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Future applications of strain imaging
Since its birth in the late 1990s, strain echocardiography has continued to grow over the past 20 years. Currently, global longitudinal strain (GLS) has been standardized for clinical application as a robust diagnostic and prognostic marker with substantial incremental value…
Evaluation of right ventricular function and pulmonary hypertension
The right ventricle plays a crucial role in determining patient functional status and prognosis in various conditions. Accordingly, the quantification of right ventricular (RV) function should be part of any routine echocardiographic workup. However, the assessment of RV size and…
Ischemic heart disease
Ischemic heart disease (IHD) Myocardial mechanics in IHD Regional function and IHD In 1935, Tennant and Wiggers demonstrated that a coronary occlusion almost immediately induced a regional wall motion abnormality. Nowadays, such ischemic wall motion abnormalities can be detected by…
Strain in valvular diseases
Valvular diseases may be viewed as a model of how inappropriate loading conditions can lead to cardiac dysfunction, symptoms, and finally death. A paradox of valvular heart diseases is that, in contrast to diseases of myocardium, there is often discordance…
Detection and characterization of diastolic dysfunction
Basics of diastolic function Left ventricular (LV) filling results from active relaxation and diastolic chamber compliance, and LV diastolic dysfunction (DD) is the result of impaired LV relaxation and increased LV chamber stiffness with increased LV filling pressures (FP). Until…
Temporal dispersion of contraction, arrhythmias, and dyssynchrony and role in resynchronization therapy
Pathophysiology of dispersed ventricular contraction The prediction of sudden cardiac arrest from ventricular arrhythmias remains challenging. Ventricular arrhythmias can occur from all major myocardial diseases and are the most common cause of sudden cardiac death. Malignant arrhythmias are most frequently…
Evaluation and monitoring of patients with cardiomyopathies (including myocardial infiltration)
Cardiomyopathy is a general term used to describe a heterogeneous group of diseases that result in impairment of ventricular function. Clinical manifestations of these diseases can range from an asymptomatic state to heart failure, arrhythmias, or sudden cardiac death (SCD).…
Evaluation of patients with heart failure
An estimated 6.2 million Americans older than 20 years suffer from heart failure. As the population ages and heart failure treatments improve, this number is expected to increase, with more than 8 million affected individuals in 2030. The frequency of…
Detection of subclinical heart failure
Introduction Limitations of left ventricular ejection fraction for detection of subclinical cardiomyopathy Left ventricular ejection fraction (LVEF) plays a primary role in the diagnosis and management of cardiovascular disease. However, in many scenarios, a reduction in LVEF occurs at a…