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(Circulation. 2007;116:2453-2464.)
© 2007 American Heart Association, Inc.

Contemporary Reviews in Cardiovascular Medicine

Investigating Cardiac Function Using Motion and Deformation Analysis in the Setting of Coronary Artery Disease

Bart Bijnens, PhD; Piet Claus, PhD; Frank Weidemann, MD, PhD; Jörg Strotmann, MD, PhD; George R. Sutherland, FESC

From the Medical School and Faculty of Electronic Engineering (B.B.), University of Zagreb, Croatia; the Department of Cardiology (B.B., P.C.), University of Leuven, Belgium; the Department of Medicine (F.W., J.S.), University Hospital Wuerzburg, Germany; and the Department of Cardiology (G.R.S.), St. George’s Hospital, London, United Kingdom.

Correspondence to Professor Bart Bijnens, University Hospital Centre Zagreb, Department for Cardiovascular Diseases, Kispaticeva 12, 10000 Zagreb, Croatia. E-mail bart@bijnens.com

Key Words: echocardiography • imaging • contractility • ischemia • myocardial infarction • stunning, myocardial • strain

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

	Introduction

 
In the last decade, noninvasive cardiac imaging has played an increasing role in cardiology. As one of the most widespread clinically used techniques, echocardiography has witnessed several technical developments in imaging modalities and image analysis. One of the most recent has been the introduction of velocity-based strain-rate imaging and speckle tracking to quantify regional deformation.¹

Coronary artery disease induces important changes in regional myocardial function. Both acute ischemia and chronic ischemia decrease regional wall motion and thickening. Despite recent technical developments in clinical cardiac imaging, the evaluation of regional radial and longitudinal function is often based on visual interpretation of wall motion. This is both qualitative and subjective.

This paper discusses regional myocardial deformation and motion, studied in different (experimental) substrates of coronary artery disease, from acute ischemia to chronic infarction. It will be shown that regional deformation at rest, combined with observations during a dobutamine challenge, can uniquely discriminate the different ischemic substrates.

	Motion and Deformation in Normal Myocardium

 
Both radial and longitudinal regional peak systolic velocities show a significant fall after β-blockade^2,3 but no added effect of additional pacing. Regional displacement shows a tendency to decrease with β-blockade. With the addition of pacing a further significant reduction in displacement takes place. The transmyocardial velocity gradient (the difference between epicardial and endocardial peak velocity, divided by their distance^4–6) is influenced by β-blockade in the same way as peak velocities and is not altered by changes in heart rate during β-blockade. With a dobutamine infusion, myocardial velocities increase.² With induced changes in contractility, either by . . . [Full Text of this Article]

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