title: Utility of global strain by two-dimensional and three-dimensional speckle tracking for assessing left ventricular diastolic function: comparison with pressure wire analysis.
abstract: OBJECTIVE
  We evaluated the utility of two-dimensional (2D) and three-dimensional (3D) left ventricular (LV) global myocardial deformity parameters for assessing LV diastolic function by comparing invasive measures of LV performance.
  
  
  METHODS
  Echocardiography and LV pressure were assessed in 39 patients. Myocardial LV longitudinal, circumferential, and radial deformations, as well as area strain, were evaluated utilizing 2D and 3D speckle tracking software. The 2D early diastolic strain rate (2D-SRe) was measured from the 3 apical and 3 short axis views. The 3D diastolic index (3D-DI) was calculated by the % change of global strain during the first one-third of the diastolic period. LV end diastolic pressure (LVEDP) and the rate of LV pressure change (dP/dt) were collected using a pressure-conducted catheter and tau was calculated.
  
  
  RESULTS
  dP/dtmin were related to early mitral annular velocity (e'), 2D-SRelong, 2D-SReradial, as well as 3D-DIlong, and 3D-DIas. Additionally, LVEDP was associated with the ratio of mitral early diastolic velocity (E) to 2D-SRelong, 2D-SRecirc, 2D-SReradial, 3D-DIlong, 3D-DIcirc, and 3D-DIas. E/2D-SRelong, E/2D-SReradial, E/3D-DIlong, and E/3D-DIas were comparable with E/e' in predicting patients with elevated LVEDP. Among those patients with E/e' of 8 to 15, E/3D-DIlong provided incremental value in identifying those with LVEDP ≥15 mm Hg.
  
  
  CONCLUSIONS
  2D-SRelong, 2D-SReradial, 3D-DIlong, and 3D-DIas were related to LV relaxation, and the ratios of E to those parameters were associated with LVEDP. In addition, among patients with indeterminate E/e', E/3D-DIlong offered incremental value in predicting elevated LVEDP, suggesting it may provide supplementary information in the evaluation of LV diastolic function.
authors.affiliation: Division of Cardiology, Inha University College of Medicine, Incheon, Korea.
authors.forename: Sung-Hee
authors.initials: SH
authors.lastname: Shin
authors.forename: Sang-Don
authors.initials: SD
authors.lastname: Park
authors.forename: Seong-Il
authors.initials: SI
authors.lastname: Woo
authors.forename: Dae-Hyeok
authors.initials: DH
authors.lastname: Kim
authors.forename: Keum-Soo
authors.initials: KS
authors.lastname: Park
authors.forename: Jun
authors.initials: J
authors.lastname: Kwan
keywords: Diastole; Echocardiography; Ventricular pressure