Noninvasive myocardial strain measurement by speckle tracking echocardiography: validation against sonomicrometry and tagged magnetic resonance imaging

Brage H Amundsen, Thomas Helle-Valle, Thor Edvardsen, Hans Torp, Jonas Crosby, Erik Lyseggen, Asbjørn Støylen, Halfdan Ihlen, João A C Lima, Otto A Smiseth, Stig A Slørdahl, Brage H Amundsen, Thomas Helle-Valle, Thor Edvardsen, Hans Torp, Jonas Crosby, Erik Lyseggen, Asbjørn Støylen, Halfdan Ihlen, João A C Lima, Otto A Smiseth, Stig A Slørdahl

Abstract

Objectives: 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.

Background: Tissue Doppler imaging allows non-invasive measurement of myocardial strain in the left ventricle (LV), but is limited by angle dependency.

Methods: 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.

Results: 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%).

Conclusions: 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.

Source: PubMed

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