Effects of LV foreshorthening on AFI strain

Effects of LV 4-chamber foreshortening on myocardial AFI longitudinal strain

June 18, 2022
Pages 1 – 4

68-year-old female patient, BSA= 1.7 m², HR= 64 bpm.
Pre-discharge exam after CABG. Known arterial hypertension and LV hypertrophy (prevalently septal). LV biplane end-diastolic volume index= 41 mlm²; ejection fraction= 61 %. Class I diastolic dysfunction (prolonged relaxation and normal filling pressures).

Figure 1. AFI strain, 2D apical 4-chamber, operator 1

Figure 2. AFI strain, 2D apical 4-chamber, operator 2

AFI strain algorithm applied to the 4-chamber view.
Figure 1: 4-chamber view acquired by Operator 1, unaware of the problem of LV foreshortening. Note the marked foreshortening of the LV long axis, and overall deformation of the LV cavity.
Figure 2: 4-chamber view acquired by Operator 2 (experienced, aware of the problem of LV foreshortening).

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