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Pastore MC, Mandoli GE, Contorni F, Cavigli L, Focardi M, D'Ascenzi F, Patti G, Mondillo S, Cameli M. Speckle Tracking Echocardiography: Early Predictor of Diagnosis and Prognosis in Coronary Artery Disease. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6685378. [PMID: 33623788 PMCID: PMC7875622 DOI: 10.1155/2021/6685378] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/12/2020] [Accepted: 01/23/2021] [Indexed: 01/24/2023]
Abstract
Echocardiography represents a first level technique for the evaluation of coronary artery disease (CAD) which supports clinicians in the diagnostic and prognostic workup of these syndromes. However, visual estimation of wall motion abnormalities sometimes fails in detecting less clear or transient myocardial ischemia and in providing accurate differential diagnosis. Speckle tracking echocardiography (STE) is a widely available noninvasive tool that could easily and quickly provide additive information over basic echocardiography, since it is able to identify subtle myocardial damage and to localize ischemic territories in accordance to the coronary lesions, obtaining a clear visualization with a "polar map" useful for differential diagnosis and management. Therefore, it has increasingly been applied in acute and chronic coronary syndromes using rest and stress echocardiography, showing good results in terms of prediction of CAD, clinical outcome, left ventricular remodeling, presence, and quantification of new/residual ischemia. The aim of this review is to illustrate the current available evidence on STE usefulness for the assessment and follow-up of CAD, discussing the main findings on bidimensional and tridimensional strain parameters and their potential application in clinical practice.
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Affiliation(s)
- Maria Concetta Pastore
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Italy
- University of Eastern Piedmont, Maggiore della Carità Hospital, Novara, Italy
| | - Giulia Elena Mandoli
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Italy
| | - Francesco Contorni
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Italy
| | - Luna Cavigli
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Italy
| | - Marta Focardi
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Italy
| | - Flavio D'Ascenzi
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Italy
| | - Giuseppe Patti
- University of Eastern Piedmont, Maggiore della Carità Hospital, Novara, Italy
| | - Sergio Mondillo
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Italy
| | - Matteo Cameli
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Italy
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Bakkestrøm R, Christensen NL, Wolsk E, Banke A, Dahl JS, Andersen MJ, Gustafsson F, Hassager C, Møller JE. Layer-specific deformation analysis in severe aortic valve stenosis, primary mitral valve regurgitation, and healthy individuals validated against invasive hemodynamic measurements of heart function. Echocardiography 2018; 35:170-178. [DOI: 10.1111/echo.13747] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Affiliation(s)
- Rine Bakkestrøm
- Department of Cardiology; Odense University Hospital; Odense Denmark
| | | | - Emil Wolsk
- The Heart Center; Copenhagen University Hospital; Rigshospitalet; Copenhagen Denmark
| | - Ann Banke
- Department of Cardiology; Odense University Hospital; Odense Denmark
| | - Jordi S. Dahl
- Department of Cardiology; Odense University Hospital; Odense Denmark
| | - Mads J. Andersen
- The Heart Center; Copenhagen University Hospital; Rigshospitalet; Copenhagen Denmark
| | - Finn Gustafsson
- The Heart Center; Copenhagen University Hospital; Rigshospitalet; Copenhagen Denmark
| | - Christian Hassager
- The Heart Center; Copenhagen University Hospital; Rigshospitalet; Copenhagen Denmark
| | - Jacob E. Møller
- Department of Cardiology; Odense University Hospital; Odense Denmark
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Maceira AM, Tuset-Sanchis L, López-Garrido M, San Andres M, López-Lereu MP, Monmeneu JV, García-González MP, Higueras L. Feasibility and reproducibility of feature-tracking-based strain and strain rate measures of the left ventricle in different diseases and genders. J Magn Reson Imaging 2017; 47:1415-1425. [PMID: 29205626 DOI: 10.1002/jmri.25894] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 09/23/2017] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND The measurement of myocardial deformation by strain analysis is an evolving tool to quantify regional and global myocardial function. PURPOSE To assess the feasibility and reproducibility of myocardial strain/strain rate measurements with magnetic resonance feature tracking (MR-FT) in healthy subjects and in patient groups. STUDY TYPE Prospective study. POPULATION Sixty patients (20 hypertensives with left ventricular (LV) hypertrophy (H); 20 nonischemic dilated cardiomyopathy (D); 20 ischemic heart disease (I); as well as 20 controls (C) were included, 10 men and 10 women in each group. FIELD STRENGTH/SEQUENCE A 1.5T MR protocol including steady-state free precession (SSFP) cine sequences in the standard views and late enhancement sequences. ASSESSMENT LV volumes, mass, global and regional radial, circumferential, and longitudinal strain/strain rate were measured using CVI42 software. The analysis time was recorded. STATISTICAL TESTS Intraobserver and interobserver agreement and intraclass correlation coefficients (ICC) were obtained for reproducibility assessment as well as differences according to gender and group of pertinence. RESULTS Strain/strain rate analysis could be achieved in all subjects. The average analysis time was 14 ± 3 minutes. The average intraobserver ICC was excellent (ICC >0.90) for strain and good (ICC >0.75) for strain rate. Reproducibility of strain measurements was good to excellent (ICC >0.75) for all groups of subjects and both genders. Reproducibility of strain measurements was good for basal segments (ICC >0.75) and excellent for middle and apical segments (ICC >0.90). Reproducibility of strain rate measurements was moderate for basal segments (ICC >0.50) and good for middle and apical segments. DATA CONCLUSION MR-FT for strain/strain rate analysis is a feasible and highly reproducible technique. CVI42 FT analysis was equally feasible and reproducible in various pathologies and between genders. Better reproducibility was seen globally for middle and apical segments, which needs further clarification. LEVEL OF EVIDENCE 3 Technical Efficacy Stage 2 J. Magn. Reson. Imaging 2018;47:1415-1425.
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Affiliation(s)
- Alicia M Maceira
- Cardiovascular Imaging Unit, ERESA Medical Center, Valencia, Spain.,Department of Medicine, Health Sciences School, CEU-Cardenal Herrera University, Moncada-Valencia, Spain
| | | | - Miguel López-Garrido
- UGC Área del Corazón, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Málaga, Red de Investigación Cardiovascular, Spain
| | - Marta San Andres
- Cardiovascular Imaging Unit, ERESA Medical Center, Valencia, Spain
| | | | - Jose V Monmeneu
- Cardiovascular Imaging Unit, ERESA Medical Center, Valencia, Spain
| | | | - Laura Higueras
- Cardiovascular Imaging Unit, ERESA Medical Center, Valencia, Spain
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Wang Y, Shan G, Shen J, Zhou Q, Tan B, Liu Y, Luo R, Zhao S, Bi W, Yao F, Li G. Assessment of left ventricular function in chronic alcoholics by real-time three-dimensional echocardiography. Medicine (Baltimore) 2017; 96:e6033. [PMID: 28151910 PMCID: PMC5293473 DOI: 10.1097/md.0000000000006033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Chronic alcohol consumption may lead to progressive cardiac dysfunction. The aim of this study was to evaluate the feasibility of using real-time 3-dimensional echocardiography (3DE) on assessing left ventricular (LV) function in chronic alcoholics.We classified 92 male alcoholics into mild, moderate, and severe groups; 30 age-matched controls were also recruited. LV end-diastolic volume (LVEDV), LV end-systolic volume (LVESV), LV ejection fraction (LVEF), LV mass (LVM), LV mass index (LVMI), and systolic dyssynchrony index (SDI) were measured by 3DE and 2-dimensional echocardiography (2DE).Compared to the control group, LV volume and mass were higher in the moderate and severe alcoholic groups (P < 0.05). The severe alcoholic (symptomatic) group demonstrated decreased LVEF and increased SDI (detected by 3DE) (P < 0.05).Real-time 3DE can detect the increases of LV volumes and mass in asymptomatic alcoholics, and the changes of LVEF and systolic synchrony index in symptomatic alcoholics.
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Affiliation(s)
- Yuanzheng Wang
- Department of Ultrasound, The Xinhua Affiliated Hospital of Dalian University, Shahekou District, Dalian, Liaoning
| | - Guoxin Shan
- Department of Ultrasound, the Weifang Traditional Chinese Hospital, Kuiwen District, Weifang, Shandong, China
| | - Jiaqi Shen
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University
| | - Qiao Zhou
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University
| | - Bijun Tan
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University
| | - Yue Liu
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University
| | - Runlan Luo
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University
| | - Shifen Zhao
- Department of Ultrasound, The Xinhua Affiliated Hospital of Dalian University, Shahekou District, Dalian, Liaoning
| | - Wenjun Bi
- Department of Ultrasound, The Xinhua Affiliated Hospital of Dalian University, Shahekou District, Dalian, Liaoning
| | - Fangyi Yao
- Department of Ultrasound, The Xinhua Affiliated Hospital of Dalian University, Shahekou District, Dalian, Liaoning
| | - Guangsen Li
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University
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Leischik R, Dworrak B, Hensel K. Intraobserver and interobserver reproducibility for radial, circumferential and longitudinal strain echocardiography. Open Cardiovasc Med J 2014; 8:102-9. [PMID: 25356089 PMCID: PMC4211138 DOI: 10.2174/1874192401408010102] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Revised: 06/26/2014] [Accepted: 06/29/2013] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES Strain echocardiography (StE) promises to be a new tool for quantitative assessment of cardiac function. Analysis of intra- and interobserver reliability is an important aspect in the process of developing these novel techniques from theory to the implementation into daily routine diagnostics.The purpose of the study was to estimate reliability of the segmental StE. METHODS Left ventricular strain analysis for radial strain (RS), circumferential strain (CS) and longitudinal strain (LS) was performed in 21 healthy volunteers. RS and CS values were obtained in the parasternal short axis at the level of the papillary muscles. LS values were determined in the apical 2-, 3- and 4-chamber views. Cine-loops were recorded and quantitative analyses were conducted on an off-line workstation. RESULTS Intraobserver reproducibility was highest using LS in the 4-chamber view (9 ± 13.6 % mean deviation, rho = 0.624, p = 0.003), followed by CS (13.3 ± 8.3 %, rho = 0.406, p = 0.068) and lowest in RS (26.3 ± 30.1 %, rho = 0.391, p = 0.080). Interobserver analyses of LS derived from 3-chamber view showed lowest deviation (11.9 ± 9.5 %, rho = 0.513, p = 0.017), followed by CS (15.2 ± 12.0 %, 0.263, p = 0.249) and the least consistent measurements in RS (35.9 ± 46.3 %, rho 0.382, p = 0.088). CONCLUSION This study shows that the clinical utility of StE depends on the regional differences of LV wall motion and image quality. LS-values showed promising intra- and interobserver reproducibility values. For quantitative follow-up studies LS should be preferred.
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Affiliation(s)
- R. Leischik
- Department of Cardiology, Section Prevention and Sports Medicine, Witten/Herdecke University, Faculty of Health, School of Medicine, Hagen, Germany
| | - B. Dworrak
- Department of Cardiology, Section Prevention and Sports Medicine, Witten/Herdecke University, Faculty of Health, School of Medicine, Hagen, Germany
| | - K. Hensel
- Helios Children Hospital, Witten/Herdecke University, Faculty of Health, School of Medicine, Wuppertal, Germany
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Early changes of left ventricular geometry and deformational analysis in obese subjects without cardiovascular risk factors: a three-dimensional and speckle tracking echocardiographic study. Int J Cardiovasc Imaging 2014; 30:1037-47. [PMID: 24794426 DOI: 10.1007/s10554-014-0429-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2014] [Accepted: 04/18/2014] [Indexed: 02/06/2023]
Abstract
Subclinical myocardial dysfunction has been identified in obese subjects without cardiovascular risks factors and has been defined as "obesity cardiomyopathy". We evaluated left ventricular (LV) function and geometry in obese patients by using a 3 dimensional echocardiography (3DE). We also aimed to look at the influence of ventricular geometry upon functional parameters of the LV by using 3D speckle tracking imaging (3D-STI). 30 consecutive and asymptomatic obese cases (OB group) with no comorbidities were prospectively enrolled. The control group included 30 healthy volunteers (HS group), matched for age and sex. All subjects underwent 3DE and 3D-STI. Ventricular geometry was evaluated with the LV sphericity index (LV SpI) and the LV diastolic volume to mass ratio (LV EDV/Mass ratio). LV Mass was significantly increased in OB group and the LV EDV/Mass ratio had a significantly lower mean value in this group (p < 0.001 and p = 0.002, respectively). LV SpI was significantly reduced in obese subjects (p < 0.001). A significant reduction in longitudinal (GLS), radial (GRS) and area strain (GAS) was observed in OB group (p = 0.001 for all) while circumferential mechanic (GCS) was not different between the two groups (p = 0.052). LV EDV to mass ratio was significantly related to GLS (r = -0.298, p = 0.022) and GAS (r = -0.289, p = 0.026). On multivariate analysis, GRS and GAS were independently related to LV SpI (β = 0.222, p = 0.031 and β = -0.222, p = 0.034, respectively). Geometrical and structural ventricular remodeling negatively influences functional properties of the LV in obese subjects without cardiovascular risks factors. Further studies are needed to assess the prognostic value of our findings.
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