Echocardiography assessment of myocardial tension

With the advantage of quantifying the rate of contraction and relaxation of each myocardial region, myocardial tension ultrasound helps diagnose and evaluate the recovery of cardiomyopathy effectively.

Tension is the term for the relative changes in length between two states. Let an object with original length L0 be stretched or compressed to a new length L1. According to the Lagrangian formula, the tension is conventionally defined as:
ε=(L1-L0)/L0
where: ε is the tension, L0 is the length of the head, and L1 is the instantaneous length.
Cardiac muscle cells are arranged in different directions depending on the layers of the heart, specifically as follows:
Middle layer: cardiomyocytes are located in the circumferential direction. In the subepicardial layer, the myocardial cells are located in a clockwise direction +60 degrees from left to right. Endocardium: in the direction of clockwise +60 degrees from right to left. The top and bottom rotate in opposite directions. The shortening and elongation of the ventricle is caused by the torsion of the ventricle along the longitudinal axis, the base of the needle rotates counterclockwise, the top rotates clockwise, causing the left ventricle to twist like when we squeeze a needle. towel.
Measurement of myocardial tension is based on the phenomenon that, during systole, the ventricular wall shortens, thickens, and twists along the longitudinal axis of the ventricle. It is therefore possible to measure the change in length of an area of ​​the myocardium or shortening and thickening by measuring the strain at several points in the wall.

Myocardial tension can be measured by ultrasound Speckle tracking, which is a method of analyzing the spatial displacement of spots (caused by the interaction between the ultrasound beam and the myocardial fibers). by 2D ultrasound. By monitoring the displacement of the spots in the cardiac cycle, the deformation of the myocardium is evaluated in three dimensions (vertical, circumferential, radial). Speckle tracking ultrasound helps to monitor and evaluate continuously the change of myocardial shape according to cardiac cycle, showing myocardial tension, myocardial tension rate, rotation, left ventricular torsion in the form of curves.
Longitudinal strain:
Longitudinal tension describes the deformation of the myocardium from the base to the apex. Total left ventricular longitudinal tension is considered to be of great significance as a quantitative indicator of total left ventricular function. Radial myocardial tension:
Describes the deformation of the myocardium towards the center of the chambers, so it indicates thickening and thinning of the cardiac wall during cardiac cycle. Tension values ​​in the radius direction can be obtained from the short axis section. Pericardial tension: describes shortening of myocardial regions along the circumference of the heart and is obtained in short-axis view.
Echocardiography like? The steps of echocardiography by Speckle tracking method are as follows:
Step 1: Cut the basic cross-sections, select images to save to the machine. Step 2: Evaluate whether the selected images are eligible for the survey. Step 3: Select points to mark: at the base of the mitral annulus, at the apex of the heart. Step 4: Endocardial border of the ventricles. Step 5: Adjust ROI Step 6: Evaluate the quality of the “tracking” contour. Step 7: Repeat steps 5.6 if the tracking contour is not optimal.

Along with many new echocardiographic techniques such as stress ultrasound, myocardial tissue Doppler ultrasound,... myocardial tension ultrasound has opened up a new direction in diagnosis, detection, and assessment of recovery. Cardiomyopathy patients after intervention. The outstanding advantage of strain echocardiography is to quantify the rate of contraction and relaxation of each myocardial region, thereby determining regional function and function of the entire left ventricle after intervention.
Applications of tension echocardiography are:
Early detection of segmental relaxation abnormalities Evaluation of regional dysfunction in myocardial infarction Evaluation of myocardial function in stress echocardiography assessment of myocardial viability Early detection of cardiomyopathy Early assessment of myocardial function status, knowing how myocardial stress is very important in cardiovascular diseases, especially Diseases such as myocardial infarction, myocardial hypertrophy, dilated cardiomyopathy, etc. high due to sudden cardiac death. Like most diseases in other systems, early detection of abnormalities will greatly improve the effectiveness of treatment and prevent unwanted complications.
Currently, Vinmec International General Hospital is not only well-regarded for its modern facilities, experienced medical team, but also as an address for early examination and diagnosis. and successfully treat many cardiovascular diseases. In addition, Vinmec is also equipped with a modern ultrasound machine of international standards, giving clear image results for examination and diagnosis. After the results are available, the Department of Diagnostic Imaging also cooperates with many other specialties to determine the stage of the disease to have an effective treatment regimen and soon bring good health to the patient.