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Studying diastology with speckle tracking echocardiography: The essentials


1 Department of Cardiac Anaesthesia, CTC, AIIMS, New Delhi, India
2 Department of Cardiology, CTC, AIIMS, New Delhi, India

Correspondence Address:
Vishwas Malik
Department of Cardiac Anaesthesia, CTC, AIIMS, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9784.197800

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Year : 2017  |  Volume : 20  |  Issue : 5  |  Page : 57-60

 

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Diastolic dysfunction is common in cardiac disease and an important finding independent of systolic function as it contributes to the signs and symptoms of heart failure. Tissue Doppler mitral early diastolic velocity (Ea) combined with peak transmitral early diastolic velocity (E) to obtain E/Ea ratio provides an estimate of the left ventricular (LV) filling pressure. However, E/Ea has a significant gray zone and less reliable in patients with preserved ejection fraction (>50%). Two-dimensional echocardiographic speckle tracking measure myocardial strain and strain rate (Sr) avoiding the Doppler-associated angulation errors and tethering artifacts. Global myocardial peak diastolic strain (Ds) and diastolic Sr (DSr) at the time of E and isovolumic relaxation combined with E (E/Ds and E/10 DSr) have been recently proposed as novel indices to determine LV filling pressure. The present article elucidates the methodology of studying diastology with strain echocardiography along with the advantages and limitations of the novel technique in light of the available literature.






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1 Department of Cardiac Anaesthesia, CTC, AIIMS, New Delhi, India
2 Department of Cardiology, CTC, AIIMS, New Delhi, India

Correspondence Address:
Vishwas Malik
Department of Cardiac Anaesthesia, CTC, AIIMS, New Delhi
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9784.197800

Rights and Permissions

Diastolic dysfunction is common in cardiac disease and an important finding independent of systolic function as it contributes to the signs and symptoms of heart failure. Tissue Doppler mitral early diastolic velocity (Ea) combined with peak transmitral early diastolic velocity (E) to obtain E/Ea ratio provides an estimate of the left ventricular (LV) filling pressure. However, E/Ea has a significant gray zone and less reliable in patients with preserved ejection fraction (>50%). Two-dimensional echocardiographic speckle tracking measure myocardial strain and strain rate (Sr) avoiding the Doppler-associated angulation errors and tethering artifacts. Global myocardial peak diastolic strain (Ds) and diastolic Sr (DSr) at the time of E and isovolumic relaxation combined with E (E/Ds and E/10 DSr) have been recently proposed as novel indices to determine LV filling pressure. The present article elucidates the methodology of studying diastology with strain echocardiography along with the advantages and limitations of the novel technique in light of the available literature.






[FULL TEXT] [PDF]*


        
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