysis of circumferential and longitudinal strain using speckle-tracking imaging can be performed on a clinical basis and may become an important method for the assessment of real-time, quantitative global and regional LV function.

Speckle Tracking Imaging in Acute Inflammatory Pericardial Diseases

Background: Left ventricular (LV) function in acute perimyocarditis is variable. We evaluated LV function in patients with acute perimyocarditis with speckle tracking. Methods: Thirty‐eight patients with acute perimyocarditis and 20 normal subjects underwent echocardiographic examination. Three‐layers strain and twist angle were assessed with a speckle tracking. Follow‐up echo was available in 21 patients. Results: Strain was higher in normal subjects than in patients with perimyocarditis. Twist angle was reduced in perimyocarditis—10.9°± 5.4 versus 17.6°± 5.8, P < 0.001. Longitudinal strain and twist angle were higher in normal subjects than in patients with perimyocarditis and apparently normal LV function. Follow‐up echo in 21 patients revealed improvement in longitudinal strain. Conclusions: Patients with acute perimyocarditis have lower twist angle, longitudinal and circumferential strain. Patients with perimyocarditis and normal function have lower longitudinal strain and twist angle. Short‐term follow‐up demonstrated improvement in clinical parameters and longitudinal strain despite of residual regional LV dysfunction. (Echocardiography 2011;28:548‐555)

Heart Failure and a Right Ventricular Mass: Pitfalls on the Way to the Diagnosis

(Echocardiography 2011;28:482‐486)

Unusual Right-Sided Cardiac Masses

(Echocardiography 2010;27:1151‐1155)