Aurora over Trondheim tonight

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

Winter is coming

#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.

#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

#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.

#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.

#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

Diastasis is the interval between heart cycles, not between early and late filling of a single heart cycle, thus EA fusion of increasing HR. Early filling releases elastic energy from previous systolic compression, atrial systole stretches the ventricles before following systole. Vortex is conserved

Early filling is LV recoil during last part of relaxation, while LV pressure⬇️ . AV plane motion generates vorticity starting at the base, the filling phase propagates from base to apex as a wave of wall deformation and flow velocity propagation and later vortex expansion.

#Cardiosky Not surprising, but nice to have it documented. Evidence is mounting that there is no effect at all, of betablocker in CAD with preserved EF www.sciencedirect.com/science/arti...

This is how to #CardioSky like a pro.

#Cardiosky LV contraction does not mean shortening, but tension increase, LV relaxation does not mean lengthening, but tension decrease. They are not simultaneous through the heart cycle.

Nacros cloud over Trondheim, with Venus and possibly the comet G3

Nacreous clouds over Trondheim this morning.

Botticelli, Goya or Munch?

#cardiosky Measuring LVOT velocities should be done above the acceleration zone, using functional, not anatomical assessment. The LVOT signal for the cw signal will always show the accelerated velocities, the convergent zone having higher intensity, and cannot be used for LVOT velocities.

The majestic icebergs of theIlulissat icefjord on Greenland

This study highlights the importance of strength training in addition to cardio exercise in the treatment plan for cardiac patients. Exercise Therapy Rescues Skeletal Muscle Dysfunction and Exercise Intolerance in Cardiometabolic HFpEF in Mouse Model #cardiosky www.jacc.org/doi/10.1016/...

#BestDiets #FoodisMedicine by @usnews For Heart Health: #1: DASH Diet #2: Mediterranean Diet @SmidtHeart @WomensHeartCS #CVPrev #Cardiosky ⤴️PLANTS🌱 ⤴️ Health fats:🥑🐟 ⤵️Processed foods ⤵️ Sugar ⤵️ Saturated/Trans fats ⤵️ Salt🧂 #NoMagicDiet See: health.usnews.com/best-diet

Titin is vital in diastolic function: Restoring forces i.e. active recoil.

IVR has constant volume, but shape change. All parts of the ventricle relax, but the apex relaxes most, and hence is most Energy demanding, the shortening of the base is not wasted work. The reconfiguration generates apical flow, giving momentum to the subsequent early filling

#CardioSky Protodiastole. Described already by Wiggers. The negative TDI spike in septum, after ejection, before e', is protodiastole, before AVC, not IVR.

I’ve made a feed for #euroecho24, it will collect all posts mentioning EuroEcho with or without hashtags. I also updated my #echosky feed to do the same bsky.app/profile/did:...

My dear colleague Ann Hjorth-Hansen presenting sobering results on automatic EF with handheld ultrasound, performed by GPs, nurses and cardiologists respectively, underlining the importance of clinical validation in real world settings before use. #POCUS #FOAMed #EuroEcho

In fact, E/e' is a confounded measure; Epeak is a function of peak AV pressure gradient, not mean LA pressure, e' is a function of early LV compliance, which are related to relaxation and IVRT.

Og hvis de samtidig stryper de offentlige helsebudsjettene, er kursen lagt mot pivatisering. www.aftenposten.no/norge/politi...

Baking for Christmas

If MAPSE is a better prognosticator, and thus possibly dignostic than GLS , what do we need strain for? For diagnosis of regional dysfunction.

#EJHCVI @jgrapsa.bsky.social #CardioSky #MedSky #whyCMR #EchoSky #pocus

#Cardiosky #Echosky On relative longitudinal LV shortening; GLS.

The reason MAPSE is a better prognosticator, is that it isn't confounded by body size (physiological heart size). pubmed.ncbi.nlm.nih.gov/35132872/

Jörgen Holmgren is often credited as the first technician to assist in acquiring and interpreting echocardiographic images. Inge Edler and Hellmuth Hertz frequently expressed admiration for his contributions to their work! #echofirst #medsky #cardiosky #unsunghero

#birds Grey mantled albatross. Drake passage

#CardioSky #EchoSky #MAPSE New version, relation of MAPSE to SV, EF in ageing, BSA, and HF. MAPSE is a better prognosticator than EF and GLS