Skip to main content
SpringerLink
Log in

Heterogeneous contraction of the left ventricle demonstrated by 2-dimensional strain imaging

  • Original Investigation
  • Published:
Journal of Echocardiography Aims and scope Submit manuscript

Abstract

Background

Tissue Doppler imaging (TDI) is useful in quantifying regional myocardial function, but has a significant limitation of Doppler angle dependency. The recently developed 2-dimensional strain imaging (2DS), based on speckle tracking imaging (STI) technology, enables us to evaluate myocardial function independent of ultrasound beam direction. The aim of this study was to assess the mode of contraction of the left ventricle.

Methods

Circumferential, radial and longitudinal strains were measured in 18 segments (anteroseptal, anterior, anterolateral, inferolateral, inferior and inferoseptal walls at the base, mid-ventricle and apex) from apical and short-axis views using 2DS in 24 healthy subjects (mean age, 33 ± 5 years). We divided the left ventricle into 2 sites: septum (anterior, anteroseptal and inferoseptal walls) and free walls (anterolateral, inferolateral and inferior walls). We then compared the mode of contraction between the septum and free walls.

Results

At the base and mid-ventricular levels, circumferential strain was larger in the septum (−22.6 ± 3.6 vs. −18.3 ± 4.1% and −24.1 ± 4.8 vs. −18.4 ± 5.7%, respectively; p < 0.0001 each), and radial strain was larger in the free walls (33.4 ± 12.4 vs. 38.7 ± 14.5% and 37.8 ± 12.6 vs. 43.0 ± 11.6%, respectively; p < 0.001 each) at the basal and mid-ventricular levels, whereas both were relatively homogeneous at the apex. The longitudinal strain did not differ among walls.

Conclusions

Heterogeneous contraction is seen in the left ventricle. The septum mainly contracts circumferentially, whereas the free walls contract radially. 2DS is helpful in understanding the mode of 3-dimensional myocardial contraction.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Buckberg GD, Weisfeldt ML, Ballester M, Beyar R, Burkhoff D, Coghlan HC, et al. Left ventricular form and function: scientific priorities and strategic planning for development of new views of disease. Circulation. 2004;110:e333–6.

    Article  PubMed  Google Scholar 

  2. Miyatake K, Yamagishi M, Tanaka N, Uematsu M, Yamazaki N, Mine Y, et al. New method for evaluating left ventricular wall motion by color-coded tissue Doppler imaging: in vitro and in vivo studies. J Am Coll Cardiol. 1995;25:717–24.

    Article  CAS  PubMed  Google Scholar 

  3. Stig U, Thor E, Hans T, Bjorn A, Otto AS. Myocardial strain by Doppler echocardiography: validation of a new method to quantify regional myocardial function. Circulation. 2000;102:1158–64.

    Google Scholar 

  4. Bach DS, Armstrong WF, Donovan CL, Muller DW. Quantitative Doppler tissue imaging for assessment of regional myocardial velocities during transient ischemia and reperfusion. Am Heart J. 1996;132:721–5.

    Article  CAS  PubMed  Google Scholar 

  5. Gorcsan J 3rd, Strum DP, Mandarino WA, Gulati VK, Pinsky MR. Quantitative assessment of alterations in regional left ventricular contractility with color-coded tissue Doppler echocardiography. Comparison with sonomicrometry and pressure–volume relations. Circulation. 1997;95:2423–33.

    PubMed  Google Scholar 

  6. Derumeaux G, Ovize M, Loufoua J, Andre-Fouet X, Minaire Y, Crivier A, et al. Doppler tissue imaging quantitates regional wall motion during myocardial ischemia and reperfusion. Circulation. 1998;97:1970–7.

    CAS  PubMed  Google Scholar 

  7. Notomi Y, Lysyansky P, Setser RM, Shiota T, Popovic ZB, Martin-Miklovic MG, et al. Measurement of ventricular torsion by two-dimensional ultrasound speckle tracking imaging. J Am Coll Cardiol. 2005;45:2034–41.

    Article  PubMed  Google Scholar 

  8. Miyazaki T, Tatara K, Mori K, Inoue M, Hayabuchi Y, Kagami S. Segmental myocardial strain of the left ventricle in patients with duchenne muscular dystrophy using two dimensional speckle tracking echocardiography. J Echocardiogr. 2008;4:100–8.

    Article  Google Scholar 

  9. Kaga S, Mikami T, Onozuka H, Omotehara S, Abe A, Yamada S, et al. Right ventricular diastolic dysfunction in patients with left ventricular hypertrophy: analysis of right ventricular myocardial relaxation using two-dimensional speckle tracking imaging. J Echocardiogr. 2009;7:25–33.

    Article  Google Scholar 

  10. Reisner SA, Lysyansky P, Agmon Y, Mutlak D, Lessick J, Friedman Z. Global longitudinal strain: a novel index of left ventricular systolic function. J Am Soc Echocardiogr. 2004;17:630–3.

    Article  PubMed  Google Scholar 

  11. Leitman M, Lysyansky P, Sidenko S, Shir V, Peleg E, Binenbaum M, et al. Two-dimensional strain––a novel software for real-time quantitative echocardiographic assessment of myocardial function. J Am Soc Echocardiogr. 2004;17:1021–9.

    Article  PubMed  Google Scholar 

  12. Young AA, Imai H, Chang CN, Axel L. Two-dimensional left ventricular deformation during systole using magnetic resonance imaging with spatial modulation of magnetization. Circulation. 1994;89:740–52.

    CAS  PubMed  Google Scholar 

  13. Moore CC, Lugo-Olivieri CH, McVeigh ER, Zerhouni EA. Three-dimensional systolic strain patterns in the normal human left ventricle: characterization with tagged MR imaging. Radiology. 2000;214:453–66.

    CAS  PubMed  Google Scholar 

  14. Hurlburt HM, Aurigemma GP, Hill JC, Narayanan A, Gaasch WH, Winch CS, et al. Direct ultrasound measurement of longitudinal, circumferential, and radial strain using 2-dimensional strain imaging in normal adults. Echocardiography. 2007;24:723–31.

    Article  PubMed  Google Scholar 

  15. Sun JP, Popović ZB, Greenberg NL, Xu XF, Asher CR, Stewart WJ, et al. Noninvasive quantification of regional myocardial function using Doppler-derived velocity, displacement, strain rate, and strain in healthy volunteers: effects of aging. J Am Soc Echocardiogr. 2004;17:132–8.

    Article  PubMed  Google Scholar 

  16. Fogel MA, Weinberg PM, Haselgrove J. Mechanics of the single left ventricle. A study in ventricular–ventricular interaction II. Circulation. 1998;98:330–8.

    CAS  PubMed  Google Scholar 

  17. Bharati S, Lev M. The pathology of congenital heart disease. 1st ed. Armonk: Futura Publishing Co; 1998. p. 403–19.

    Google Scholar 

  18. Weinberg PM. Pathologic anatomy of tricuspid atresia. In: Rao PS, editor. Triduspid Atresia. 2nd ed. Mount Kisco: Futura Publishing Co; 1992. p. 81–100.

    Google Scholar 

  19. Streeter DD Jr, Spotnitz HM, Patel DP, Ross J Jr, Sonnenblick EH. Fiber orientation in the canine left ventricle during diastole and systole. Circ Res. 1996;24:339–47.

    Google Scholar 

  20. Greenbaum RA, Ho SY, Gibson DG, Becker AE, Anderson RH. Left ventricular fibre architecture in man. Br Heart J. 1981;45:248–63.

    Article  CAS  PubMed  Google Scholar 

  21. Cheng A, Nguyen TC, Malinowski M, Daughters GT, Miller DC, Ingels NB. Heterogeneity of left ventricular wall thickening mechanics. Circulation. 2008;118:713–21.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Cardiovascular Medicine, Shinshu University Graduate School of Medicine, 3-1-1 Asahi, Matsumoto, Japan

    Hirohiko Motoki

  2. Department of Health Sciences, Osaka University Graduate School of Medicine, 1-7 Yamadaoka, Suita, 565-0871, Japan

    Satoshi Nakatani

  3. Division of Cardiovascular Medicine, National Hospital Organization Osaka Minami Medical Center, 2-1 Kidohigashimachi, Kawachinagano, Japan

    Haruhiko Abe

  4. Division of Cardiovascular Medicine, National Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Japan

    Hideaki Kanzaki & Masafumi Kitakaze

Authors
  1. Hirohiko Motoki
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Satoshi Nakatani
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Haruhiko Abe
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hideaki Kanzaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Masafumi Kitakaze
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Satoshi Nakatani.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Motoki, H., Nakatani, S., Abe, H. et al. Heterogeneous contraction of the left ventricle demonstrated by 2-dimensional strain imaging. J Echocardiogr 8, 33–39 (2010). https://doi.org/10.1007/s12574-009-0027-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12574-009-0027-z

Keywords

Search

Navigation