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(Circulation. 2005;112:3820-3822.)
© 2005 American Heart Association, Inc.

Editorial

Echocardiographic Strain Imaging for Myocardial Viability

An Improvement Over Visual Assessment?

John Gorcsan, III, MD

From the University of Pittsburgh, Pittsburgh, Pa.

Correspondence to John Gorcsan III, MD, University of Pittsburgh, Scaife 564, 200 Lothrop St, Pittsburgh, PA 15213-2582. E-mail gorcsanj@upmc.edu

Key Words: Editorials • echocardiography • infarction • ischemia

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Echocardiographic strain imaging was introduced by Heimdal et al in 1998¹ as a means to calculate myocardial regional function from tissue Doppler velocity data.^2,3 Strain imaging is a variation of the previous concept of tissue Doppler myocardial velocity gradient, which calculates regional thickening independent of passive whole heart motion.^4,5 Because routine clinical evaluation of regional function is usually by visual wall-motion assessment, strain imaging has great promise to improve objective quantification of regional function. Strain imaging calculates deformation, which translates clinically to percent shortening in the longitudinal dimension (assessed from apical views) or percent thickening in the radial dimension (assessed from parasternal views).^1,6,7 Theoretically, it has the important advantage of differentiating active myocardial motion from passive translational or tethering movements that other echocardiographic-Doppler approaches cannot differentiate. Indeed, there have been literally hundreds of publications over the last 10 years detailing a wide range of experimental and potential clinical applications of strain imaging; however, currently, few centers have adopted strain imaging in their routine clinical practice, preferring visual "eyeball" assessment, even though this is inherently subjective and requires a high level of experience and training.⁸ An important question remains: Is it now time for strain imaging to be adopted in a widespread clinical sense?

Articles pp 3892 and 3901

Two important articles are contained in this issue of Circulation that address the application of strain imaging as a tool to assess myocardial viability: an animal study of experimental ischemia and infarction by Lyseggen et al⁹ and a clinical study using dobutamine . . . [Full Text of this Article]

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