Focused Cardiac Ultrasound: Virtual Transthoracic Echocardiography, TTE, FOCUS, FATE, Standard views. This learning module outlines the TEE 20 standard views using video and a 3D heart model. Abbreviations xi. 1. What is echo? 1. Basic notions. 1. Viewing the heart. 3 . Echo techniques. Normal echo. Who should have an echo?.

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In this case there are three normal strains along the x, y and z axes and six shear strains.

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Left efhokardiographie longitudinal strain images obtained from the 4-chamber view of a patient with LV apical aneurysma after myocardial infarction before panel A and after panel B surgical LV restoration. The more recent introduction of 2D-strain imaging in our weaning protocol for patients with mechanical circulatory support has substantially improved our ability to evaluate cardiac recovery during mechanical unloading and the information obtained global strain and strain rate plus evaluation echokadriographie mechanical synchrony and synergy was essential to the decision to wean six patients from their assist devices.

Experimental work performed on adult dogs showed that global diastolic strain rate can be useful for the assessment of ventricular relaxation and estimation of filling pressures [ 28 ].

In a study on 30 patients Leitmann et al. The necessity of high image quality is a major limitation for routine clinical applicability in all patients. Abstract Echocardiographic strain and strain-rate imaging deformation imaging is a new non-invasive method for assessment of myocardial function.

Nevertheless, whereas parameters of systolic dyssynchrony based on TDI longitudinal and radial velocity measurements were able to predict the efficacy of CRT in patients with heart failure, parameters of systolic dyssynchrony based on longitudinal and radial strain data obtained from TDI and speckle tracking 2D-strain imaging appeared not predictive for CRT results [ 9194 ]. Left ventricular function Starter Kit: Comparing the deformation parameters obtained from patients who underwent routine endomyocardial biopsies, Marciniak et al.

The Review explains the fundamental concepts of deformation imaging, describes in a comparative manner echokardiographoe two major deformation imaging methods TDI-derived and speckle tracking 2D-strain derived and discusses the clinical applicability of these new echocardiographic tools, which recently have become echokarxiographie subject of great interest for clinicians.

This can be improved by increasing sample distance but only in exchange for lower spatial resolution. Cardiac-resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure.

National Center for Biotechnology InformationU. Thus, as the apical parts of the ventricle pull down the ventricular base, the wall motion velocity and wall displacement increase from apex to base and some of the motion in the base echokardipgraphie an effect of apical contraction — tethering. Therefore, for the evaluation of regional and echokardiographif myocardial deformation in children, HR echokardiograpphie rest should be considered an important factor.


To date none of these 6 patients showed heart failure recurrence after assist device explantation. Low frame rate increases the spatial resolution, but because speckle-tracking software uses a frame-by-frame approach to follow the myocardial movement and searches each consecutive frame for a speckle pattern closely resembling and in close proximity to the reference frame, with too low a frame rate the speckle pattern could be outside the search area, again resulting in poor tracking [ 2324 ].

The main reason for these discrepancies is well known: Strain and strain rate measurements also appeared useful for detection of regional myocardial dysfunction in patients with right ventricular RV echokardiograpyie infarction [ 69 ]. Echocardiographic quantification of myocardial function using tissue deformation imaging, a guide to image acquisition and analysis using tissue Doppler and speckle tracking.

Users can view the TTE recordings for each of the 20 standard views used in a full cardiology exam and see the corresponding 3D model of the probe, ultrasound plane, heart and rib cage for that view. The images in badics A and B show that myocardial displacement can be misleading by suggesting regional differences in contractile function, although, as shown in absics Cmyocardial deformation analysis strain imaging does not reveal relevant regional differences in myocardial longitudinal shortening.

Thus, echokardiographiw completely passive segments, without deformation, can show motion [ 5 ]. Thus, as shown by the yellow curves, despite the very low wall motion velocity in the apical region panel Athe longitudinal myocardial shortening in this region can be even higher than in basal regions panel B.

Online Echocardiography Course & Sonography Training | Sonography

However, in the echokagdiographie study the accuracy of 2D-strain rate measurements for the diagnosis of right coronary artery RCA stenosis, was lower than that of TDI-derived strain rate measurements. Primary Care Ultrasound 4. During recent years, velocity imaging, displacement imaging and deformation imaging strain and strain-rate imaging have emerged as valuable tools for more comprehensive and reliable echocardiographic assessment of myocardial function [ 2 – 11 ].

Global diastolic strain rate for assessment of left ventricular relaxation and filling pressure. Strain rate and tissue tracking imaging in quantification of left ventricular systolic function in endurance and strength athletes.

Detection of left ventricular systolic dysfunction in cardiac amyloidosis with strain rate echocardiography. Early prediction of infarct size by strain Doppler echocardiography after coronary reperfusion. Although conventional echocardiography is considered to be reliable for ventricular wall motion analysis and assessment of regional myocardial function, the visual estimation of wall motion is very subjective and therefore highly operator dependent.


The accuracy of speckle tracking 2D-strain echocardiography in the detection and quantification of cardiac dyssynchrony was validated experimentally in canine and sheep models [ 9596 ]. Comparison of two-dimensional speckle and tissue Doppler strain measurement during dobutamine stress echocardiography: The validity of non-Doppler 2D-strain imaging for identification and quantification of myocardial ischemia was also proved experimentally in pigs with occlusion of the LAD and in rat ischemia-reperfusion models with temporary LAD occlusion [ 6667 ].

Due to its ability to differentiate between active and passive movement of myocardial segments, to quantify intraventricular dyssynchrony and to evaluate components of myocardial function, such as longitudinal myocardial shortening, that are not visually assessable, it allows comprehensive assessment of myocardial function and the echokadiographie of potential clinical applications is very wide.

Association of myocardial strain with left ventricular geometry and prognosis of hypertensive heart disease. The intraobserver and interobserver variability for 2D-strain and SR measurements were found to be low: Time course of 2D-strain images recorded during reduction of the LVAD Type Incor rate in a patient with idiopathic dilated cardiomyopathy who showed relevant myocardial recovery during echokardiogrpahie unloading.

J Am Soc Echocardiogr. Impact of left ventricular lead position on the efficacy of cardiac resynchronization therapy: Moreover, rapid events during the cardiac cycle such as isovolumetric phases may not appear on images and peak SR values may be reduced due to under-sampling, in isovolumetric phases and in early diastole.

The negative effects of altered electrical activation on ventricular mechanical function were already recognized more than 40 years ago [ 85 ].

Therefore, strain and SR imaging deformation analysis is more useful than wall motion analysis velocity and displacement for detection of regional myocardial dysfunction [ 57 ].

Abnormal right ventricular myocardial strain generation in mild pulmonary hypertension. Journal List Curr Cardiol Rev v. It is important to be aware that assessing tissue movement in relation to the transducer rather than relative to adjacent segments is a fundamental limitation of tissue velocity imaging, which can also affect tissue Doppler derived strain and basicz rate imaging [ 11 ].

International Journal of Cardiology ]. Changes in systolic left ventricular function in isolated mitral regurgitation.

UniversitätsKlinikum Heidelberg: Echokardiographie

For small deformations the Lagrangian and natural strain are approximately equal whereas for large deformations which can occur during ventricular contraction and relaxation the difference between Lagrangian and natural strain are relevant. Arch Mal Coeur Vaiss. How does our approach differ from other approaches?