A Focus On: Myocardial deformation imaging

A Focus On: Myocardial deformation imaging

Video 1.9 as taken from Transthoracic anatomy and pathology: chambers and vessels. In: OSH Echocardiography, 2e. Leeson P, Augustine D, Mitchell A and Becher H. Publisher Oxford University Press. DOI:10.1093/med/9780199591794.001.0001 © OUP 2012.

Myocardial deformation imaging has recently emerged as a new way to gain insights into early changes in myocardial function before the development of gross changes in volumetric indices such as ejection fraction. Both ‘movement’ and ‘thickening’ can now be quantified as ‘displacement’ and ‘strain’, respectively. Furthermore, by tracking displacement using three dimensional datasets, such as can be acquired with echocardiography (see Video 1.9  [above] and 1.10, OSH Echocardiography ), even the twisting motion of the heart during the cardiac cycle can be assessed. Recently, speckle tracking echocardiography has emerged as an elegant approach to track these deformations (see Video 4.28, OSH Echocardiography). When ultrasound strikes the myocardial microstructure an acoustic speckle pattern is created, which is relatively stable over time. Therefore image analysis techniques can identify these characteristic speckle patterns and use algorithms to identify the same pattern in subsequent image frames. From this information it is possible to track motion of the myocardium over the cardiac cycle (see Video 4.3, 4.9, 4.10, 4.11, 4.12, OSH Echocardiography). Similar deformation patterns can be derived from other modalities, such as cardiovascular magnetic resonance, either by using equivalent computational feature tracking software or with the use of specialised tagging sequences that artificially generate a fixed magnetic resonance pattern within the myocardium (see Fig 1.21, OSH Cardiovascular Imaging). Myocardial deformation imaging has now been applied in a range of studies and, for example, it has been found that changes in myocardial strain precede clinical deterioration in patients with cardiomyopathies and emerge before wall motion abnormalities in those developing myocardial ischaemia. Therefore, these new technologies are now being explored in the clinical arena to better understand the potential they give for early identification of changes in cardiac function that might be used to guide interventions and improve outcomes.

Paul Leeson, Consultant Cardiologist, John Radcliffe Hospital and BHF Senior Research Fellow, University of Oxford, Oxford, UK


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