title: Two-dimensional acoustic pattern derived strain parameters closely correlate with one-dimensional tissue Doppler derived strain measurements.
abstract: BACKGROUND
  Two-dimensional strain echocardiography (2D-SE) calculates tissue velocities via frame-to-frame tracking of unique acoustic markers within the image and provides strain parameters in two dimensions. Novel 2D-SE software allows semi-automated strain measurements and increased averaging capabilities optimizing signal-noise ratio.
  
  
  OBJECTIVE
  We tested whether 2D-SE and the currently used and well-validated tissue Doppler derived strain echocardiography (TD-SE) yield similar information in the clinical setting.
  
  
  RESULTS
  We performed 2D-SE and TD-SE on 17 patients with amyloid cardiomyopathy and 10 age-matched healthy volunteers. Single walls from standard apical views (2- and 4-chamber) were acquired at high frame rates ( approximately 200fps). Offline analysis was performed by observers blinded to clinical data using the EchoPAC program with custom 2D-SE software. Longitudinal strain rate and strain from the basal, mid and apical segments of the septal and lateral walls were determined by each method (TD-SE and 2D-SE). Ejection fraction was >0.55 in healthy volunteers and ranged from 0.30 to 0.80 in cardiomyopathy group. A total of 54 walls (162 segments) were examined. Acceptable quality strain data was available in 92% and 85% segments by 2D-SE and TD-SE, respectively. Two-dimensional strain echocardiography values correlated closely with TD-SE values (r=0.94 and 0.96 for strain rate and strain, respectively).
  
  
  CONCLUSIONS
  Deformation analysis by 2D-SE is feasible in a clinical setting and 2D-SE values correlate closely with TD-SE measurements over a wide range of global systolic function. Two-dimensional strain echocardiography may help to facilitate the routine clinical implementation of deformation analysis.
authors.affiliation: Division of Cardiology, Mayo Clinic College of Medicine, Rochester, MN, USA.
authors.forename: Karen M
authors.initials: KM
authors.lastname: Modesto
authors.forename: Sanderson
authors.initials: S
authors.lastname: Cauduro
authors.forename: Angela
authors.initials: A
authors.lastname: Dispenzieri
authors.forename: Bijoy
authors.initials: B
authors.lastname: Khandheria
authors.forename: Marek
authors.initials: M
authors.lastname: Belohlavek
authors.forename: Peter
authors.initials: P
authors.lastname: Lysyansky
authors.forename: Zvi
authors.initials: Z
authors.lastname: Friedman
authors.forename: Morie
authors.initials: M
authors.lastname: Gertz
authors.forename: Theodore P
authors.initials: TP
authors.lastname: Abraham
mesh_terms: D000162:Acoustics; D000686:Amyloidosis; D009202:Cardiomyopathies / Q000000981:diagnostic imaging* / Q000503:physiopathology; D004452:Echocardiography / Q000379:methods*; D015150:Echocardiography, Doppler; D005260:Female; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D012984:Software; D013318:Stroke Volume