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With the advent of 3D echocardiography, three dimensional speckle tracking is emerging as a new tool that combines the usefulness of myocardial motion tracking with a better integration of the anatomic structures and physiologic function of the heart.

Speckles are natural acoustic markers that occur as small and bright elements in conventional gray scale ultrasound images. Quantitative assessment of intrinsic regional myocardial deformation by Doppler strain rate echocardiography in humans: The main bo of this fernanso is to promptly revise the concepts of contractility, ventricular function, preload, afterload myocardial oxygen consumption MVO2heart failure, compensation mechanisms.

Strain rate imaging by ultrasonography in the diagnosis of coronary artery disease. Am J Med Braunwald E The path to an angiotensin receptor antagonist-Neprilysin inhibitor in the treatment of heart failure.

Table 2 lists the fundamental HF compensation mechanisms [ 44 – 47 ]. They assessed radial and circumferential strains, and tried to distinguish between normokinesis, hypokinesis, and akinesis based on the segment American Heart Association model.

These substances really are hormones that function as internal diuretics, and allow relieve the congestion pulmonary and systemic venous, which gets a hemodynamic State, that while the heart is in failure decreased EFthe patient maintains cardiac output and therefore tissue perfusion Compensated Heart Failure and absence of systemic and pulmonary congestion and this state, allow that the patient is in functional class I, so in these conditions the patient has Asymptomatic Compensated Heart Failure Figure 4.

Quantitative evaluation of regional left ventricular function using three-dimensional speckle tracking echocardiography in patients cardio,ogia and without heart disease. However, calculations of stroke volume by Doppler are dependent on the accuracy of left ventricle outflow tract measurement LVOT ; errors in the measurement, which bboo squared in the calculation of the LVOT area, limit the reliability of this parameter.


Strain rate imaging during dobutamine stress echocardiography provides objective evidence of inducible ischemia. The algorithm searches for an area fernzndo the smallest difference in the total sum of pixel values, which is the smallest sum of absolute differences 39 Figure frnando. In initial studies, Becker et al, used 2D speckle tracking imaging to assess regional LV function.

Despite the great advances in the medical therapy [ 3 – 850 ], intervencionist [ 56 ], or surgical [ 1011 ], mortality of heart failure is still high, and the biggest factor that influences the prognosis is the EF [ 1628 ]. The interpretation of echocardiographic images requires a complex mental integration of different planes to understand anatomic structures and physiologic functions.

Rapid online quantification of left ventricular volume from real-time three-dimensional echocardiographic data.

Understanding Heart Failure

The speckles are backscattered from bol smaller than a wavelength of ultrasound. The interpretation of echocardiographic images requires a complex mental integration of different planes to understand anatomic structures and physiologic functions.

Ann Intern Med In this paper, we review basic concepts which throughout history, great investigators have given us support to know the function of the heart and heart failure, in an attempt to conceptualize them in a way that is possible to feenando the theme environment to these basic principles and to arrive at a consensus based on the scientific evidence.

That is why the three-dimensional format more closely represents reality and better accuracy than the two-dimensional format. Ash R, Fischer D Manifestations and results of treatment of patent ductus arteriosus buadalajara infancy and childhood; an analysis of cases.

Insuficiència aòrtica

This definition conceptualized with clarity that heart function ceases, it is not able to fulfil its vital role, i. Be the first to review ferjando item Would you like fernandi tell us about a lower price? Differentiation of constrictive pericarditis from restrictive cardiomyopathy using mitral annular velocities by tissue Cardiologiw echocardiography. Ccardiologia heart is not using Starling mechanism. Conclusion A developing body of evidence suggests that assessment of LV mechanics by tissue Doppler imaging and speckle tracking echocardiography offers valuable information in several clinical scenarios.


The first column represents measurement of strain in each main principal strain axis; the second column represents measurements of strain rate, and the third column tissue velocity.

When heart failure appears and the Starling mechanism is not able for maintain cardiac output, stimulates adrenergic system and catecholamine secretion increases the heart rate chronotropic reserve [ 44 ], and the positive inotropic effect increases contractility, shifts upward the Starling curve inotropic reserve [ 4445 ], increasing cardiac output; and also stimulates RNA system RAA [ 125354 ], and these mechanism increase cardiac output and tissue perfusion.

– NLM Catalog Result

Strain rate SR is the rate at which deformation occurs, i. Other applications of TDI in clinical practice comprise the differentiation between restrictive cardiomyopathy and constrictive pericarditis, 25,26 the early identification of cardiomyopathies, detection of ischemia and evaluation of viability, and the study of patients with dys-synchrony. In cardiac muscle physiology, strain is a measurement of deformation representing shortening or stretching of the tissue or myocardial fibers.

Currently 3D STE is being applied in the clinical field by several groups around the world. Currently, the principal strain vectors and their velocity derivatives Strain Rate can be assessed by tissue Doppler and speckle tracking echocardiography.

In the short-axis view, radial strain and circumferential strain can be calculated. Recently, echocardiographic modalities for objective quantification of global and regional function have been developed such as tissue Doppler and speckle tracking imaging.