Cell signaling of adjacent cells. In cardiac muscle, gap junctions between adjacent cells allows for action potential propagation from the cardiac pacemaker region of the heart to spread and coordinately cause contraction of the heart. The notch signaling mechanism is an example of juxtacrine signaling (also known as contact-dependent signaling) in which two adjacent cells must make physical contact in order to communicate. This requirement for direct contact allows for very precise control of cell differentiation during embryonic development. In the worm "Caenorhabditis elegans", two cells of the developing gonad each have an equal chance of terminally differentiating or becoming a uterine
Strain rate imaging Cardiac stress test), the regional dysfunction due to ischemia will become evident when the myocardial oxygen demand surpasses the Coronary flow reserve of a stenosed coronary artery. Strain rate imaging during stress has been shown to give incremental value over ordinary echocardiography, both diagnostic and prognostic. In stress echo, the increased heart rate has speckle tracking at a disadvantage, due to the limited frame rate that affects tracking at higher heart rates. In Left bundle branch block (LBBB), the asynchronous activation of the left ventricle gives asynchronous contraction as well. This asynchrony can be visualised by ordinary echocardiography. It can