DOI: 10.5176/2382-5669_CCMR14.08
Authors: Raghav Sharma and Sadagopan Thanikachalam
Abstract:
BACKGROUND: The myofiber geometry of the left ventricle (LV) changes gradually from a right-handed helix in the subendocardium to a left-handed helix in the subepicardium. In this review, we associate the LV myofiber architecture with emerging concepts of the electromechanical sequence in a beating heart. We discuss: 1) the morphogenesis and anatomical arrangement of muscle fibers in the adult LV; 2) the sequence of depolarization and repolarization; 3) the physiological inhomogeneity of transmural myocardial mechanics and the apex-to-base sequence of longitudinal and circumferential deformation; 4) the sequence of LV rotation; and 5) the link between LV deformation and the intracavitary flow direction observed during each phase of the cardiac cycle.
METHODS: 88 patients were enrolled in the study from august 2013 to janurary 2014 in our institution and patients were divided into three groups normal subjects , those with overt disease and those with occult disease based on risk factors , TMT and angio proven TVD OR DVD. Longitudnal Strain and strain rate was calculated.
RESULTS: patients with overt disease i.e. angiography proven DVD or TVD with TMT positive and risk factors had lowest longitudinal strain and strain rate and it correlated well with the vascular territory too.
CONCLUSION: the Doppler derived strain and strain rate and its imaging modality of investigation even though a part of image or Doppler derived information on myocardial function, it has an edge over assessment of left ventricular ejection fraction eyeballing of segmental wall motion abnormality. Utility of this modality is useful in all forms of cardiovascular disease not only assessing the LV function but also long term mortality and morbidity benefit.
Keywords: LV ejection fraction,longitudnal strain and strain rate
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