Pérez GJH, López GLM, Hernández SI, Valle ML, García MF, Medel JO, Esquivel M, Sánchez CR, Cruz RN, Pérez GG

Idioma: Español
Referencias bibliográficas: 37
Paginas: 77-84
Archivo PDF: 395.24 Kb.

RESUMEN

Objetivo. Determinar la utilidad del speckle-tracking en pacientes con cardiopatía dilatada de origen isquémico en el Hospital Juárez de México en el periodo marzo-diciembre 2009. Material y métodos. Diseño del estudio: serie de casos. Por medio de ecocardiograma con el equipo Vivid 7 y técnica de speckle-tracking se cuantificó la deformación miocárdica a través del bull-eye. Resultados. Se realizó ecocardiograma a 37 pacientes, 31 hombres y seis mujeres. El strain sistólico global disminuyó en general con una media de -8% y una desviación estándar de 4. El strain sistólico a nivel segmentario disminuyó en promedio en el 3 cámaras a -9%, en el 4 cámaras a -8%, en el 2 cámaras -8%. Asimismo, se describe el promedio con los máximos y mínimos encontrados: en el segmento anteroseptal -5% (7/-17); septal -7% (8/-19); lateral -6% (19/-19); anterior -7% (6/-18); posterior -9% (8/-23); inferior -8% (8/-22). La fracción de expulsión fue en promedio de 30% (13%/51%) y un diámetro diastólico en promedio de 64 mm (53/88 mm). Al realizar la correlación de los segmentos analizados se observó una correlación entre el strain global y el de 3 cámaras con p ‹ 0.005, al igual que en los segmentos inferiores y posteriores con una p ‹ 0.005. Conclusiones. Realizar el strain longitudinal por medio de la técnica de speckle-tracking es de utilidad para conocer la deformación de un signo cuantitativo en los pacientes con cardiopatía dilatada de origen isquémico. En este estudio se observó que el strain disminuye en todos los segmentos analizados en el bull-eye, lo cual se correlaciona con la gravedad de la disminución de la fracción de eyección y la gravedad de la dilatación del ventrículo izquierdo.

REFERENCIAS (EN ESTE ARTÍCULO)

1. Perk G, Tunik P, Kronzon I. Non-doppler two dimensional strain imaging by echocardiography from technical considerations to clinical application. JASE 2007; 20: 234-43.

2. Quiñones M, Otto C, Stoddard M. Recommendations for quantification of Doppler echocardiography. A report from the Doppler Quantification Task Force of The Nomenclature and Standards Committee of The American Society of Echocardiography. J Am Soc Echocardiogr 2002; 15: 167-84.

3. Diamano L, Hsin A, Yeun L. Role of tissue Doppler and strain echocardiography in current clinical practice. Circulation 2007; 116: 2597-06.

4. Hashimoto I, Xiaokui L, Bhat Ah. Myocardial strain rate is a superior method for evaluation of left ventricular subendocardial function compared with tissue Doppler imaging. J Am Coll Cardiol 2003; 42: 1574-83.

5. Pislaru C, Anagnostopoulos P, Seward J. Higher myocardial strain rates during isovolumetric relaxation phase than during ejection characterize acutely ischemic myocardium. J Am Coll Cardiol 2002; 40: 1487-94.

6. Sutherland GR, Di Salvo G, Claus P, et al. Strain and strain rate imaging: a new clinical approach to quantifying regional myocardial function. J Am Soc Echocardiogr 2004; 17: 788-802.

7. Voigt Ju, Flachskampf F. Strain and strain rate: new and clinically relevant echo-parameters of regional myocardial function. Z Kardiol 2004; 93: 249-58.

8. Yip G, Abraham T, Belohlavek M. Clinical applications of strain rate imaging. J Am Soc Echocardiogr 2003; 16: 1334-42.

9. Pislaru C, Abraham T, Belohlavek M. Strain and strain rate echocardiography. Curr Opin Cardiol 2002; 17: 443-54.

10. Marwick T. Measurement of strain and strain rate by echocardiography: ready for prime time? J Am Coll Cardiol 2006; 47: 1313-27.

11. Kukulski T, Jamal F, D’hooge J. Acute changes in systolic and diastolic events during clinical coronary angioplasty: a comparison of regional velocity, strain rate, and strain measurement. J Am Soc Echocardiogr 2002; 15: 1-12.

12. Kukulski T, Jamal F, Herbots L. Identification of acutely ischemic myocardium using ultrasonic strain measurements. J Am Coll Cardiol 2003; 41: 810-9.

13. Gilman G, Khandheria BK, Hagen M. Strain rate and strain: step-by-step approach to image and data acquisition. J Am Soc Echocardiogr 2004; 17: 1011-20.

14. Voigt Ju, Lindenmeier G, Exner B. Incidence and characteristics of segmental postsystolic longitudinal shortening in normal, acutely ischemic and scarred myocardium. J Am Soc Echocardiogr 2003; 16: 451-23.

15. Jamal F, Kulkulski T, Sutherland Gr. 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: 723-30.

16. Korinek J, Wang J, Sengupta P. Two-dimensional strain-a Doppler-independent ultrasound method for quantitation of regional deformation: validation in vitro and in vivo. J Am Soc Echocardiogr 2005; 18: 1247-53.

17. Amundsen BH, Helle-Valle T, Edvardsen T. Noninvasive myocardial strain measurement by speckle tracking echocardiography; validation against sonomicrometry and tagged magnetic resonance imaging. J Am Coll Cardiol 2006; 47: 789-93.

18. Vidal B, Sitges M, Delgado V. Cardiac resynchronization therapy is less effective in patients with very dilated cardiomyopathy. Eur J Echocardiogr 2007; 8(Suppl. 1): S160.

19. Soliman O, Kirschbaum SW, Geleijnse M. Three-dimensional echocardiographic parametric quantification of regional left ventricular function: validation and clinical application in cardiac resynchronization therapy. Eur J Echocardiogr 2007; 8(Suppl. 1): S36.

20. Hoffmann R, Altiok E, Nowak B, Heussen N, Kuhl H, Kaiser Hj, et al. Strain rate measurement by Doppler echocardiography allows improved assessment of myocardial viability inpatients with depressed left ventricular function. J Am Coll Cardiol 2002; 39: 443-9.

21. Hita A, Chejtman D, Baratta S, Turri D. La caracterización y el Doppler tisular mejoran el diagnóstico diferencial de la hipertrofia ventricular entre atletas e hipertensos. Rev Argent Cardiol 2005; 73: 112-8.

22. Chejtman D, Baratta S, Fernández H, Marani A, Ferroni F, Bilbao J, et al. Valor clínico del análisis de la fase de la contracción ventricular con Doppler tisular en la discriminación de hipertrofia fisiológica de formas patológicas. Rev Argent Cardiol 2006; 74: 129-35.

23. Voigt Ju, Exner B, Schmiedehausen K, Huchzermeyer C, Reulbach U, Nixdorff U, et al. Strain-rate imaging during dobutamine stress echocardiography provides objective evidence of inducible ischemia. Circulation 2003; 107: 2120-6.

24. Notomi Y, Lysyansky P, Setser RM. Measurement of ventricular torsion by two-dimensional ultrasound speckle tracking imaging. J Am Coll Cardiol 2005; 45: 2034-41.

25. Caso I, Severino S, Pacileo G. New parameters of systolic and diastolic function and left ventricletorsion evaluated with 2D-strain in patients with hypertrophic cardiomyopathy and normal systolic function. Eur J Echocardiogr 2007; 8(Suppl. 1): S38-9.

26. Suffoletto MS, Dohi K, Cannesson M. novel speckle tracking radial strain from routine black-and-white echocardiography images to quantify dyssynchrony and predict response to cardiac resynchronization therapy. Circulation 2006; 113: 960-8.

27. Reisner SA, Lysyansky P, Agmon Y. Global longitudinal strain: a novel index of left ventricular systolic function. J Am Soc Echocardiogr 2004; 17: 630-3.

28. Demarco F, Kanu C, Kim S, Walter F, Kerwin E, Botvinick J, et al. Ventricular contraction abnormalities in dilated cardiomyopathy: effect of biventricular pacing to correct interventricular dyssynchrony. Am Coll Cardiol 2000; 35: 1221-7.

29. European Society of Cardiology. The treatment of heart failure. The task force of The Working Group on Heart Failure of the European Society of Cardiology. Eur Heart J 1997; 18: 736-53.

30. Chen C, Rodriguez L, Guerrero Jl, Marshall S, Levine Ra, Weyman AE, et al. Noninvasive estimation of the instantaneous first derivative of left ventricular pressure using continuous-wave Doppler echocardiography. Circulation 1991; 83: 2101-10.

31. Migliore RA, Adaniya ME, Miramont G, Guerrero FT, Tamagusuku H. Non-invasive estimation of Dp/Dt of the left ventricle: is the measurement taken during the isovolumetric contraction? Arch Inst Cardiol Mex 2000; 70: 580-8.

32. Bargiggia GS, Bertucci C, Recusani F, Raisaro A, De Servi S, Valdes-Cruz LM, et al. A new method for estimating left ventricular Dp/Dt by continuous wave Dopplerechocardiography. Validation studies at cardiac catheterization. Circulation 1989; 80: 1287-92.

33. Kolias TJ, Aaronson KD, Armstrong WF. Doppler-derived Dp/ Dt and -Dp/Dt predict survival in congestive heart failure. J Am Coll Cardiol 2000; 36: 1594-9.

34. Merlo I, Chianelli O, Migliore R, Adaniya M, Miramont G, Tamagusuku H, et al. Valor pronóstico de la Dp/Dt positiva y negativa en la miocardiopatía dilatada. Rev Argent Cardiol 2001; 69: 82.

35. Gougnot S, Arnould MA, Duhoux F. Assessment of global left ventricular systolic function by automated function imaging, a novel software for semi-automated strain measurement. Eur J Echocardiogr 2007; 8(Suppl. 1): S82.

36. Bhan A, Kapetanakis S, Rana BS, Casella F, Monaghan MG. Can increased myocardial contractility during dobutamine infusion can be reliably measured by speckle tracking? Eur J Echocardiogr 2007; 8(Suppl. 1): S30-1.

37. Gutierrez L, Rodriguez Fernandez A, Tocadu Unzalu B. Untwisting: a new marker for assessment of myocardial relaxation and its relationship with torsion. Eur J Echocardiogr 2007; 8(Suppl. 1): S125.