Synchronized Pressure-Strain Echocardiography

Left ventricular pressure was measured by a micromanometer-tipped catheter (Millar) and a fluid-filled catheter connected to an external pressure transducer served as an absolute pressure reference. Brachial artery cuff pressure was measured. Myocardial strain was measured by STE in apical long-axis and two- and four-chamber views (frame rate 67 ± 7s⁻¹), and 2D images with a narrow sector over the valves (frame rate 91 ± 23 s⁻¹) were used to define opening and closure of the aortic and mitral valves. Pressure and strain data were recorded in a synchronized fashion and stored on the scanner for offline analysis. Echocardiography was performed immediately after the PET study. Patients with echocardiography images not amenable for speckle tracking were excluded prior to invasive pressure measurements (n = 2). An average of 16 ± 2 segments were analysed in each patient.