Ultrasound strain imaging of altered myocardial stiffness: Stunned versus infarcted reperfused myocardium

Cristina D Pislaru, Charles J Bruce, Peter C. Anagnostopoulos, Jill L. Allen, James B. Seward, Patricia Pellikka, Erik L. Ritman, James F Greenleaf

Research output: Contribution to journalArticle

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Abstract

Background-In this study we evaluate the diastolic deformation of ischemic/reperfused myocardium and relate this deformation to tissue elastic properties. Methods and Results-Farm pigs were subjected to left anterior descending coronary artery occlusion followed by reperfusion to create either stunning (n=12) or transmural myocardial infarction (n=12). Ultrasound-derived radial strain rates (SR) and strain were measured in the ischemic and remote walls. Myocardial stiffness was estimated from diastolic pressure-wall thickness relationship obtained from preload alterations. At reperfusion, end-systolic strain (εsys) was significantly reduced in both stunned and infarcted walls compared with their remote walls (3±3% versus 26±2% and 1±0% versus 33±5%, respectively; P<0.0001) or baseline values. Diastolic passive deformation (εA) and rates of deformation during early (ESR) and late (ASR) diastole were comparable between stunned and remote walls (εA: 7.3±1.6% versus 7.9±1.9%; ESR: -2.7±0.4 s -1 versus -2.6±0.5 s-1; ASR: -1.8±0.2 s-1 versus -1.9±0.3 s-1; P=NS for all) but were of significantly lower magnitude in infarcted walls versus remote walls (εA: 1.1±0.2% versus 11.4±1.9%; E SR: -0.3±0.1 s-1 versus -2.4±0.4 s -1; ASR: -0.3±0.1 s-1 versus -2.5±0.4 s-1; (P<0.0001 for all). Stiffness coefficient of exponential diastolic pressure-wall thickness relation was higher for infarcted (P<0.05) but not for stunned walls (P=NS) compared with their remote walls. Conclusions-Early after postischemic reperfusion and in the presence of severely reduced systolic deformation, diastolic passive deformation (and rates of deformation) can distinguish stiff, noncompliant, transmurally infarcted myocardial walls from those more compliant walls containing viable but stunned myocardium.

Original languageEnglish (US)
Pages (from-to)2905-2910
Number of pages6
JournalCirculation
Volume109
Issue number23
DOIs
StatePublished - Jun 15 2004

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Reperfusion
Ultrasonography
Myocardium
Myocardial Stunning
Blood Pressure
Elastic Tissue
Diastole
Coronary Occlusion
Coronary Vessels
Swine
Myocardial Infarction
Farms
4-(2-(4-isopropylbenzamido)ethoxy)benzoic acid

Keywords

  • Diastole
  • Echocardiography
  • Myocardial infarction
  • Myocardial stiffness
  • Stunning, myocardial

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Ultrasound strain imaging of altered myocardial stiffness : Stunned versus infarcted reperfused myocardium. / Pislaru, Cristina D; Bruce, Charles J; Anagnostopoulos, Peter C.; Allen, Jill L.; Seward, James B.; Pellikka, Patricia; Ritman, Erik L.; Greenleaf, James F.

In: Circulation, Vol. 109, No. 23, 15.06.2004, p. 2905-2910.

Research output: Contribution to journalArticle

Pislaru, Cristina D ; Bruce, Charles J ; Anagnostopoulos, Peter C. ; Allen, Jill L. ; Seward, James B. ; Pellikka, Patricia ; Ritman, Erik L. ; Greenleaf, James F. / Ultrasound strain imaging of altered myocardial stiffness : Stunned versus infarcted reperfused myocardium. In: Circulation. 2004 ; Vol. 109, No. 23. pp. 2905-2910.
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abstract = "Background-In this study we evaluate the diastolic deformation of ischemic/reperfused myocardium and relate this deformation to tissue elastic properties. Methods and Results-Farm pigs were subjected to left anterior descending coronary artery occlusion followed by reperfusion to create either stunning (n=12) or transmural myocardial infarction (n=12). Ultrasound-derived radial strain rates (SR) and strain were measured in the ischemic and remote walls. Myocardial stiffness was estimated from diastolic pressure-wall thickness relationship obtained from preload alterations. At reperfusion, end-systolic strain (εsys) was significantly reduced in both stunned and infarcted walls compared with their remote walls (3±3{\%} versus 26±2{\%} and 1±0{\%} versus 33±5{\%}, respectively; P<0.0001) or baseline values. Diastolic passive deformation (εA) and rates of deformation during early (ESR) and late (ASR) diastole were comparable between stunned and remote walls (εA: 7.3±1.6{\%} versus 7.9±1.9{\%}; ESR: -2.7±0.4 s -1 versus -2.6±0.5 s-1; ASR: -1.8±0.2 s-1 versus -1.9±0.3 s-1; P=NS for all) but were of significantly lower magnitude in infarcted walls versus remote walls (εA: 1.1±0.2{\%} versus 11.4±1.9{\%}; E SR: -0.3±0.1 s-1 versus -2.4±0.4 s -1; ASR: -0.3±0.1 s-1 versus -2.5±0.4 s-1; (P<0.0001 for all). Stiffness coefficient of exponential diastolic pressure-wall thickness relation was higher for infarcted (P<0.05) but not for stunned walls (P=NS) compared with their remote walls. Conclusions-Early after postischemic reperfusion and in the presence of severely reduced systolic deformation, diastolic passive deformation (and rates of deformation) can distinguish stiff, noncompliant, transmurally infarcted myocardial walls from those more compliant walls containing viable but stunned myocardium.",
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T2 - Stunned versus infarcted reperfused myocardium

AU - Pislaru, Cristina D

AU - Bruce, Charles J

AU - Anagnostopoulos, Peter C.

AU - Allen, Jill L.

AU - Seward, James B.

AU - Pellikka, Patricia

AU - Ritman, Erik L.

AU - Greenleaf, James F

PY - 2004/6/15

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N2 - Background-In this study we evaluate the diastolic deformation of ischemic/reperfused myocardium and relate this deformation to tissue elastic properties. Methods and Results-Farm pigs were subjected to left anterior descending coronary artery occlusion followed by reperfusion to create either stunning (n=12) or transmural myocardial infarction (n=12). Ultrasound-derived radial strain rates (SR) and strain were measured in the ischemic and remote walls. Myocardial stiffness was estimated from diastolic pressure-wall thickness relationship obtained from preload alterations. At reperfusion, end-systolic strain (εsys) was significantly reduced in both stunned and infarcted walls compared with their remote walls (3±3% versus 26±2% and 1±0% versus 33±5%, respectively; P<0.0001) or baseline values. Diastolic passive deformation (εA) and rates of deformation during early (ESR) and late (ASR) diastole were comparable between stunned and remote walls (εA: 7.3±1.6% versus 7.9±1.9%; ESR: -2.7±0.4 s -1 versus -2.6±0.5 s-1; ASR: -1.8±0.2 s-1 versus -1.9±0.3 s-1; P=NS for all) but were of significantly lower magnitude in infarcted walls versus remote walls (εA: 1.1±0.2% versus 11.4±1.9%; E SR: -0.3±0.1 s-1 versus -2.4±0.4 s -1; ASR: -0.3±0.1 s-1 versus -2.5±0.4 s-1; (P<0.0001 for all). Stiffness coefficient of exponential diastolic pressure-wall thickness relation was higher for infarcted (P<0.05) but not for stunned walls (P=NS) compared with their remote walls. Conclusions-Early after postischemic reperfusion and in the presence of severely reduced systolic deformation, diastolic passive deformation (and rates of deformation) can distinguish stiff, noncompliant, transmurally infarcted myocardial walls from those more compliant walls containing viable but stunned myocardium.

AB - Background-In this study we evaluate the diastolic deformation of ischemic/reperfused myocardium and relate this deformation to tissue elastic properties. Methods and Results-Farm pigs were subjected to left anterior descending coronary artery occlusion followed by reperfusion to create either stunning (n=12) or transmural myocardial infarction (n=12). Ultrasound-derived radial strain rates (SR) and strain were measured in the ischemic and remote walls. Myocardial stiffness was estimated from diastolic pressure-wall thickness relationship obtained from preload alterations. At reperfusion, end-systolic strain (εsys) was significantly reduced in both stunned and infarcted walls compared with their remote walls (3±3% versus 26±2% and 1±0% versus 33±5%, respectively; P<0.0001) or baseline values. Diastolic passive deformation (εA) and rates of deformation during early (ESR) and late (ASR) diastole were comparable between stunned and remote walls (εA: 7.3±1.6% versus 7.9±1.9%; ESR: -2.7±0.4 s -1 versus -2.6±0.5 s-1; ASR: -1.8±0.2 s-1 versus -1.9±0.3 s-1; P=NS for all) but were of significantly lower magnitude in infarcted walls versus remote walls (εA: 1.1±0.2% versus 11.4±1.9%; E SR: -0.3±0.1 s-1 versus -2.4±0.4 s -1; ASR: -0.3±0.1 s-1 versus -2.5±0.4 s-1; (P<0.0001 for all). Stiffness coefficient of exponential diastolic pressure-wall thickness relation was higher for infarcted (P<0.05) but not for stunned walls (P=NS) compared with their remote walls. Conclusions-Early after postischemic reperfusion and in the presence of severely reduced systolic deformation, diastolic passive deformation (and rates of deformation) can distinguish stiff, noncompliant, transmurally infarcted myocardial walls from those more compliant walls containing viable but stunned myocardium.

KW - Diastole

KW - Echocardiography

KW - Myocardial infarction

KW - Myocardial stiffness

KW - Stunning, myocardial

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