title: Doppler-derived myocardial systolic strain rate is a strong index of left ventricular contractility.
abstract: BACKGROUND
  Myocardial fiber strain is directly related to left ventricular (LV) contractility. Strain rate can be estimated as the spatial derivative of velocities (dV/ds) obtained by tissue Doppler echocardiography (TDE). The purposes of the study were (1) to determine whether TDE-derived strain rate may be used as a noninvasive, quantitative index of contractility and (2) to compare the relative accuracy of systolic strain rate against TDE velocities alone.
  
  
  RESULTS
  TDE color M-mode images of the interventricular septum were recorded from the apical 4-chamber view in 7 closed-chest anesthetized mongrel dogs during 5 different inotropic stages. Simultaneous LV volume and pressure were obtained with a combined conductance-high-fidelity pressure catheter. Peak elastance (Emax) was determined as the slope of end-systolic pressure-volume relationships during caval occlusion and was used as the gold standard of LV contractility. Peak systolic TDE myocardial velocities (Sm) and peak (epsilon'(p)) and mean (epsilon'(m)) strain rates obtained at the basal septum were compared against Emax by linear regression. Emax as well as TDE systolic indices increased during inotropic stimulation with dobutamine and decreased with the infusion of esmolol. A stronger association was found between Emax and epsilon'(p) (r=0.94, P<0.01, y=0.29x+0.46) and epsilon'(m) (r=0.88, P<0.01) than for Sm (r=0.75, P<0.01).
  
  
  CONCLUSIONS
  TDE-derived epsilon'(p) and epsilon'(m) are strong noninvasive indices of LV contractility. These indices appear to be more reliable than S(m), perhaps by eliminating translational artifact.
authors.affiliation: Cardiovascular Imaging Center, Department of Cardiology, Cleveland Clinic Foundation, Cleveland, Ohio OH 44195, USA. greenbn@ccf.org.
authors.forename: Neil L
authors.initials: NL
authors.lastname: Greenberg
authors.forename: Michael S
authors.initials: MS
authors.lastname: Firstenberg
authors.forename: Peter L
authors.initials: PL
authors.lastname: Castro
authors.forename: Michael
authors.initials: M
authors.lastname: Main
authors.forename: Agnese
authors.initials: A
authors.lastname: Travaglini
authors.forename: Jill A
authors.initials: JA
authors.lastname: Odabashian
authors.forename: Jeanne K
authors.initials: JK
authors.lastname: Drinko
authors.forename: L Leonardo
authors.initials: LL
authors.lastname: Rodriguez
authors.forename: James D
authors.initials: JD
authors.lastname: Thomas
authors.forename: Mario J
authors.initials: MJ
authors.lastname: Garcia
mesh_terms: D000818:Animals; D004285:Dogs; D015150:Echocardiography, Doppler; D006339:Heart Rate; D018485:Muscle Fibers, Skeletal / Q000166:cytology / Q000502:physiology*; D009200:Myocardial Contraction; D009206:Myocardium / Q000166:cytology; D013599:Systole / Q000502:physiology; D016277:Ventricular Function, Left / Q000502:physiology*