Background: The purpose of the present study was to assess the subendocardial wall function using tissue Doppler imaging (TDI) and strain rate imaging (SRI) in patients with congenital left ventricular outflow (LVOT) obstruction. Methods: We studied with TDI and SRI 19 pts aged 11-31 years with congenital aortic stenosis (valvular, 12 pts; subvalvular, 6pts; supravalvular, 1pt). 13 age-and sex-matched subjects with no signs of heart disease were selected as normal controls (CTR). On the basis of LVOT pressure gradient, pts were distinguished in two groups: group 1 (10 pts), gradient < 50mmHg; group 2 (9 pts), gradient 50 mmHg. TDI wall velocities during systole (Sw), early relaxation (Ew) and atrial systole (Aw) were measured in both groups in the apical four chambers views. Peak strain (e) and strain rate (SR) were measured during isovolumic contraction (IC), systole (S), isovolumic relaxation (IR), early diastole (E) and late diastole (A) in endocardium (End), myocardium (Myo) and epicardium (Epi) in the same views. Results: TDI measurements of the three myocardial layers showed no statistically significant difference among velocities in both pts groups although there was a trend for End velocities to be higher than those of Epi. There was a significant difference in strain and strain rate between the myocardial layers for both isovolumic contraction and relaxation (End-e -38.1 +/- 12.7%, Myo-e -21.7 +/- 8.9%, Epi-e -10.8 +/- 5.5% during IC; End-e 31.9 +/- 11.3%, Myo-e 20.1 +/- 6.3%, Epi-e 10.4 +/- 4.9% during IR; End-SR -2.9 +/- 1.7 sec-1, Myo-SR -1.7 +/- 0.9 sec-1, Epi-SR -0.8 +/- 0.5 sec-1 during IC; End-SR 1.9 +/- 1.3 sec-1, Myo-SR 1.1 +/- 0.3 sec-1, Epi-SR 0.6 +/- 0.5 sec-1 during IR). There was a significant correlation between endocardial strain rate (during IC) and LVOT pressure gradients (r=0.69, p<0.005). Compared to group 1, group 2 pts showed a significant decrease in endocardial strain and strain rate for both isovolumic contraction and relaxation (p<0.001). Conclusion: Strain and strain rate echocardiography provide a unique insight in evaluating subendocardial wall dysfunction in pts with significant LVOT obstruction.
Evaluation of subendocardial ischemia by strain Doppler echocardiography in patients with left ventricular outflow tract obstruction / Vitarelli, Antonino; Conde, Y; Cimino, E; Colantonio, R; D'Angeli, Ilaria; Stellato, Simona. - In: EUROPEAN JOURNAL OF ECHOCARDIOGRAPHY. - ISSN 1525-2167. - STAMPA. - 4 (Suppl 1):(2003), p. S62. (Intervento presentato al convegno Euroecho 7 tenutosi a Barcelona, Spain nel 3-6 Dec 2003).
Evaluation of subendocardial ischemia by strain Doppler echocardiography in patients with left ventricular outflow tract obstruction.
VITARELLI, Antonino;D'ANGELI, ILARIA;STELLATO, SIMONA
2003
Abstract
Background: The purpose of the present study was to assess the subendocardial wall function using tissue Doppler imaging (TDI) and strain rate imaging (SRI) in patients with congenital left ventricular outflow (LVOT) obstruction. Methods: We studied with TDI and SRI 19 pts aged 11-31 years with congenital aortic stenosis (valvular, 12 pts; subvalvular, 6pts; supravalvular, 1pt). 13 age-and sex-matched subjects with no signs of heart disease were selected as normal controls (CTR). On the basis of LVOT pressure gradient, pts were distinguished in two groups: group 1 (10 pts), gradient < 50mmHg; group 2 (9 pts), gradient 50 mmHg. TDI wall velocities during systole (Sw), early relaxation (Ew) and atrial systole (Aw) were measured in both groups in the apical four chambers views. Peak strain (e) and strain rate (SR) were measured during isovolumic contraction (IC), systole (S), isovolumic relaxation (IR), early diastole (E) and late diastole (A) in endocardium (End), myocardium (Myo) and epicardium (Epi) in the same views. Results: TDI measurements of the three myocardial layers showed no statistically significant difference among velocities in both pts groups although there was a trend for End velocities to be higher than those of Epi. There was a significant difference in strain and strain rate between the myocardial layers for both isovolumic contraction and relaxation (End-e -38.1 +/- 12.7%, Myo-e -21.7 +/- 8.9%, Epi-e -10.8 +/- 5.5% during IC; End-e 31.9 +/- 11.3%, Myo-e 20.1 +/- 6.3%, Epi-e 10.4 +/- 4.9% during IR; End-SR -2.9 +/- 1.7 sec-1, Myo-SR -1.7 +/- 0.9 sec-1, Epi-SR -0.8 +/- 0.5 sec-1 during IC; End-SR 1.9 +/- 1.3 sec-1, Myo-SR 1.1 +/- 0.3 sec-1, Epi-SR 0.6 +/- 0.5 sec-1 during IR). There was a significant correlation between endocardial strain rate (during IC) and LVOT pressure gradients (r=0.69, p<0.005). Compared to group 1, group 2 pts showed a significant decrease in endocardial strain and strain rate for both isovolumic contraction and relaxation (p<0.001). Conclusion: Strain and strain rate echocardiography provide a unique insight in evaluating subendocardial wall dysfunction in pts with significant LVOT obstruction.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
