Application of three-dimensional speckle tracking echocardiography to assess left ventricular regional work using wall tension-regional area loop

作者：Hioki Ayana; Masuda Kasumi; Asanuma Toshihiko; Goto Yoichi; Nakatani Satoshi^*

来源：American Journal of Physiology - Heart and Circulatory Physiology, 2015, 308(10): H1258-H1264.

DOI：10.1152/ajpheart.00932.2014

• three-dimensional echocardiography
• pressure-volume loop
• cardiac function
• ventricular work

Three-dimensional (3-D) speckle tracking echocardiography allows us to track a change in regional endocardial surface area. The change of regional area during a cardiac cycle should be useful for assessing left ventricular regional work. We investigated the feasibility of assessing regional work, calculated as the area within the wall tension-regional area (T-A) loop using 3-D echocardiography. Three-dimensional full-volume images were acquired using 3-D echocardiography (Artida, Toshiba) at baseline and during brief occlusion of the left circumflex coronary artery in eight dogs. Wall tension was calculated according to Laplace's law for a spherical model. Area change ratio (in %) determined by area tracking was transformed into a change of regional area (in cm(2)) by a custom software. We calculated the area within the T-A loop (TAA) in the area under transient ischemia (risk area) and the remote area as regional work and validated the T-A loop method by comparing the global integral of TAA with the total work assessed by the pressure-volume loop. During coronary occlusion, regional work for the risk area significantly decreased (baseline vs. occlusion, 26.8 +/- 10.7 vs. 18.4 +/- 7.8 mmHg.cm(3); P < 0.05), whereas that for the remote area did not change. The global integral of TAA closely correlated with the total work assessed by the pressure-volume loop (r = 0.91, P < 0.0001). The wall T-A loop reflected regional dysfunction caused by myocardial ischemia. This analysis using 3-D speckle tracking echocardiography might be useful to quantify left ventricular regional work.

• 出版日期2015-5-15