Wall Motion Studies P2 Flashcards
Define Amplitude
- The magnitude of myocardial wall movement during systole
◦ Amount blood ejected LV/pixel
◦ Max count difference per pixel
◦ ED max – ES min
Define phase
- The timing of myocardial contraction relative to the cardiac cycle
Define stroke volume
- The amount of blood ejected from the left ventricle per beat
- SV= End diastolic volume- end systolic volume
Define paradox
- Abnormal outward movement of the heart during systole instead of inward contraction (dyskinesis)
- ES min- ED max
Define global ejection fraction
- Overall percentage of blood ejected from the entire left ventricle during systole 55-75%
Define regional ejection fraction
- EF measured in specific ventricular segments instead of the whole heart
Define septal wall analysis
- The muscular wall separating the left and right ventricles
- LAO views
- Depends on wall thickening,
myocardial contraction &
anterior motion of heart
Define peak filling rate
The maximum rate at which the left ventricle fills with blood during diastole
Define peak emptying rate
- The maximum rate at which the left ventricle ejects blood during systole
- systolic portion of the TAC
- steeply sloped emptying rate
Describe amplitude image interpretation
◦ Donut shape
◦ Break indicates WM issue
◦ High EF areas = high amplitude
◦ Darker = higher amplitude
◦ Apex & lateral wall
◦ Bkg, hypokinetic, akinetic Areas = low amplitude
Describe phase images/histograms
Purpose
◦ When does motion occur
◦ Regardless of amount
Method
◦ TAC for each pixel & Fourier Transform applied
◦ Values applied to color scale
Describe phase images/histogram interpretation
◦ Normal:
◦ Atria contract→ fills ventricular chambers→ ventricles contract
◦ Atria to ventricle contraction 180°
◦ Pixels of same color are in-phase
◦ Abnormal:
◦ CAD, pacemaker, BBB, ventricular tachycardia
Describe regional stroke volume and interpretation
Purpose
◦ Blood ejected LV during systole
Method
◦ ED max - ES min (frame subtraction)
Interpretation
◦ Negative pixels set to zero
◦ Only positive pixels displayed
◦ Donut shape
◦ Regional hypokinesis or akinesis
Describe the purpose of global and regional EF
Purpose
* Assessment of EF
* Assessment of motion
* Akinetic regions = diminished or
absent activity
Method
* Images
* Resemble SV
* Calculate: SV image/ED image
* Regional: attempts to quantify
contractibility
* Expect variations between
regions
Describe global and regional EF interpretation
Normal: donut and horshoe appearance
- 55-75%
Abnormal: Regional hypokinesis or akinesis
Describe EF calculation formulas
% EF = ED cts - ES cts/ED cts x 100%
% EF = net ED cts - net ES cts /net ED cts x 100%
Net ED or ES cts:
◦ ED cts – (bkgd cts x ED # pixels)/
bkgd # pixels
Describe paradox image interpretation
Normal:
◦ No focal regions in LV walls
◦ Visualization of atria and great vessels
Abnormal:
◦ Focal area of activity
Describe peak filling rate interpretation
- means CAD, hypertrophic
cardiomyopathy, pericardial
disease & hypertension when values are low
How to assess right ventricle
- Best visualized on ANT & LAO
- Only on LLT if RV dilation
- Assess apex, lateral & inferior walls
for general motion
List possible clinical findings
Chemotoxicity
Hibernating Myocardium
Myocardial Stunning
Acute MI
Pre-op
CAD
LV Aneurysms
Valvular Disease
Cardiomyopathy and Myocarditis
Pulmonary Disease - SOB
Congenital
List issues with the left ventricle
MI
Chronic Hypertension
Aortic Valve Disease
Aortic Stenosis
Myocardial Hypertrophy
List right ventricle issues
Pulmonary Hypertension
Left Side Heart Failure
Cor Pulmonale
