Evaluation Of Left Ventricular Strains In Patients With Chronic Heart Failure By Three-dimensional Speckle Tracking

Part 1 Evaluation of left ventricular strains in healthy subjects by three-dimensional speckle trackingObjective To assess left ventricular longitudinal strains(Sl), radial strains(Sr) and circumferential strains(Sc) in healthy subjects by using two-dimensional speckle tracking (2DT) and three-dimensional speckle tracking(3DT), and to investigate the feasibility of 3DT for assessment of left ventricular(LV) myocardial strains.Methods The dynamic images of apical two- and four-chamber views were displayed and apical full-volume acquisition was obtained in 32 subjects to visualize the entire LV in a volumetric imagine. The full-volume imagines were recorded and then were analyzed by off-line 3DT analysis software. The images were recorded from the left ventricular short-axis views at the levels of mitral valve, papillary muscle and apex, and the four-chamber view, two-chamber view and long-axis view of left ventricle. Then these images were analyzed by off-line 2DT analysis software. The longitudinal peak systolic strains, radial peak systolic strains and circumferential peak systolic strains of left ventricle were obtained by using 3DT and 2DT, then compared them.Results The mean longitudinal strain of left ventricular by 3DT was significantly smaller than by 2DT, and the mean circumferential strain by 3DT was significantly larger than by 2DT. But there was no significant difference in the mean radial strain between 3DT and 2DT. The times for acquisition and analysis of the images by 3DT were significantly shorter than by 2DT. No significant difference in the intraobserver and interobserver coefficient variation between 3DT and 2DT was observed.Conclusions The 3DT is a convenient, feasible, reproducible and new method to evaluate longitudinal strains, radial strains and circumferential strains of left ventricle. The limitation of 2DT could not track the spot out of plane, which differentiates from 3DT.Part 2 Evaluation of left ventricular strains in patients with chronic heart failure by three-dimensional ultrasound speckle tracking imagingObjective To analyze the left ventricular(LV) strain by three-dimensional ultrasound speckle-tracking imaging(3DT), and evaluate the clinical value of 3DT in analyzing left ventricular strains.Methods Twenty-eight patients with CHF and thirty-two healthy volunteers were included. Echocardiographic examinations were performed in all subjects. Dynamic images of apical two- and four-chamber views were displayed and apical full-volume acquisition was obtained in all subjects to visualize the entire LV in a volumetric imagines. The full-volume imagines were recorded and then were analyzed off line. Images were analyzed and all parameters of every segment were obtained. The parameters, including the global longitudinal strain(GSl) , the global radial strain(GRr), the global circumferential strain(GSc), the global longitudinal displacement(GDl), the global radial displacement(GDr) and the global three-dimensional displacement(GD3d), were selected and analyzed. The above parameters of the CHF group and the normal control group were compared and the correlation between LVEF and GSl was evaluated.Results①Compared to the normal control group, GSl, GSr, Gsc, GDl, GDr and GD3d were significantly decreased in the CHF group(P<0.001);②Significant correlations were noted between LVEF and GSl(r=0.75, P<0.01).Conclusions The left ventricular strains in patients with CHF were significantly decreased, and 3DT can quickly evaluate left ventricular systolic function.