title: Use of three-dimensional speckle-tracking echocardiography for quantitative assessment of global left ventricular function: a comparative study to three-dimensional echocardiography.
abstract: BACKGROUND
  The aim of this study was to determine whether global strains derived from three-dimensional (3D) speckle-tracking echocardiography (STE) are as accurate as left ventricular (LV) ejection fraction (LVEF) obtained by two-dimensional (2D) and 3D echocardiography in the quantification of LV function.
  
  
  METHODS
  Two-dimensional and 3D echocardiography and 2D and 3D STE were performed in 88 patients (LVEF range, 17%-79%). Two-dimensional and 3D global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain, and global area strain were quantified and correlated with LV function determined by 2D and 3D echocardiographic LVEF. Reproducibility, feasibility, and duration of study to perform 3D STE were assessed by independent, blinded observers.
  
  
  RESULTS
  A total of 78 patients (89%) underwent 3D STE. All 3D speckle-tracking echocardiographic parameters had strong correlations with assessment of LV function determined by 2D and 3D echocardiographic LVEF. Three-dimensional GCS was the best marker of LV function (r = -0.89, P < .0001). Subgroup analysis demonstrated that 3D speckle-tracking echocardiographic parameters were particularly useful in identifying LV dysfunction (LVEF < 50%). Receiver operating characteristic curve analysis demonstrated areas under the curve of 0.97 for 3D GCS, 0.96 for 3D global radial strain, 0.95 for 3D global area strain, and 0.87 for 3D GLS. An optimal 3D GCS cutoff value of magnitude < -12% predicted LV dysfunction (LVEF obtained by 2D echocardiography < 50%) with 92% sensitivity and 90% specificity. There was good correlation between 2D GLS and 3D GLS (r = 0.85, P < .001; mean difference, -1.7 ± 6.5%). Good intraobserver, interobserver, and test-retest agreements were seen with 3D STE. Time for image acquisition to postprocessing analysis was significantly reduced with 3D STE (3.7 ± 1.0 minutes) compared with 2D STE (4.6 ± 1.5 min) (P < .05).
  
  
  CONCLUSIONS
  Global strain by 3D STE is a promising novel alternative to quantitatively assess LV function. Three-dimensional STE is reproducible, feasible, and time efficient.
authors: Department of Cardiology, The Prince Charles Hospital, Queensland Health, Chermside, Queensland, Australia.
authors: Sushil A
authors: SA
authors: Luis
authors: Heart Foundation Research Centre, Griffith Health Institute, Griffith University, Gold Coast, Queensland, Australia.
authors: Akira
authors: A
authors: Yamada
authors: Aurora Cardiovascular Services, Aurora Sinai/Aurora St. Luke's Medical Centers, University of Wisconsin School of Medicine and Public Health, Milwaukee, Wisconsin.
authors: Bijoy K
authors: BK
authors: Khandheria
authors: Department of Cardiology, The Prince Charles Hospital, Queensland Health, Chermside, Queensland, Australia.
authors: Vicki
authors: V
authors: Speranza
authors: Department of Cardiology, The Prince Charles Hospital, Queensland Health, Chermside, Queensland, Australia.
authors: Anthony
authors: A
authors: Benjamin
authors: Department of Cardiology, The Prince Charles Hospital, Queensland Health, Chermside, Queensland, Australia.
authors: Matthew
authors: M
authors: Ischenko
authors: Department of Cardiology, The Prince Charles Hospital, Queensland Health, Chermside, Queensland, Australia.
authors: David G
authors: DG
authors: Platts
authors: Department of Cardiology, The Prince Charles Hospital, Queensland Health, Chermside, Queensland, Australia.
authors: Christian R
authors: CR
authors: Hamilton-Craig
authors: Heart Foundation Research Centre, Griffith Health Institute, Griffith University, Gold Coast, Queensland, Australia.
authors: Luke
authors: L
authors: Haseler
authors: Department of Cardiology, The Prince Charles Hospital, Queensland Health, Chermside, Queensland, Australia.
authors: Darryl
authors: D
authors: Burstow
authors: Department of Cardiology, The Prince Charles Hospital, Queensland Health, Chermside, Queensland, Australia; Heart Foundation Research Centre, Griffith Health Institute, Griffith University, Gold Coast, Queensland, Australia. Electronic address: jonathan.chan@griffith.edu.au.
authors: Jonathan
authors: J
authors: Chan
mesh_terms: D000368:Aged; D000465:Algorithms; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D055119:Elastic Modulus; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology*
keywords: Left ventricular function; Speckle-tracking echocardiography; Strain; Three-dimensional echocardiography