Dia: 12 de julho de 2014

Left Atrial Strain Measured by Two-Dimensional Speckle Tracking Represents a New Tool to Evaluate Left Atrial Function

.
http://www.onlinejase.com/article/S0894-7317(09)01041-4/fulltext
.
Clinical Implications
There is great potential clinical use of these new LA functional parameters derived from 2D speckle tracking. The value of LA ε derived from tissue Doppler analysis has been the subject of several recent studies focusing on conditions such as atrial fibrillation19, 21 and hypertrophic cardiomyopathy.20 However, all these previous studies analyzed LA ε only at specific segments of the LA, whereas 2D speckle tracking can analyze global LA ε and therefore may become a better surrogate for LA function. It is also important to recognize the significant relationship we found between global LA εtot and LA SRpos peak and maximal LA volume index, a recognized predictor index in different conditions. LA ε may become a tool for analyzing LA function in clinical trials evaluating the prediction of developing arrhythmias or the success of drugs or radiofrequency ablation to treat arrhythmias.
.

.
O uso nas arritmias ainda não tem resultados conclusivos. Para que serve o Strain Atrial?
.
Quando se fala em Átrio esquerdo, Diástole é o que surge primeiro na mente do ecocardiografista. Estando isolado da sístole ventricular pela valva Mitral, é a Diástole que convive com o AE. Mas a tração do anel Mitral na sístole pode modificar o Strain, interferindo no ciclo cardíaco. Vejam a relação com o ECG no quadro

Segmental Analysis of Carotid Arterial Strain Using Speckle-Tracking
.
http://www.onlinejase.com/article/S0894-7317(11)00560-8/fulltext
.

.
Conclusions
Speckle-tracking to measure CAS is feasible and modestly reliable. Patients with diabetes had lower CAS obtained with speckle-tracking compared with healthy controls.
.
O mais interessante vem abaixo:
.
Finally, we found arterial strain measurements to be significantly higher in the right than in the left carotid artery for the two of the three far wall segments, the average of all three far wall segments, and the net average of all arterial wall segments. Differences in right versus left measurements have been reported in common carotid intima-media thickness measurements, with the right having lesser values than the left.43, 44, 45 In fact, in one study of participants with and without migraine headaches, arterial distension was also found to be significantly greater in the right than in the left for both groups of individuals. These findings are consistent with the findings in our study. These observations suggest that there may be differences in blood pressure, shear forces, and vascular anatomy specific in the same individual between the right and the left carotid arteries and merit further investigation.
.
Diferenças entre o lado esquerdo e direito também no Strain.
Demonstração clara que a mecânica dos fluxos é muito importante na Aterosclerose, muito mais que depósitos tardios de Cálcio.
.

Já que o D.I.C é o D.I.C dos sonhos do blog EchoTalk, não custa nada fazer um último pedido:

.

Está na hora de reconhecer o papel do Fernando Morcerf como um dos ecocardiografistas principais do Brasil, por seu papel no ensino e na descoberta de novas abordagens ao ecocardiograma.
.

Devemos esquecer antigos atritos e desvio dos objetivos no passado e criar um prêmio com o seu nome, além de nomeá-lo presidente honorável do congresso no Rio de Janeiro.

.

Sei que ele, Morcerf, não precisa disso, que recebe o reconhecimento de seus alunos e fãs em todo o mundo diariamente.

.

Faremos para honrar o “nosso” papel de ecocardiografistas no Brasil.