Background .– Two-dimensional (2D) speckle tracking echocardiographic strain analysis has demonstrated good capacities in the quantification of left ventricular (LV) contraction but it is limited by LV geometric modelling and the assumption that speckles can be tracked from frame to frame, despite their out of plane motion.
Aims .– First, to evaluate the reproducibility of 2D and real-time tridimensional echocardiography (RT3DE) analysis of global longitudinal (GLS), circumferential (GCS), radial (GRS), and area (GAS) systolic strains. Second, to study values in different populations: healthy subjects, hypertrophic cardiomyopathy (HCM), dilated cardiomyopathy (DCM), and ischemic cardiomyopathy (ICM).
Methods and results .– After exclusion of 54 patients for poor quality window or arrhythmia, GLS, GCS, GRS, and GAS were determined in 171 subjects (40 healthy individuals, 30 HCM, 34 DCM, 30 ICM, and 37 others indications) by 2D and RT3DE. Mean intra-observer (novice) and inter-observer (novice vs expert) variabilities were 7% and 10% for 3D GLS, 6% and 12% for GCS, 6% and 10% for GRS, and 5% and 8% for GAS. The best correlations with LV output were obtained for GAS (y = –0.11x + 1.27, r = 0.74, P < 0.001). Values obtained in controls and in the different populations of patients (HCM, ICD, DCM) are presented in the Table. Patients with HCM and normal EF had significant decrease in GLS, GCS and GAS but nor GRS (compared to controls). In ICM and DCM, all strains were significantly decreased compared to controls.
Conclusion .– New RT3DE strain analysis is robust and accurate with greater reproducibility than 2DE particularly concerning radial strain. Area strain is the greatest parameter correlated to LV output. The reference values for 3D global strains were obtained in a healthy population and is available for use in a wide clinical setting.
| Controls ( n = 40) | HCM ( n = 30) | ICM ( n = 30) | DCM ( n = 34) | |
|---|---|---|---|---|
| LVEF (%) | 64.2 ± 5.7 | 63.2 ± 10.8 | 42.9 ± 13.0 * | 37.1 ± 11.2 * |
| GLS (%) | –19.2 ± 2.1 | –16.0 ± 2.5 * | –10.9 ± 3.3 * | –9.6 ± 3.3 * |
| GCS (%) | –19.5 ± 2.7 | –17.5 ± 4.7 * | –11.7 ± 5.1 * | –9.5 ± 3.8 * |
| GRS (%) | 53.4 ± 8.9 | 47.1 ± 10.4 | 28.7 ± 12.7 * | 23.2 ± 9.3 * |
| GAS (%) | –32.7 ± 3.4 | –29.7 ± 5.3 * | –19.7 ± 7.0 * | –17.1 ± 6.1 * |
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
