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Echocardiography 5 minutes before starting  

Echocardiographic examinations

—Echocardiographic examinations

Transthoracic examination
TEE - views
Stress echocardiography
Contrast echocardiography
Cardiac asynchrony
Strain Imaging
3D | 4D echo
Indications for echocardiography
Training in echocardiography

—Cardiac function and PA pressure

—Examples of pathological

Strain Imaging: assessment of myocardial mechanics

Strain: myocardial deformation (strain) can be assessed with this tool. It can be obtained based on Tissue Doppler Imaging (TDI) or on bidimensional images (speckle tracking). TDI allows better time definition and can be also used in case of poor echocardiographic windows. Analyses from bidimensional images allow assessment of radial and circumferencial strain, as well as apical and basal rotation, needed to calculate ventricular torsion. Normal values of longitudinal LV deformation are between -20 to -25 %.

Strain rate: rate of myocardial deformation in time. Units are expressed in number/second or %/second. Diastolic myocardial deformation can be assessed more clearly in this way. Normal values of longitudinal LV deformation are 1 - 1.5/s or higher.

Here an extensive tutorial on this topic by Dr. Asbjørn Støylen - NTNU Trondheim, Norway.

ASE/EAE consensus statement on methodology and indications for the quantitative evaluation of cardiac mechanics, 2011.

Normal strain: values of myo- cardial deformation at systole lie here around -25 % on the lateral segments of the left ventricle. Color encoded dynamic bidimen- sional image helps to visualize strain, red stands here for -20 %.

Pathological strain: values of myocardial deformation at systole lie here around -7 %, being consequently very reduced. This case is a proven myocardial invol- vement in systemic amyloidosis.

Normal strain rate: values of diastolic myocardial deformation in this normal heart lie between 1.3 and 1.7/s.

Pathological strain rate: this former amyloidosis case shows also a severe impairment of longitudinal diastolic myocardial deformation, with values around 0.6/s.