Abstract
Longitudinal myocardial strain is considered to deteriorate in the early ischemic stage compared to circumferential and radial strains because the subendocardial inner oblique fibers are generally directed along the longitudinal axis. However, it is unclear whether the decrease in longitudinal strain precedes a decrease in circumferential and radial strains during acute coronary flow reduction. The left anterior descending artery was gradually narrowed in 13 open-chest dogs. Whole-wall and subendocardial longitudinal, circumferential, and radial strains were analyzed at baseline and during flow reduction. Peak systolic and end-systolic strains, the postsystolic strain index (PSI), and the early systolic strain index (ESI) were measured in the risk area; the decreasing rate in each parameter and the diagnostic accuracy to detect flow reduction were evaluated. Absolute values of peak systolic and end-systolic strains gradually decreased with flow reduction. The decreasing rate and diagnostic accuracy of longitudinal systolic strain were not significantly different from those in other strains, although the diagnostic accuracy of radial systolic strain tended to be lower. PSI and ESI gradually increased with flow reduction. In these parameters, a lower diagnostic accuracy with respect to radial strain was not demonstrated. During acute coronary flow reduction, the decrease in longitudinal systolic strain did not precede that in circumferential systolic strain; however, the decrease in radial systolic strain may be smaller than that of other systolic strains. In contrast, there appeared to be no differences in the PSI and ESI values among the three strains.
Similar content being viewed by others
References
Kalam K, Otahal P, Marwick TH (2014) Prognostic implications of global LV dysfunction: a systematic review and meta-analysis of global longitudinal strain and ejection fraction. Heart 100:1673–1680
Smiseth OA, Torp H, Opdahl A, Haugaa KH, Urheim S (2016) Myocardial strain imaging: how useful is it in clinical decision making? Eur Heart J 37:1196–1207
Klaeboe LG, Edvardsen T (2019) Echocardiographic assessment of left ventricular systolic function. J Echocardiogr 17:10–16
Ng AC, Sitges M, Pham PN et al (2009) Incremental value of 2-dimensional speckle tracking strain imaging to wall motion analysis for detection of coronary artery disease in patients undergoing dobutamine stress echocardiography. Am Heart J 158:836–844
Shimoni S, Gendelman G, Ayzenberg O et al (2011) Differential effects of coronary artery stenosis on myocardial function: the value of myocardial strain analysis for the detection of coronary artery disease. J Am Soc Echocardiogr 24:748–757
Yu Y, Villarraga HR, Saleh HK, Cha SS, Pellikka PA (2013) Can ischemia and dyssynchrony be detected during early stages of dobutamine stress echocardiography by 2-dimentional speckle tracking echocardiography? Int J Cardiovasc Imaging 29:95–102
Biering-Sørensen T, Hoffmann S, Mogelvang R et al (2014) Myocardial strain analysis by 2-dimensional speckle tracking echocardiography improves diagnostics of coronary artery stenosis in stable angina pectoris. Circ Cardiovasc Imaging 7:58–65
Stankovic I, Putnikovic B, Cvjetan R et al (2015) Visual assessment vs. strain imaging for the detection of critical stenosis of the left anterior descending coronary artery in patients without a history of myocardial infarction. Eur Heart J Cardiovasc Imaging 16:402–409
Tanaka H, Oishi Y, Mizuguchi Y et al (2007) Three-dimensional evaluation of dobutamine-induced changes in regional myocardial deformation in ischemic myocardium using ultrasonic strain measurements: the role of circumferential myocardial shortening. J Am Soc Echocardiogr 20:1294–1299
Reant P, Labrousse L, Lafitte S et al (2010) Quantitative analysis of function and perfusion during dobutamine stress in the detection of coronary stenoses: two-dimensional strain and contrast echocardiography investigations. J Am Soc Echocardiogr 23:95–103
Sakurai D, Asanuma T, Masuda K, Hioki A, Nakatani S (2014) Myocardial layer-specific analysis of ischemic memory using speckle tracking echocardiography. Int J Cardiovasc Imaging 30:739–748
Asanuma T, Fukuta Y, Masuda K, Hioki A, Iwasaki M, Nakatani S (2012) Assessment of myocardial ischemic memory using speckle tracking echocardiography. JACC Cardiovasc Imaging 5:1–11
Vatner SF (1980) Correlation between acute reductions in myocardial blood flow and function in conscious dogs. Circ Res 47:201–207
Chan J, Hanekom L, Wong C, Leano R, Cho GY, Marwick TH (2006) Differentiation of subendocardial and transmural infarction using two-dimensional strain rate imaging to assess short-axis and long-axis myocardial function. J Am Coll Cardiol 48:2026–2033
Cheng A, Nguyen TC, Malinowski M, Daughters GT, Miller DC, Ingels NB Jr (2008) Heterogeneity of left ventricular wall thickening mechanisms. Circulation 118:713–721
Reant P, Labrousse L, Lafitte S et al (2008) Experimental validation of circumferential, longitudinal, and radial 2-dimensional strain during dobutamine stress echocardiography in ischemic conditions. J Am Coll Cardiol 51:149–157
Sarvari SI, Haugaa KH, Zahid W et al (2013) Layer-specific quantification of myocardial deformation by strain echocardiography may reveal significant CAD in patients with non-ST-segment elevation acute coronary syndrome. JACC Cardiovasc Imaging 6:535–544
Leone BJ, Norris RM, Safwat A, Foëx P, Ryder WA (1992) Effects of progressive myocardial ischaemia on systolic function, diastolic dysfunction, and load dependent relaxation. Cardiovasc Res 26:422–429
Kimura K, Takenaka K, Ebihara A et al (2011) Reproducibility and diagnostic accuracy of three-layer speckle tracking echocardiography in a swine chronic ischemia model. Echocardiography 28:1148–1155
Asanuma T, Nakatani S (2015) Myocardial ischaemia and post-systolic shortening. Heart 101:509–516
Voigt JU, Exner B, Schmiedehausen K et al (2003) Strain-rate imaging during dobutamine stress echocardiography provides objective evidence of inducible ischemia. Circulation 107:2120–2126
Smedsrud MK, Sarvari S, Haugaa KH et al (2012) Duration of myocardial early systolic lengthening predicts the presence of significant coronary artery disease. J Am Coll Cardiol 60:1086–1093
Mirea O, Pagourelias ED, Duchenne J et al (2018) Intervendor differences in the accuracy of detecting regional functional abnormalities: a report from the EACVI-ASE strain standardization task force. JACC Cardiovasc Imaging 11:25–34
Mirea O, Pagourelias ED, Duchenne J et al (2018) Variability and reproducibility of segmental longitudinal strain measurement: a report from the EACVI-ASE strain standardization task force. JACC Cardiovasc Imaging 11:15–24
Funding
This study was supposed in part by the Japan Society for the Promotion of Science Grant-in-Aid for Scientific Research (JSPS KAKENHI Grant Number JP17K01410).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors Hitomi Adachi, Toshihiko Asanuma, Kasumi Masuda, and Satoshi Nakatani declare no disclosure.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Adachi, H., Asanuma, T., Masuda, K. et al. Deterioration of longitudinal, circumferential, and radial myocardial strains during acute coronary flow reduction: which direction of strain should be analyzed for early detection?. Int J Cardiovasc Imaging 36, 1725–1735 (2020). https://doi.org/10.1007/s10554-020-01888-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10554-020-01888-4