Doppler Strain Imaging Closely Reflects Myocardial Energetic Status in Acute Progressive Ischemia and Indicates Energetic Recovery After Reperfusion

Josef Korinek, Partho P. Sengupta, Jianwen Wang, Abel Romero-Corral, Anna E. Boukatina, Jan Vitek, Vijay K. Krishnamoorthy, Stephen S. Cha, Petras P. Dzeja, Andre Terzic, Bijoy K. Khandheria, Marek Belohlavek

Research output: Contribution to journalArticle

8 Scopus citations


Background: Capitalizing on mechanoenergetic coupling, we investigated whether strain echocardiography can noninvasively estimate the ratio of adenosine triphosphate (ATP) to adenosine diphosphate (ADP), a marker of energetic status during acute myocardial ischemia and reperfusion. Methods: Twenty-eight pigs were divided into 7 groups (1 baseline, 4 ischemic, and 2 reperfusion). Ischemia was induced by left anterior descending coronary artery occlusion. Longitudinal systolic lengthening (SL) and postsystolic shortening (PSS) strain were measured by echocardiography. The ATP/ADP ratio was obtained from myocardial biopsies in the ischemic and control regions. Results: SL and PSS strain and the ATP/ADP ratio progressively decreased (P < .05) with increased duration (12, 40, 120, and 200 minutes) of ischemia. A mathematical formula (ATP/ADP = -0.97 + 0.25 × PSS strain + 0.20 × SL strain) estimated best the ATP/ADP ratio (r = 0.94, P < .05). Reperfusion after 12 but not after 120 minutes of ischemia significantly improved the ATP/ADP ratio and decreased SL and PSS strain. Conclusions: Strain echocardiography closely reflected changes and enabled the noninvasive estimation of the ATP/ADP ratio. A higher ATP/ADP ratio is associated with functional improvement after reperfusion.

Original languageEnglish (US)
Pages (from-to)961-968
Number of pages8
JournalJournal of the American Society of Echocardiography
Issue number8
StatePublished - Aug 1 2008



  • Energy phosphates
  • Ischemia
  • Strain echocardiography

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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