Figure 4 This figure shows transverse view at the level of the mitral valve from the parasternal short axis using full-volume 3D imaging in a patient with prolapse of posterior leaflet and ruptured chordae (arrow). The accuracy, feasibility, and value of 3D echocardiography also have been demonstrated in the operating room.57 In addition, the use of contrast 3D echocardiography has several advantages to improve left ventricular volumes quantification.58 The clinical applications of 3D Inhibitors,research,lifescience,medical echocardiography are expanding rapidly, but quantitative measurements of LV volumes, RWMA,

congenital heart disease, valvular disease (figure 4), and evaluation of ventricular dyssynchrony are the most common indications of real-time 3D echocardiography. The advantages of 3D echocardiography over 2D echocardiography include improvements in visualization Inhibitors,research,lifescience,medical of complex shapes and relations SN-38 nmr between cardiac structures, calculation of cardiac volumes, mass, and function, imagination of color Doppler flow fields, and assessment of valvular abnormalities and dysfunctions. Tissue Doppler Imaging (TDI) and Strain and Strain Rate Imaging (SRI) The Doppler technique

is used to measure myocardial velocities because of different signal amplitudes and Doppler frequencies between the blood and myocardium. Inhibitors,research,lifescience,medical The myocardial motion speed is much lower than that of the blood; however, the amplitude of myocardial signals is much higher than those for the blood. These differences

allow the separation of myocardial velocities from Inhibitors,research,lifescience,medical blood flow velocities by filters, which reject echo signals originating from the blood pool. Velocities can be recorded using color Doppler or pulsed wave Doppler. Myocardial velocity imaging was first introduced in the early 1990s,59,60 and is now well established Inhibitors,research,lifescience,medical for quantifying the LV systolic and diastolic function. Myocardial motion can be imaged in real time as color-coded velocities superimposed on a 2D gray scale image. The frame rate for 2D color Doppler is between 80-200 frames per second, depending on the sector width, and is usually set higher than for the simultaneous gray scale images. The myocardial velocities can be analyzed offline though (figure 5). Figure 5 This figure shows offline analyses of tissue secondly Doppler imaging from apical 4-chamber view at basal, middle and apical segments of interventricular septum in a healthy individual. Tissue Doppler velocity imaging can be applied clinically to diagnose myocardial ischemia, to evaluate patients with diastolic dysfunction and select patients for cardiac resynchronization therapy by assessment of ventricular dyssynchrony (figure 6). Figure 6 This figure shows the assessment of left ventricular dyssynchrony by tissue Doppler imaging from apical 4-chamber view in a normal patient (right panel) versus a patient with LBBB (left panel).