二维斑点追踪成像技术评价急性心肌梗死左室短轴方向心肌功能
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摘要
目的
应用二维斑点追踪成像技术评价急性心肌梗死患者急诊经皮冠状动脉介入治疗术后左室短轴方向心肌节段不同形式运动的变化情况。了解急诊经皮冠状动脉介入治疗(PCI)对急性心肌梗死再灌注治疗的疗效。
方法
2008年12月至2009年4月入住我院接受急诊PCI治疗的急性心肌梗死患者32例,年龄(52.4±9.4)岁。除外陈旧性心肌梗死、糖尿病、严重瓣膜疾病、严重高血压性心脏病、先天性心脏病、严重心律失常及图像质量欠佳患者。应用二维斑点追踪成像技术于PCI术后一周和三个月分别获得心脏短轴圆周应变、径向应变、扭转角度。对所得数据进行统计学比较分析。结果
1、PCI术后患者的射血分数、左心室舒张末期内径、左心室舒张末期容积、收缩末期容积、二尖瓣口E波峰值及E／A均低于对照组(P<0.05)。
2、心肌梗死节段PCI术后一周圆周应变、径向应变及扭转角度较正常值明显减低(P<0.001)。心肌梗死节段PCI术后三个月圆周应变、径向应变及扭转角度较术后一周提高(P<0.05)。
结论
PCI可有效开通梗死相关动脉,提供持续的前向血流。随着心肌缺血的改善,局部和整体左室收缩功能逐渐恢复,表现为圆周应变、径向应变及扭转角度的增高。超声斑点追踪技术能够定量评价节段性室壁运动异常,为临床评价心肌梗死患者左心收缩功能提供无创性新方法。
Objective
To assess strain changes after percutaneous coronary intervention in patients with acute myocardial Infarction by left ventricular short axis two-dimensional speckle tracking imaging in different directions.To evaluate the effectt of emergency percutaneous coronary interventionon in patients with acute myocardial infarction.
Methods
30 cases of acute myocardial infarction with average age of 52.4±9.4 years old underwent emergency percutaneous coronary intervention between December,2008 and April,2009.Exclution previous myocardial infarction,diabetes mellitus(DM), Severe valve disease, severe hypertensive heart disease(HHD),congenital heart disease(CHD),severe arrhythmia and poor quality LV images.Circumferential strain, radial strain,rotation were evaluated with left ventricular short axis view speckle tracking imaging after PCI. Analyze the data with statistics method.
Results
1.Mean value of left ventricular ejection fraction,left ventricular end-diastolic diameter,left ventricular end-diastolic volume,left ventricular end-systolic volume, peak velocity of the early rapid filling wave after PCI were all lower than normal value, where there was remarkable difference(all of P<0.05).
2.Mean value of circumferential strain,radial strain and rotation of 1 week after PCI were all lower than normal value,where there was remarkable difference(all of P<0.001).Mean value of circumferential strain,radial strain and rotation of 3 month after PCI were all higher than that of 1 week (all of P<0.05).
Conclusions
Percutaneous coronary intervention can relieving infarction related artery,recover global andregional systolic function.Then radial strain,circumferential strain and rotation increased.Regional systolic function damaged because of myocardial ischemia in patients with acute myocardial infarction.Mean value of radial strain,circumferential strain and rotation were all degraded. Regional wall motion of left ventricule can be evaluated accurately and sensitively with two-dimensional speckle tracking imaging.
应用二维斑点追踪成像技术评价急性心肌梗死患者急诊经皮冠状动脉介入治疗术后左室短轴方向心肌节段不同形式运动的变化情况。了解急诊经皮冠状动脉介入治疗(PCI)对急性心肌梗死再灌注治疗的疗效。
方法
2008年12月至2009年4月入住我院接受急诊PCI治疗的急性心肌梗死患者32例,年龄(52.4±9.4)岁。除外陈旧性心肌梗死、糖尿病、严重瓣膜疾病、严重高血压性心脏病、先天性心脏病、严重心律失常及图像质量欠佳患者。应用二维斑点追踪成像技术于PCI术后一周和三个月分别获得心脏短轴圆周应变、径向应变、扭转角度。对所得数据进行统计学比较分析。结果
1、PCI术后患者的射血分数、左心室舒张末期内径、左心室舒张末期容积、收缩末期容积、二尖瓣口E波峰值及E／A均低于对照组(P<0.05)。
2、心肌梗死节段PCI术后一周圆周应变、径向应变及扭转角度较正常值明显减低(P<0.001)。心肌梗死节段PCI术后三个月圆周应变、径向应变及扭转角度较术后一周提高(P<0.05)。
结论
PCI可有效开通梗死相关动脉,提供持续的前向血流。随着心肌缺血的改善,局部和整体左室收缩功能逐渐恢复,表现为圆周应变、径向应变及扭转角度的增高。超声斑点追踪技术能够定量评价节段性室壁运动异常,为临床评价心肌梗死患者左心收缩功能提供无创性新方法。
Objective
To assess strain changes after percutaneous coronary intervention in patients with acute myocardial Infarction by left ventricular short axis two-dimensional speckle tracking imaging in different directions.To evaluate the effectt of emergency percutaneous coronary interventionon in patients with acute myocardial infarction.
Methods
30 cases of acute myocardial infarction with average age of 52.4±9.4 years old underwent emergency percutaneous coronary intervention between December,2008 and April,2009.Exclution previous myocardial infarction,diabetes mellitus(DM), Severe valve disease, severe hypertensive heart disease(HHD),congenital heart disease(CHD),severe arrhythmia and poor quality LV images.Circumferential strain, radial strain,rotation were evaluated with left ventricular short axis view speckle tracking imaging after PCI. Analyze the data with statistics method.
Results
1.Mean value of left ventricular ejection fraction,left ventricular end-diastolic diameter,left ventricular end-diastolic volume,left ventricular end-systolic volume, peak velocity of the early rapid filling wave after PCI were all lower than normal value, where there was remarkable difference(all of P<0.05).
2.Mean value of circumferential strain,radial strain and rotation of 1 week after PCI were all lower than normal value,where there was remarkable difference(all of P<0.001).Mean value of circumferential strain,radial strain and rotation of 3 month after PCI were all higher than that of 1 week (all of P<0.05).
Conclusions
Percutaneous coronary intervention can relieving infarction related artery,recover global andregional systolic function.Then radial strain,circumferential strain and rotation increased.Regional systolic function damaged because of myocardial ischemia in patients with acute myocardial infarction.Mean value of radial strain,circumferential strain and rotation were all degraded. Regional wall motion of left ventricule can be evaluated accurately and sensitively with two-dimensional speckle tracking imaging.
引文
1 Brage H.Amundsen, Thomas Helle-Valle, Thor Edvardsen, et al. Noninvasive Myocardial Strain Measurement by Speckle Tracking Echocardiography:Validation Against Sonomicrometry and Tagged Magnetic Resonance Imaging. Journal of the American College of Cardiology.2006; 47 (4):789-793.
2 Artis NJ, Oxborough DL, Williams G, et al. Two-dimensional strain imaging:A new echocardiographic advance with research and clinical applications. International Journal of Cardiology.2008; 123:240-248.
3 郭薇,欧宓,王春,等.超声的二维径向应变显像对心肌缺血的研究.中国超声医学杂志.2007；23(11)：833-835.
4 沈燕华,高云华,杨晔,等.超声二维应变技术对心肌缺血早期诊断的应用研究.临床超声医学杂志.2008；10(8)：514-516.
5 Winter R, Jussila R, Nowak J, et al. Speckle tracking echocardiography is a sensiti-ve tool for the detection of myocardial ischemia:a pilot study from the catheterization laboratory during percutaneous coronary intervention. J Am Soc Echocardiogr.2007; 20 (8):974-981.
6 韩伟,谢明星,王心房,等.超声斑点追踪显像技术评价健康人左室心肌整体和局部扭转运动特征的临床初步研究.中国超声医学杂志.2008；24(8)：78-80.
7 熊莉,邓又斌,超声斑点追踪技术对心肌梗死患者室壁运动的二维应变研究.中国医学影像技术.2007；23(7)：1003-3289.
8 刘谦.心肌顿抑的相关研究进展.北京医学2005年第27卷第1期.
9 Han W, Xie MX, Wang XF, et al. Assessment of left ventricular torsion in patients with anterior wall myocardial infarction before and after revascularization using speckle tracking imaging. Chinese Medical Journal.2008; 121 (16):1543-1548.
10 Anders Opdahl, MD, Thomas Helle-Valle, MD, Espen W, et al. Apical Rotation by Speckle Tracking Echocardiography:A Simplified Bedside Index of Left Ventricul-ar Twist. J Am Soc Echocardiogr.2008; 21:1121-1128.
11 Yang Y, Chen F, Zhang BW, et al. Two-dimensional strain in evaluation of global left ventricular strain and strain rate. Chin J Med Imaging Technol.2006; 22 (7):1018-1020.
12 D'Hooge J, Bijnens B, Jamal F, et al. High frame rate myocardial integrated backsca-tter:dose this change our understanding of this acoustic parameter? Eur J Echocar-diogr.2000; 1 (1):32-41.
1 Amundsen BH, Thomas Helle-Valle, Thor Edvardsen, et al. Noninvasive Myocardial Strain Measurement by Speckle Tracking Echocardiography:Validation Against Sonomicrometry and Tagged Magnetic Resonance Imaging. Journal of the American College of Cardiology.2006; 47 (4):789-793.
2 Mirsky I, Parmley WW, et al. Assessment of passive elastic stiffness forisolated heart muscle and the intact heart. Circ Res.1973; 33:233-243.
3 Kukulski T, Jamal F, Herbots L, et al. Identification of acutely ischemic myocardium using ultrasonic strain measurements.A clinical study in patients undergoing coronary angioplasty. J Am Coll Cardiol.2003; 41 (5):810-819.
4 Jamal F, Kkukulski T, Sut herland GR, et al. Can changes in systolic longitudinal deformation quantify regional myocardial function after an acute infarction?An ultrasonic strain rate and strain study. J Am Soc Echocardiogr.2002; 15 (7):723-730.
5 Kukulski T, J amal F, D'Hooge J, et al. Acute changes in systolic and diastolic events during clinical coronary angioplasty:a comparison of regional veloci-ty,srain rate,and strain measurement. J Am Soc Echocardiogr.2002; 15 (1):1-12.
6 Jamal F, Kukulski T, Strotmann J, et al. Quantification of the spectrum ofchanges in regional myocardial function during acute ischemia in closedchest pigs:an ultrasonic strain rate and strain study.J Am Soc Echocardiogr.2001; 14 (9):874-884.
7 Jamal F, Kukulski T, Strotmann J, et al. Noninvasive quantification of the contract ile reserve of stunned myocardium by ultrasonic strain rate and strain. Circulation.2001; 104 (9): 1059-1065.
8 Breithardt OA, Stellbrink C, Herbots L, et al. Cardiac resynchronization therapy can reverse abnormal myocardial strain distribution in patients with heart failure and left bundle branch block. J Am Coll Cardiol.2003; 42 (3):486-494.
9 Dohi K, Suffoletto MS, Schwartzman D, et al. Utility of echocardiographic radial strain imaging to quantify left ventricular dyssynchrony and predict acute respo-nse to cardiac resynchronization therapy. Am J Cardiol.2005; 96 (1):112-116.
10 Sun JP, Chinchoy E, Donal E, et al. Evaluation of ventricular synchrony using novel Doppler echocardiographic indices in patients with heart failure receiving cardiac resynchronization therapy. J Am Soc Echocardiogr.2004; 17 (8):845-850.
11 Yu CM, Fung JWH, Zhang Q, et al. Tissue Doppler imaging is superior to strain rate imaging and post systolic shortening on the prediction of reverse remodeling in both ischemic and nonischemic heart failure after cardiac resynchronization therapy. Circulation.2004; 110 (1): 66-73.
12 Torrent-Guasp F, Buckberg GD, Clemente C, et al. The structure and function of the helical
heart and its buttress wrapping.Ⅰ.The normal macroscopic structure of the heart. Semin Thorac Cardiovasc Surg.2001; 13:301-319.
13 熊莉,邓又斌,申屠伟慧,等.超声斑点追踪技术测量正常人二维应变的初步研究.中华超声影像学杂志.2007；16(5)：373-376.
14 Adamu U, Schmitz F, Becker M, et al. Advanced speckle tracking echocardiography allowing a three-myocardial layer-specific analysis of deformation parameter-s. Eur J Echocardiogr.2009; 10 (2):303-308.
15 Hurlburt HM, Aurigemma GP, Gaasch WH, et al. Direct ultrasound measurement of the 3 principal components of left ventricular regional systolic strain. J Am Coll Cardiol.2006; 47116A.
16 Helle-Valle T, Crosby J, Edvardsen T, et al. New noninvasive method for assessment of left ventricular rotation speckle tracking echocardiogramphy. Circulation.2005; 112 (20): 3149-3156.
17 Greenberg NL, Firstenberg MS, Castro PL, et al. Doppler derived myocardial systolic strain rate is a strong index of left ventricularcont ractility. Circulation.2002; 105 (1):99-105.
18 Jiang WL, Guo RQ, Zhou Q, et al. Comparison among strain rate,ejection fraction and corrected QV peak interval in evaluating systolic function in hypertension patients with different left ventricular patterns. Chin J Med Imaging Technol.2005; 21 (10):1503-1505.
19 Kosmala W, Plaksej R, Strotmann JM, et al. Progression of left ventricular functional abnormalities in hypertensive patients with heart failure:an ultrasonic two-dimensional speckle tracking study. J Am Soc Echocardiogr.2008 Dec; 21 (12):1309-1317.
20 Perry R, De Pasquale CG, Chew DP, et al. Assessment of early diastolic left ventricular function by two-dimensional echocardiographic speckle tracking. Eur J Echocardiogr.2008 Nov; 9 (6):791-795.
21 Choi JO, Cho SW, Song YB, et al. Longitudinal 2D strain at rest predicts the presence of left main and three vessel coronary artery disease in patients without regional wall motion abnormality. Eur J Echocardiogr.2009 Apr 28. [Epub ahead of print]
22 Gjesdal O, Hopp E, Vartdal T, et al. Global longitudinal strain measured by two dimensional speckle tracking echocardiography is closely related to myocardial infarct size in chronic ischaemic heart disease. Clinical Science.2007; 113:287-296.
23 Torrent-Guasp F, Ballester M, Buckberg GD, et al.Spatial orientation of the ventricular muscle band:physiologic contributionand surgical implications. J Thorac Cardiovasc Surg. 2001; 122:389-392.
24 Takeuchi M, Nakai H, Kokumai M, et al. Age-related changes in left ventricular twist assessed by two-dimensional speckle tracking imaging. J Am Soc Echocardiogr.2006; 19: 1077-1084.
25 Wang JW, Khoury DS, Yue Y, et al. Left Ventricular Untwisting Rate by Speckle Tracking Echocardiography. Circulation.2008; 105 (1):117:337.
26 Zhang L, Xie M, Fu M, et al. Assessment of age-related changes in left ventricular twist by two-dimensional ultrasound speckle tracking imaging.Huazhong Univ Sci Technolog Med Sci. 2007; 27:691-695.
27 Kim HK, Sohn DW, Lee SE, et al. Assessment of left ventricular rotation and torsion with two-dimensional speckle tracking echocardiography. J Am Soc Echocardiogr.2007; 20:45-53.
28 Setser RM, Kasper JM, Lieber ML, et al. Persistent abnormal left ventricular systolic torsion in dilated cardiomyopathy after partial left ventriculectomy. J Thorac Cardiovasc Surg.2003; 126:48-55.
29 Torrent-Guasp F, Ballester M, Buckberg GD, et al. Spatial orientation of the ventricular muscle band:physiologic contribution and surgical implications. JThorac Cardiovasc Surg. 2007; 28:2756-2762.
30 Moonen M, Senechal M, Cosyns B, et al. Impact of contractile reserve on acute response to cardiac resynchronization therapy. Cardiovasc Ultrasound.2008 Dec 31; 6:65.
31 Tanabe M, Lamia B, Tanaka H, et al. Echocardiographic speckle tracking radial strain imaging to assess ventricular dyssynchrony in a pacing model of resynchronization therapy. J Am Soc Echocardiogr.2008 Dec; 21 (12):1382-1388.
32 Gorcsan J, Tanabe M, Bleeker GB, et al. Combined Longitudinal and Radial Dyssynchrony Predicts Ventricular Response After Resynchronization Therapy. J Am CollCardiol.2007; 50: 1476-1483.
33 Zhang Q, Fung J, Gabriel WK, et al. Improvement of left ventricular myocardial short-axis,but not long-axis function or torsion after cardiac resynchronization therapy an assessment by two-dimensional speckle tracking. Heart Published Online.2008:15.
34 Block M, Hourigan L, Bellows WH, et al. Comparison of left atrialdimension by transesophageal and transthoracic echocardiography. J Am Soc Echocardiogr.2002; 15 (2): 143-149.
35 Ogawa K, Hozumi T, Sugioka K, et al. Automated assessment of left atrial function from time left atrial volume curves using a novel speckle tracking imaging method. J Am Soc Echocardiogr.2009 Jan; 22 (1):63-69.
36 Okamatsu K, Takeuchi M, Nakai H, et al. Effects of aging on left atrial function assessed by two-dimensional speckle tracking echocardiography. J Am Soc Echocardiogr.2009 Jan; 22 (1): 70-75.
37 D'Andrea A, Caso P, Romano S, et al. Different effects of cardiac resynchronization therapy on left atrial function in patients with either idiopathic or ischaemic dilated cardiomyopathy:a two-dimensional speckle strain study.Eur Heart J.2007 Nov; 28 (22):2738-2748.
38 D'Andrea A, Caso P, Romano S, et al. Association between left atrial myocardial function and exercise capacity in patients with either idiopathic or ischemic dilated cardiomyopathy:a two-dimensional speckle strain study. Int J Cardiol.2009 Mar 6; 132 (3):354-63.
39 Di Salvo G, Pacileo G, Castaldi B, et al. Two-dimensional strain and atrial function:a study on patients after percutaneous closure of atrial septal defect. Eur J Echocardiogr.2009 Mar; 10 (2):256-9.
40 Yang Y, Chen F, Zhang BW, et al. Two-dimensional strain in evaluation of global left ventricular strain and strain rate. Chin J Med Imaging Technol.2006; 22 (7):1018-1020.
41 D'Hooge J, Bijnens B, Jamal F, et al. High frame rate myocardial integrated backscatter:dose this change our understanding of this acoustic parameter? Eur J Echocardiogr.2000; 1 (1): 32-41.
2 Artis NJ, Oxborough DL, Williams G, et al. Two-dimensional strain imaging:A new echocardiographic advance with research and clinical applications. International Journal of Cardiology.2008; 123:240-248.
3 郭薇,欧宓,王春,等.超声的二维径向应变显像对心肌缺血的研究.中国超声医学杂志.2007；23(11)：833-835.
4 沈燕华,高云华,杨晔,等.超声二维应变技术对心肌缺血早期诊断的应用研究.临床超声医学杂志.2008；10(8)：514-516.
5 Winter R, Jussila R, Nowak J, et al. Speckle tracking echocardiography is a sensiti-ve tool for the detection of myocardial ischemia:a pilot study from the catheterization laboratory during percutaneous coronary intervention. J Am Soc Echocardiogr.2007; 20 (8):974-981.
6 韩伟,谢明星,王心房,等.超声斑点追踪显像技术评价健康人左室心肌整体和局部扭转运动特征的临床初步研究.中国超声医学杂志.2008；24(8)：78-80.
7 熊莉,邓又斌,超声斑点追踪技术对心肌梗死患者室壁运动的二维应变研究.中国医学影像技术.2007；23(7)：1003-3289.
8 刘谦.心肌顿抑的相关研究进展.北京医学2005年第27卷第1期.
9 Han W, Xie MX, Wang XF, et al. Assessment of left ventricular torsion in patients with anterior wall myocardial infarction before and after revascularization using speckle tracking imaging. Chinese Medical Journal.2008; 121 (16):1543-1548.
10 Anders Opdahl, MD, Thomas Helle-Valle, MD, Espen W, et al. Apical Rotation by Speckle Tracking Echocardiography:A Simplified Bedside Index of Left Ventricul-ar Twist. J Am Soc Echocardiogr.2008; 21:1121-1128.
11 Yang Y, Chen F, Zhang BW, et al. Two-dimensional strain in evaluation of global left ventricular strain and strain rate. Chin J Med Imaging Technol.2006; 22 (7):1018-1020.
12 D'Hooge J, Bijnens B, Jamal F, et al. High frame rate myocardial integrated backsca-tter:dose this change our understanding of this acoustic parameter? Eur J Echocar-diogr.2000; 1 (1):32-41.
1 Amundsen BH, Thomas Helle-Valle, Thor Edvardsen, et al. Noninvasive Myocardial Strain Measurement by Speckle Tracking Echocardiography:Validation Against Sonomicrometry and Tagged Magnetic Resonance Imaging. Journal of the American College of Cardiology.2006; 47 (4):789-793.
2 Mirsky I, Parmley WW, et al. Assessment of passive elastic stiffness forisolated heart muscle and the intact heart. Circ Res.1973; 33:233-243.
3 Kukulski T, Jamal F, Herbots L, et al. Identification of acutely ischemic myocardium using ultrasonic strain measurements.A clinical study in patients undergoing coronary angioplasty. J Am Coll Cardiol.2003; 41 (5):810-819.
4 Jamal F, Kkukulski T, Sut herland GR, et al. Can changes in systolic longitudinal deformation quantify regional myocardial function after an acute infarction?An ultrasonic strain rate and strain study. J Am Soc Echocardiogr.2002; 15 (7):723-730.
5 Kukulski T, J amal F, D'Hooge J, et al. Acute changes in systolic and diastolic events during clinical coronary angioplasty:a comparison of regional veloci-ty,srain rate,and strain measurement. J Am Soc Echocardiogr.2002; 15 (1):1-12.
6 Jamal F, Kukulski T, Strotmann J, et al. Quantification of the spectrum ofchanges in regional myocardial function during acute ischemia in closedchest pigs:an ultrasonic strain rate and strain study.J Am Soc Echocardiogr.2001; 14 (9):874-884.
7 Jamal F, Kukulski T, Strotmann J, et al. Noninvasive quantification of the contract ile reserve of stunned myocardium by ultrasonic strain rate and strain. Circulation.2001; 104 (9): 1059-1065.
8 Breithardt OA, Stellbrink C, Herbots L, et al. Cardiac resynchronization therapy can reverse abnormal myocardial strain distribution in patients with heart failure and left bundle branch block. J Am Coll Cardiol.2003; 42 (3):486-494.
9 Dohi K, Suffoletto MS, Schwartzman D, et al. Utility of echocardiographic radial strain imaging to quantify left ventricular dyssynchrony and predict acute respo-nse to cardiac resynchronization therapy. Am J Cardiol.2005; 96 (1):112-116.
10 Sun JP, Chinchoy E, Donal E, et al. Evaluation of ventricular synchrony using novel Doppler echocardiographic indices in patients with heart failure receiving cardiac resynchronization therapy. J Am Soc Echocardiogr.2004; 17 (8):845-850.
11 Yu CM, Fung JWH, Zhang Q, et al. Tissue Doppler imaging is superior to strain rate imaging and post systolic shortening on the prediction of reverse remodeling in both ischemic and nonischemic heart failure after cardiac resynchronization therapy. Circulation.2004; 110 (1): 66-73.
12 Torrent-Guasp F, Buckberg GD, Clemente C, et al. The structure and function of the helical
heart and its buttress wrapping.Ⅰ.The normal macroscopic structure of the heart. Semin Thorac Cardiovasc Surg.2001; 13:301-319.
13 熊莉,邓又斌,申屠伟慧,等.超声斑点追踪技术测量正常人二维应变的初步研究.中华超声影像学杂志.2007；16(5)：373-376.
14 Adamu U, Schmitz F, Becker M, et al. Advanced speckle tracking echocardiography allowing a three-myocardial layer-specific analysis of deformation parameter-s. Eur J Echocardiogr.2009; 10 (2):303-308.
15 Hurlburt HM, Aurigemma GP, Gaasch WH, et al. Direct ultrasound measurement of the 3 principal components of left ventricular regional systolic strain. J Am Coll Cardiol.2006; 47116A.
16 Helle-Valle T, Crosby J, Edvardsen T, et al. New noninvasive method for assessment of left ventricular rotation speckle tracking echocardiogramphy. Circulation.2005; 112 (20): 3149-3156.
17 Greenberg NL, Firstenberg MS, Castro PL, et al. Doppler derived myocardial systolic strain rate is a strong index of left ventricularcont ractility. Circulation.2002; 105 (1):99-105.
18 Jiang WL, Guo RQ, Zhou Q, et al. Comparison among strain rate,ejection fraction and corrected QV peak interval in evaluating systolic function in hypertension patients with different left ventricular patterns. Chin J Med Imaging Technol.2005; 21 (10):1503-1505.
19 Kosmala W, Plaksej R, Strotmann JM, et al. Progression of left ventricular functional abnormalities in hypertensive patients with heart failure:an ultrasonic two-dimensional speckle tracking study. J Am Soc Echocardiogr.2008 Dec; 21 (12):1309-1317.
20 Perry R, De Pasquale CG, Chew DP, et al. Assessment of early diastolic left ventricular function by two-dimensional echocardiographic speckle tracking. Eur J Echocardiogr.2008 Nov; 9 (6):791-795.
21 Choi JO, Cho SW, Song YB, et al. Longitudinal 2D strain at rest predicts the presence of left main and three vessel coronary artery disease in patients without regional wall motion abnormality. Eur J Echocardiogr.2009 Apr 28. [Epub ahead of print]
22 Gjesdal O, Hopp E, Vartdal T, et al. Global longitudinal strain measured by two dimensional speckle tracking echocardiography is closely related to myocardial infarct size in chronic ischaemic heart disease. Clinical Science.2007; 113:287-296.
23 Torrent-Guasp F, Ballester M, Buckberg GD, et al.Spatial orientation of the ventricular muscle band:physiologic contributionand surgical implications. J Thorac Cardiovasc Surg. 2001; 122:389-392.
24 Takeuchi M, Nakai H, Kokumai M, et al. Age-related changes in left ventricular twist assessed by two-dimensional speckle tracking imaging. J Am Soc Echocardiogr.2006; 19: 1077-1084.
25 Wang JW, Khoury DS, Yue Y, et al. Left Ventricular Untwisting Rate by Speckle Tracking Echocardiography. Circulation.2008; 105 (1):117:337.
26 Zhang L, Xie M, Fu M, et al. Assessment of age-related changes in left ventricular twist by two-dimensional ultrasound speckle tracking imaging.Huazhong Univ Sci Technolog Med Sci. 2007; 27:691-695.
27 Kim HK, Sohn DW, Lee SE, et al. Assessment of left ventricular rotation and torsion with two-dimensional speckle tracking echocardiography. J Am Soc Echocardiogr.2007; 20:45-53.
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