Name: transthoracic speckle tracking echocardiography for the quantitative assessment of left ventricular myocardial deformation
Uploaded: 2016-10-20T15:00:00
Description: Watch this Scientific Journal Video about Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation at JoVE.com

The authors thank the echocardiographic study subject for volunteering in the video as well as Witten/Herdecke University and HELIOS Research Center (HRC-ID 000416 assigned to Kai O. Hensel) for funding.

该协议内容的威滕/赫德克大学伦理委员会已经批准了道德。 1.技术要求<ol><li>利用配备了充足的部门数组组织谐波成像传感器的超声心动图检查设备都配有斑点追踪技术。 </li><li>在图像采集，记录，并直接以超声心动图的动态影像机电活动同步连接标准的3导心电图的超声心动图设备。这是强制性的在随后的后处理分析时间的目的。连接研究受EKG和解冻超声波图像来开始检测EKG信号。 </li><...

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	<li>Leischik, R., Dworrak, B., Hensel, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intraobserver+and+interobserver+reproducibility+for+radial,+circumferential+and+longitudinal+strain+echocardiography.">Intraobserver and interobserver reproducibility for radial, circumferential and longitudinal strain echocardiography.</a> Open Cardiovasc. Med. J. 8, 102-109 (2014).</li><li>Smiseth, O. A., Torp, H., Opdahl, A., Haugaa, K. H., Urheim, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Myocardial+strain+imaging:+how+useful+is+it+in+clinical+decision+making?.">Myocardial strain imaging: how useful is it in clinical decision making?.</a> Eur Heart J. , (2015).</li><li>Opdahl, A., Helle-Valle, T., Skulstad, H., Smiseth, O. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Strain,+strain+rate,+torsion,+and+twist:+echocardiographic+evaluation.">Strain, strain rate, torsion, and twist: echocardiographic evaluation.</a> Curr. Cardiol. Rep. 17, 568 (2015).</li><li>Kukulski, T., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Identification+of+acutely+ischemic+myocardium+using+ultrasonic+strain+measurements.+A+clinical+study+in+patients+undergoing+coronary+angioplasty.">Identification of acutely ischemic myocardium using ultrasonic strain measurements. A clinical study in patients undergoing coronary angioplasty.</a> J. Am. Coll. Cardiol. 41, 810-819 (2003).</li><li>Suffoletto, M. S., Dohi, K., Cannesson, M., Saba, S., Gorcsan, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Novel+speckle-tracking+radial+strain+from+routine+black-and-white+echocardiographic+images+to+quantify+dyssynchrony+and+predict+response+to+cardiac+resynchronization+therapy.">Novel speckle-tracking radial strain from routine black-and-white echocardiographic images to quantify dyssynchrony and predict response to cardiac resynchronization therapy.</a> Circulation. 113, 960-968 (2006).</li><li>Hensel, K. O., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Subclinical+Alterations+of+Cardiac+Mechanics+Present+Early+in+the+Course+of+Pediatric+Type+1+Diabetes+Mellitus:+A+Prospective+Blinded+Speckle+Tracking+Stress+Echocardiography+Study.">Subclinical Alterations of Cardiac Mechanics Present Early in the Course of Pediatric Type 1 Diabetes Mellitus: A Prospective Blinded Speckle Tracking Stress Echocardiography Study.</a> J Diabetes Res. 2016, 2583747 (2016).</li><li>Kalam, K., Otahal, P., Marwick, T. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Prognostic+implications+of+global+LV+dysfunction:+a+systematic+review+and+meta-analysis+of+global+longitudinal+strain+and+ejection+fraction.">Prognostic implications of global LV dysfunction: a systematic review and meta-analysis of global longitudinal strain and ejection fraction.</a> Heart. 100, 1673-1680 (2014).</li><li>Hensel, K. O., Grimmer, F., Jenke, A. C., Wirth, S., Heusch, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+influence+of+real-time+blood+glucose+levels+on+left+ventricular+myocardial+strain+and+strain+rate+in+pediatric+patients+with+type+1+diabetes+mellitus+-+a+speckle+tracking+echocardiography+study.">The influence of real-time blood glucose levels on left ventricular myocardial strain and strain rate in pediatric patients with type 1 diabetes mellitus - a speckle tracking echocardiography study.</a> BMC Cardiovasc. Disord. 15, 175 (2015).</li><li>Kurt, M., Tanboga, I. H., Aksakal, E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Two-Dimensional+Strain+Imaging:+Basic+principles+and+Technical+Consideration.">Two-Dimensional Strain Imaging: Basic principles and Technical Consideration.</a> Eurasian J Med. 46, 126-130 (2014).</li><li>Cameli, M., Lisi, M., Righini, F. M., Mondillo, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Novel+echocardiographic+techniques+to+assess+left+atrial+size,+anatomy+and+function.">Novel echocardiographic techniques to assess left atrial size, anatomy and function.</a> Cardiovasc. Ultrasound. 10 (4), (2012).</li><li>Pellikka, P. A., Nagueh, S. F., Elhendy, A. A., Kuehl, C. A., Sawada, S. G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=American+Society+of+Echocardiography+recommendations+for+performance,+interpretation,+and+application+of+stress+echocardiography.">American Society of Echocardiography recommendations for performance, interpretation, and application of stress echocardiography.</a> J. Am. Soc. Echocardiogr. 20, 1021-1041 (2007).</li><li>Lang, R. M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Recommendations+for+cardiac+chamber+quantification+by+echocardiography+in+adults:+an+update+from+the+American+Society+of+Echocardiography+and+the+European+Association+of+Cardiovascular+Imaging.">Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging.</a> J. Am. Soc. Echocardiogr. 28, 1-39 (2015).</li><li>Curtis, J. P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+association+of+left+ventricular+ejection+fraction,+mortality,+and+cause+of+death+in+stable+outpatients+with+heart+failure.">The association of left ventricular ejection fraction, mortality, and cause of death in stable outpatients with heart failure.</a> J. Am. Coll. Cardiol. 42, 736-742 (2003).</li><li>Liebson, P. R., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Echocardiographic+correlates+of+left+ventricular+structure+among+844+mildly+hypertensive+men+and+women+in+the+Treatment+of+Mild+Hypertension+Study+(TOMHS).">Echocardiographic correlates of left ventricular structure among 844 mildly hypertensive men and women in the Treatment of Mild Hypertension Study (TOMHS).</a> Circulation. 87, 476-486 (1993).</li><li>Hensel, K. O., Jenke, A., Leischik, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Speckle-tracking+and+tissue-Doppler+stress+echocardiography+in+arterial+hypertension:+a+sensitive+tool+for+detection+of+subclinical+LV+impairment.">Speckle-tracking and tissue-Doppler stress echocardiography in arterial hypertension: a sensitive tool for detection of subclinical LV impairment.</a> Biomed Res Int. , 472562 (2014).</li><li>Gorcsan, J., Tanaka, H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Echocardiographic+assessment+of+myocardial+strain.">Echocardiographic assessment of myocardial strain.</a> J. Am. Coll. Cardiol. 58, 1401-1413 (2011).</li><li>Holmes, A. A., Taub, C. C., Garcia, M. J., Shan, J., Slovut, D. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Increased+Apical+Rotation+in+Severe+Aortic+Stenosis+is+Associated+with+Reduced+Survival:+A+Speckle-Tracking.">Increased Apical Rotation in Severe Aortic Stenosis is Associated with Reduced Survival: A Speckle-Tracking.</a> J. Am. Soc. Echocardiogr. , (2015).</li><li>Auger, D., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effect+of+cardiac+resynchronization+therapy+on+the+sequence+of+mechanical+activation+assessed+by+two-dimensional+radial+strain+imaging.">Effect of cardiac resynchronization therapy on the sequence of mechanical activation assessed by two-dimensional radial strain imaging.</a> Am. J. Cardiol. 113, 982-987 (2014).</li><li>To, A. C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Strain-time+curve+analysis+by+speckle+tracking+echocardiography+in+cardiac+resynchronization+therapy:+Insight+into+the+pathophysiology+of+responders+vs.+non-responders.">Strain-time curve analysis by speckle tracking echocardiography in cardiac resynchronization therapy: Insight into the pathophysiology of responders vs. non-responders.</a> Cardiovasc. Ultrasound. 14 (14), (2016).</li><li>Seo, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Three-dimensional+propagation+imaging+of+left+ventricular+activation+by+speckle-tracking+echocardiography+to+predict+responses+to+cardiac+resynchronization+therapy.">Three-dimensional propagation imaging of left ventricular activation by speckle-tracking echocardiography to predict responses to cardiac resynchronization therapy.</a> J. Am. Soc. Echocardiogr. 28, 606-614 (2015).</li><li>Trache, T., Stobe, S., Tarr, A., Pfeiffer, D., Hagendorff, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+agreement+between+3D,+standard+2D+and+triplane+2D+speckle+tracking:+effects+of+image+quality+and+3D+volume+rate.">The agreement between 3D, standard 2D and triplane 2D speckle tracking: effects of image quality and 3D volume rate.</a> Echo Res Pract. 1, 71-83 (2014).</li><li>Sanchez, A. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effects+of+frame+rate+on+two-dimensional+speckle+tracking-derived+measurements+of+myocardial+deformation+in+premature+infants.">Effects of frame rate on two-dimensional speckle tracking-derived measurements of myocardial deformation in premature infants.</a> Echocardiography. 32, 839-847 (2015).</li><li>Hensel, K. O. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Non-ischemic+diabetic+cardiomyopathy+may+initially+exhibit+a+transient+subclinical+phase+of+hyperdynamic+myocardial+performance.">Non-ischemic diabetic cardiomyopathy may initially exhibit a transient subclinical phase of hyperdynamic myocardial performance.</a> Medical Hypotheses. 94, 7-10 (2016).</li></ol>

相对于其他方法的技术意义 目前的金标准左室收缩功能的超声心动图的评估是左室射血分数（EF）13。然而，EF的确定是基于被密切相关心肌收缩的径向分量，但不考虑的重要纵向和圆周平面的简单的方法。因此，EF简单化心肌变形的三维的复杂性。因此，EF测量不揭露细微心脏功能障碍，但只在一个相对先进的状态14检测的LV恶化。另一方面，STE?...

心血管内科的科学和临床方案是，而不是简单的多，并连续变量和临界值以上处理“是或否”的算法。成像技术已经发展到能够评估在不断增加的细节心脏功能。斑点跟踪超声心动图（STE）是心肌性能的定量评价一个新兴的诊断工具。虽然常规超声心动图是主观影像解译和个人考官的专业知识很强的依赖性有限，STE已被引入作为一个可重复的，更客观的方法来量化全球和区域的收缩和舒张功能1,2。 左心室（LV）心肌变形 - 纵向和圆周缩短以及在收缩和舒张反之亦然径向增厚 - 可被描述测量参数应变（ε）和斯特拉在率（SR）。 ε是在心肌长度的量纲变化百分比。 SR为ε3的时间导数。心肌功能的这些重要指标已显示出能够识别心肌缺血4，预测响应于心脏再同步治疗5和检测亚临床心肌功能障碍而常规超声心动图参数仍然正常6。在系统的荟萃分析，全球纵向ε，最常用的定量左室收缩功能参数，已被证明对主要不良心脏事件的预测则左室射血分数（EF），目前的黄金标准卓越的预后价值左室收缩功能7的评估。即使是很细微的变化，如对无症状患者心肌力学短期代谢变化的影响可以利用STE 8进行检测。 从技术上讲，采用STEš灰度2D或记录在标准的超声心动图的看法3D B模式动态影像。几个连续的心动周期被记录在心尖4-，3-和2-室次测量纵向变形和在周向和径向变形9胸骨旁短轴图。此外，通过在二尖瓣的水平捕获短轴视图，乳头肌和顶点，LV扭转可以评估3。随后向图像采集和存储作为数字环路，心肌变形是在离线的工作站或超声波装置本身上测得。软件检测中所记录的灰度图像独特心肌像素图案，所谓的“斑点”，并跟踪它们在整个分析心动周期。矢量测量和变形参数随后计算。这样的区域和全球心肌变形可以在收缩和舒张用于左和右心室的两者来评估ð庭10。

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			<td height="21" style="height:21px;width:373px;">Phillips iE33 ultrasound system</td>
			<td style="width:155px;">Philips Healthcare</td>
			<td style="width:155px;"></td>
			<td style="width:619px;">http://www.umiultrasound.com/ultrasound-machine/philips/ie33</td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:373px;"> 
			S5-1 broadband sector array transducer&#160;</td>
			<td style="width:155px;">Philips Healthcare</td>
			<td style="width:155px;"></td>
			<td>5-1 MHz, http://www.usa.philips.com/healthcare/product/HC989605412081/s5-1</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">QLAB Advanced Quantification Software Version 10.5</td>
			<td style="width:155px;">Philips Healthcare</td>
			<td style="width:155px;"></td>
			<td>Q-App: Automated Cardiac Motion Quantification (aCMQ), www.philips.com/QLAB-cardiology</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">Xcelera R3.3L1 (Version 3.3.1.1103)&#160;</td>
			<td style="width:155px;">Philips Healthcare</td>
			<td style="width:155px;"></td>
			<td>http://www.usa.philips.com/healthcare/product/HC830038/xcelera-r41-cardiology-information-management-system</td>
		</tr>
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transthoracic speckle tracking echocardiography for the quantitative assessment of left ventricular myocardial deformation

常规超声心动图的价值是通过个体间影像解译，因此很大程度上取决于考官的专业知识差异的限制。斑点跟踪超声心动图（STE）是可用于定量评估区域和全球收缩和舒张心肌表现一个有前途的，但技术上的挑战的方法。心肌应变和应变率可以在所有三个维度来测量 - 径向，周向，纵向 - 心肌变形。标准横截面二维B模式图像被记录并随后由心肌内散斑自动化连续帧接一帧的跟踪和运动分析后处理。影像记录数字环路和同步到3导心电图用于定时。纵向变形在心尖4-，3-和2-室次评估。周向和径向的变形是在parasterna测L类短期轴平面。 最佳的图像质量和准确的组织追踪是最重要的正确判断心肌的性能参数。在一个健康的志愿者利用经胸STE，本文章的基本步骤和定量超声心动图心肌变形分析潜在的陷阱的详细大纲。

对于心肌性能的定量评估的原则参数ε和SR。从技术上讲，所有心腔可以用STE进行分析。然而，由于斑点追踪方法大多已经用于研究LV，本文的重点是LV心肌力学。通常，纵向ε和SR是最常用评估左心室变形参数。纵向ε和SR描述心肌收缩期缩短（和舒张压延长）。因此，收缩值被注解为负数。 图1和2表示STE衍生节段性和全球ε和SR分析的好例子。最佳?...

Watch this Scientific Journal Video about Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation at JoVE.com

Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation

斑点跟踪超声心动图是全球和区域心肌的性能定量评估一个新兴的诊断成像技术。标准视图超声心动图的运动图像被记录和变形参数由心肌的B模式图像中散斑的自动化连续帧接一帧的跟踪和运动分析随后测定。

经胸斑点跟踪超声心动图左室心肌变形的定量评价

The value of conventional echocardiography is limited by differences in inter-individual image interpretation and therefore largely dependent on the ...

Research

JoVE Journal

Medicine

Transthoracic Echocardiography in Mice

经胸超声心动图在小鼠

In recent years, murine models have become the primary avenue for studying the molecular mechanisms of cardiac dysfunction resulting from changes in gene ...

科研

医学

Magnetic Resonance Derived Myocardial Strain Assessment Using Feature Tracking

磁共振衍生的心肌劳损评估使用特征跟踪

Purpose: An accurate and practical method to measure parameters like strain in myocardial tissue is of great clinical value, since it has been shown, that ...

Ultrasonic Assessment of Myocardial Microstructure

心肌微观结构超声波评估

Echocardiography is a widely accessible imaging modality that is commonly used to noninvasively characterize and quantify changes in cardiac structure and ...

Assessment of Right Ventricular Structure and Function in Mouse Model of Pulmonary Artery Constriction by Transthoracic Echocardiography

右心室结构和功能的肺动脉缩窄经胸超声小鼠模型的评估

Emerging clinical data support the notion that RV dysfunction is critical to the pathogenesis of cardiovascular disease and heart failure1-3. Moreover, ...

Myocardial Infarction and Functional Outcome Assessment in Pigs

心肌梗死和功能预后评估的猪

Introduction of newly discovered cardiovascular therapeutics into first-in-man trials depends on a strictly regulated ethical and legal roadmap. One ...

A Murine Model of Myocardial Ischemia-reperfusion Injury through Ligation of the Left Anterior Descending Artery

心肌缺血再灌注损伤的通过左前降支结扎小鼠模型

Acute or chronic myocardial infarction (MI) are cardiovascular events resulting in high morbidity and mortality. Establishing the pathological mechanisms ...

Murine Echocardiography of Left Atrium, Aorta, and Pulmonary Artery

左心房，主动脉和肺动脉的超声心动图小鼠

The present methodology teaches the investigator how to measure and use the LAV as a surrogate of chronic elevations in Left Ventricular diastolic ...

Technique of Minimally Invasive Transverse Aortic Constriction in Mice for Induction of Left Ventricular Hypertrophy

小鼠横主动脉狭窄诱导左心室肥厚的技术研究

Transverse aortic constriction (TAC) in mice is one of the most commonly used surgical techniques for experimental investigation of pressure ...

Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography

使用3D超声心动图对右心室进行形态学和功能评估

Traditionally, it was believed that the right side of the heart has a minor role in circulation; however, more and more data suggest that right ...

Echocardiographic Characterization of Left Ventricular Structure, Function, and Coronary Flow in Neonate Mice

Echocardiography is a non-invasive procedure that enables the evaluation of structural and functional parameters in animal models of cardiovascular ...