2003 Volume 1 Issue 1 Pages 23-28
Background: Since regional tissue velocities are affected by motion of the adjacent regions as well as the whole heart translational motion, the quantification of wall motion using conventional tissue Doppler method may be questionable. Recently, a new echocardiographic system which enables the calculation of myocardial strain based on tissue Doppler information has been developed.
Methods: We investigated whether myocardial strain could quantify regional myocardial contraction in 13 patients with normal wall motion and in 18 patients with wall motion abnormalities. Left ventricular segmental wall motion was assessed with conventional 2-dimensional echocardiography at the apical 2-, 3-, and 4-chamber views. The same views were imaged also with tissue Doppler method to determine regional systolic myocardial strain.
Results: By 2-dimensional echocardiography, 230 segments were judged normokinesis, 83 segments hypokinesis and 23 segments showed akinesis. No segments showed dyskinesis. Peak systolic strain values of normokinetic, hypokinetic and akinetic wall segments were significantly different from each other (−20.1±5.5% for normokinesis, −11.9±5.0% for hypokinesis, p<0.0001 vs. normokinesis, and −6.3±3.4% for akinesis, p<0.0001 vs. normokinesis and p<0.0001 vs. hypokinesis) without significant overlap. Peak systolic strain values in normal subjects were similar among all segments, suggesting insignificant regional variations (p=ns).
Conclusion: Systolic myocardial strain agreed well with assessed wall motion. Myocardial strain imaging may be a new powerful tool to quantify regional wall contraction.