Assessment of left ventricular functions with strain and strain rate echocardiography and tissue Doppler imaging in patients with cardiac tamponade

Abstract

We evaluated left ventricular (LV) myocardial functions with strain (S) and strain rate (Sr) echocardiography and tissue Doppler imaging (TDI) before and after pericardiocentesis in patients with cardiac tamponade. The study included 27 patients (19 men, 8 women; mean age 51.4 ± 16.3 years) who underwent pericardiocentesis following clinical and echocardiographic diagnosis of cardiac tamponade. Besides echocardiographic parameters of LV functions, S/Sr parameters and TDI velocities were measured before and five days after pericardiocentesis, including peak systolic S, peak systolic Sr (Sr-s), peak early diastolic Sr (Sr-e), peak late diastolic Sr (Sr-a), peak lateral and septal mitral annular systolic (Sm), early diastolic (E'), and late diastolic (A') velocities. Pericardiocentesis was successful in all the patients, resulting in significant patient comfort and symptomatic improvement. In segmental analysis, there were no significant differences in peak systolic S and Sr values obtained before and after pericardiocentesis (p>0.05), except for basal lateral segment S and apical anterior segment Sr-s values (p<0.05). After pericardiocentesis, Sr-e and Sr-a values measured in all the walls and segments, and TDI-derived lateral and septal mitral E' and A' velocities showed significant decreases (p<0.05). All these changes demonstrated by S and Sr echocardiography corresponded well to those obtained by TDI. We concluded that S and Sr echocardiography was not superior to TDI in the assessment of LV functions in patients with cardiac tamponade.