Two-dimensional speckle tracking strain in follow-up of adults with transposition of the great arteries: Should it be used in daily clinical practice? (original) (raw)
Related papers
Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology, 2018
Transposition of the great arteries (TGA) is a rare form of congenital heart disease in which most patients reach adulthood. Right ventricular dysfunction is the most severe residual complication in long-term follow-up, both in patients treated by atrial switch and in those with congenitally corrected TGA. New echocardiographic tools such as longitudinal strain by two-dimensional (2D) speckle tracking may improve assessment of ventricular function in these patients. We performed a retrospective analysis of echocardiograms in adult patients with TGA (26 patients with dextro-TGA - 15 treated by atrial switch and six by arterial switch - and five with congenitally corrected TGA) and in a control group of 14 healthy individuals. Right ventricular strain was significantly worse (p<0.001), as was the corresponding annular plane systolic excursion (p=0.010) in atrial switch patients, in comparison to arterial switch patients, while no differences were found in left ventricular parameter...
International journal of cardiology, 2014
Two-dimensional speckle tracking echocardiography (2DSTE) has been used widely in research, but rarely in clinical practice because data acquisition and analysis are time-consuming. By reducing the acquisition and analysis time, 3-dimensional STE may improve clinical impact. We investigated the feasibility of 3DSTE myocardial deformation, with comparison to 2DSTE. Transthoracic 3DSTE and 2DSTE were performed in 230 adults (138 men, 51 ± 14 years, and 142 hypertension, 10 heart failure and 78 normotensive subjects). The variables of LV deformation were analyzed using EchoPAC software. The 3D LV longitudinal (LS) analysis was feasible in 84.9% of the study subjects, which was lower than the 2D analysis (97.2%). The success rates for circumferential strain (CS) and radial strain (RS) were similar between the 2D and 3D techniques. All magnitude of strains measured by 2DSTE and 3DSTE were significantly correlated. The magnitude of 3D LS and CS was lower, but the 3D RS is higher than that...
European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology, 2010
To validate intramural strain measured by a speckle tracking imaging (STI) system against that measured by sonomicrometry crystals. In 11 anaesthetized sheep, six sets of three sonomicrometry crystals were implanted in endo-, mid-wall, and epimyocardium on the anterior and lateral walls. Circumferential strain (CS) was calculated at three layers from endo-, mid-wall, and epicardial speckle. Radial strain (RS) was assessed for inner and outer halves of the myocardium. We compared ultrasound-derived strain measurements against those by sonomicrometry at baseline and during pharmacological stress and coronary occlusion. Intraclass correlation coefficients at baseline and during coronary occlusion were as follows: endocardial CS 0.80, 0.97; mid-wall CS 0.58, 0.89; epicardial CS 0.71, 0.81; endocardial RS 0.50, 0.78; epicardial RS 0.35, 0.83; and total RS 0.33, 0.71; respectively. At baseline, endocardial strains were higher than mid-wall and epicardial strains, resulting in an inner/out...
The Egyptian Heart Journal, 2017
Background: Significant coronary artery stenosis might cause persistently impaired longitudinal left ventricle (LV) function at rest. LV global longitudinal strain (LVGLS) can be accurately assessed by 2D speckle-tracking strain echocardiography(2D-STE). Objective: We aimed to evaluate the diagnostic accuracy of LV global longitudinal strain obtained by 2D-STE in prediction of severity of CAD. Methods: Eighty patients with suspected stable angina pectoris were included. They underwent transthoracic echocardiography (TTE) to measure LV ejection fraction, 2-D-STE to measure GLS and coronary angiography (CA). The patients were divided into two groups: group 1 (58 patients) with significant (>70%) CAD, and group 2 (22 patients) with non-significant (<70%) CAD. Images were obtained in the apical long-axis, four-chamber, and two chamber views. Regional longitudinal systolic strain was measured in 17 myocardial segments and averaged to provide global longitudinal strain (LVGLS). Results: There was significant decrease in GLS in group 1 compared to group 2 (À11.86 ± 2.89% versus À18.65 ± 0.79%, P < 0.000). The optimal cutoff value of GLS for prediction of significant CAD was À15.6% [AUC 0.88, 95% CI 0.78-0.96 p < 0.000]. The sensitivity, specificity and accuracy of GLS for detecting significant CAD were 93.1%, 81.8%,and 90% respectively.There was a significant positive correlation between GLS and EF (r = 0.33; p = 0.036).There was incremental significant decrease in GLS with increasing number of coronary vessels involved. Conclusion: Measurement of global longitudinal strain using 2D speckle tracking echocardiography is sensitive and accurate tool in the prediction of severe CAD.
Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography, 2017
Although left ventricular global longitudinal strain (GLS) is an index of systolic function recommended by the guidelines, poor image quality may hamper strain measurements. While contrast agents are commonly used to improve endocardial visualization, no commercial speckle-tracking software is able to measure strain in contrast-enhanced images. This study aimed to test the accuracy of speckle-tracking software when applied to contrast-enhanced images in patients with suboptimal image quality. We studied patients with a wide range of GLS values who underwent transthoracic echocardiography. Protocol 1 included 44 patients whose images justified use of contrast but still allowed noncontrast speckle-tracking echocardiography (STE), which was judged as accurate and used as a reference. Protocol 2 included 20 patients with poor image quality that precluded noncontrast STE; cardiac magnetic resonance- (CMR-) derived strain was used as the reference instead. Half the manufacturer recommende...
Noninvasive Myocardial Strain Measurement by Speckle Tracking Echocardiography
Journal of The American College of Cardiology, 2006
The aim of this study was to validate speckle tracking echocardiography (STE) as a method for angle-independent measurement of regional myocardial strain, using sonomicrometry and magnetic resonance imaging (MRI) tagging as reference methods.Tissue Doppler imaging allows non-invasive measurement of myocardial strain in the left ventricle (LV), but is limited by angle dependency.Strain measurements with STE were obtained by a custom-made program that allowed tracking of two-dimensional motion of speckle patterns in a B-mode image. In anesthetized dogs, we compared LV long- and short-axis measurements by STE to sonomicrometry during preload changes and regional myocardial ischemia. Measurements in the two orthogonal axes were obtained simultaneously in a single imaging plane. In human subjects, long-axis strain by STE and MRI tagging were compared in multiple segments of the LV.In the experimental study there was good correlation and agreement between STE and sonomicrometry for systolic strain in the long axis (r = 0.90, p < 0.001; 95% limits of agreement −4.4% to 5.0%) and systolic shortening in the short axis (r = 0.79, p < 0.001; −5.6% to 5.1%). In the clinical study, 80% of the segments could be analyzed, and correlation and agreement between STE and MRI tagging were good (r = 0.87, p < 0.001; −9.1% to 8.0%).Speckle tracking echocardiography provides accurate and angle-independent measurements of LV dimensions and strains and has potential to become a clinical bedside tool for quantifying myocardial strain.
American Journal of Cardiology, 2006
We investigated the influence of ≥70% luminal coronary artery stenosis on regional diastolic deformation at rest using 2-dimensional strain echocardiography. We prospectively imaged patients during/within 24 hours of coronary angiography. Longitudinal systolic (SRs), early (SRe), and late diastolic strain rates, systolic, early, and late diastolic strain and times to isovolumic relaxation and peak SRe were measured in the 3 major vascular territories. Regions subtended by ≥70% coronary stenosis were labeled ischemic. Ischemic regions were compared with the same region in patients without significant coronary stenosis. Of 61 enrolled patients (38 men), 39 had ≥70% coronary stenosis (1 vessel in 14, 2 vessels in 15, 3 vessels in 10), and 15 had normal coronary arteries. There were no significant differences between the normal and ischemic groups with regard to age (59 ± 13 vs 64 ± 10 years, p = 0.20), clinical variables (dyslipidemia, smoking, diabetes), systolic (130 ± 26 vs 139 ± 31 mm Hg, p = 0.38) or diastolic (72 ± 13 vs 72 ± 11 mm Hg, p = 0.81) blood pressure and ejection fraction (58 ± 12% vs 56 ± 11%, p = 0.66). SRs and SRe were significantly decreased in ischemic compared with normal regions in all vascular distributions. SRs and SRe together (values below cutoff) or SRe alone were the most specific (93%) and SRe or SRs below cutoff the most sensitive (93%) parameters for detecting ischemic regions. In conclusion, analysis of regional deformation by 2-dimensional strain echocardiography enables detection of significantly diseased coronary arteries at rest. Altered diastolic deformation at rest identifies regions subtended by ≥70% coronary stenosis with high specificity.