🇳🇴Asbjørn Støylen🇩🇰

US anti-vax stance to blame for continent-wide surge in measles, say experts

Aurora over Trondheim tonight

Intraventricular pressure difference estimation based on blood speckle tracking—invasive validation and early clinical application AbstractAims. Ventricular relaxation creates an intraventricular pressure difference (IVPD) and resultant diastolic suction. Non-invasive estimation by ech

#Cardiosky. Blood speckle tracking. No longer only visualisation. Validation of quantitative intraventricular pressure gradient measurement. Congratulation. academic.oup.com/ehjcimaging/...

Winter is coming

Not sure I would accept the validity of physiology derived partly from a circular reference

Imaging-based method to quantify left ventricular diastolic pressures AbstractAims. To establish an imaging-based method to quantify left ventricular (LV) diastolic pressures.Methods and results. In 115 patients suspected of

#Cardiosky Attempt to estimate LA pressure from echo. The formula uses among other measures tau, non invasive estimated from among other IVRT. But IVRT depends both on tau and LAP. How is that for circular reasoning?
doi.org/10.1093/ehjc...

#Cardiosky Regional strain pressure loops. Do they add information to regional strain? (Spoiler alert: they don't)

#Cardiosky Fractional longitudinal LV shortening.
An alternative to LV GLS

#EchoSky Nine uncomfortable facts about Global longitudinal left ventricular strain.

#Cardiosky Contractility cannot be measured by cardial imaging; all imaging measures shortening (=volume reduction), which is load dependent.
Myocardial contraction is not shortening, during systole there is both contraction without shortening, and shortening without contraction.

Since BSA don't change, I'd suppose it will follow MAPSE very closely, thus reflecting SV, but I can't see any advantage over MAPSE.

#Cardiosky. Being both pre-and afterload dependent, myocardial stroke work is not a contractility measure. As GLS do not correlate with SV, Strain pressure loops do not measure stroke work.

#Cardiosky When has normal EF been equivalent to normal LV function?!??

#Cardiosky Atrial contraction strain. Numerator is AV-plane motion during atrial systole, expressing volume injected into the ventricle (i.e. the A wave). Denominator is atrial length, but as volume is partly a function of ventricular EDP, ventricular compliance is a confounder.

#Cardiosky Atria fills during ventricular ejection and early ventricular diastole. In ventr. ejection, atria expand by apical AV-plane motion driven by ventricular shortening. In early diastole, atria fill by ventricular transverse recoil/expansion, as the atria are compressed longitudinally.

#Cardiosky #Echosky The north wind is just as cold blowing from the front or the back. AV-plane motion does not change interpretation when seen from the atrium or the ventricle. And what is the physiological meaning of MAPSE relative to atrial size??? On LA strain during ventricular systole.

The Aurora exploded over Trondheim tonight

#Cardiosky #Echosky Atrial filling and emptying is related to ventricular systolic and diastolic ventricular function, as volume changes are mainly a function of AV-plane motion within a relatively unchanged outer heart contour

Animations will still be in *.GIF format, so they will run on web browsers, and can be embedded in presentations. Pictures and animations are still free to use, with due credit. Strain and strain rate are the concepts of myocardial deformation. My basic views are still that

#Cardiosky #Echosky I have collected some recent posters from Bluesky / Twitter and some diagrams from the strain rate website in a compendium on Left ventricular mechanics. It can bee downloaded (free) as *.pdf. from the strain rate front page. stoylen.folk.ntnu.no/strainrate/

#Cardiosky #Echosky LV ejection is a complex interaction between LV contraction - relaxation, flow acceleration - deceleration and artery - ventricular coupling.

#Cardiosky #Echosky
Pre ejection velocity
-occurs before MVC, and is not isovolumic.
-is true ventricular contraction, not atrial recoil
-is the true LV electromechanical activation timepoint.
-peak pre ejection velocity or acceleration is not an LV contractility measure

#Cardiosky #Echosky Late filling is the atrial systole, driven by the atrial pressure increase, propagated into the LV as pulse propagation, seen as a deformation wave from base to apex.

Thank you very much.

bsky.app/profile/ourh...

In the physiological aspects, as these were largely overlapping anyway.There will be discussions of validity on composite measures, these will be based almost solely on physiological principles.

Pseudodyskinesia looks all kormal in longitudinal strain, se example here: stoylen.folk.ntnu.no/strainrate/B...

#Cardiosky #Echosky MAPSE and GLS are sensitive to both HFpEF and HFrEF. GLS is confounded by BSA, MAPSE is not, both are age dependent. EF is insensitive to HFpEF, but BSA and age. independent. All are load dependent.

-or could it be the opposite, coffe later in the day is more dangerous?...

#Cardiosky #Echosky MAPSE generates a constant % of SV. MAPSE is sex independent, and near near body size independent. MAPSE correlates with SV and EF.
GLS (numerical) decreases with increasing body size, and is higher in women. GLS correlates with EF, but not with SV, so GLS based GMW is not valid.

Over at the other site somebody is boasting to have saved a life but stenting a proximal Cx in an asymptomatic patient (big yellow arrows underscore the success!)

I think it could be argued that this patient was actually harmed, given the never-ending 2% annual event rate of any PCI.

#cardiosky