What can three-dimensional speckle-tracking echocardiography contribute to evaluate global left ventricular systolic performance in patients with heart failure?
OBJECTIVE
Three-dimensional speckle-tracking echocardiography (3D-STE) is a newly developed technique to evaluate left ventricular (LV) deformation by measuring the area strain (AS) of endocardial surface that combines information from both longitudinal (LS) and circumferential strain (CS). We performed a study to examine myocardial deformation in patients with heart failure (HF) using 3D-STE.


METHODS
A total of 149 subjects including 58 patients with HF and preserved ejection fraction (HFPEF), 45 patients with HF and reduced ejection fraction (HFREF), and 46 normal subjects were prospectively studied by 3D-STE.


RESULTS
After adjusting for age, gender and BSA, global CS, LS, radial strain (RS) and AS derived from 3D-STE in patients with HFPEF were significantly higher than their counterparts in patients with HFREF (all p<0.001), but lower than that in normal subjects (all p<0.05). In addition, among all the strain parameters, global AS exhibited the highest correlation with LV ejection fraction (y=1.243x+6.332, r=0.982, p<0.001) and the best intra- (ICCs: 0.986, p<0.001) and inter-observer variability (ICCs: 0.978, p<0.001) than other parameters of 3D strain (CS: 0.981 and 0.974; LS: 0.908 and 0.841; RS: 0.946 and 0.915; all p<0.001).


CONCLUSIONS
Measurement of endocardial surface AS based on 3D-STE technique is reproducible and proves to be accurate and comprehensive in assessing the global LV performance and multidirectional deformation of the LV myocardium in HF patients.
Division of Cardiology, Department of Medicine and Therapeutics, Prince of Wales Hospital and Institute of Vascular Medicine, The Chinese University of Hong Kong, Hong Kong.
Xiu-Xia
XX
Luo
Division of Cardiology, Department of Medicine and Therapeutics, Prince of Wales Hospital and Institute of Vascular Medicine, The Chinese University of Hong Kong, Hong Kong.
Fang
F
Fang
Division of Cardiology, Department of Medicine and Therapeutics, Prince of Wales Hospital and Institute of Vascular Medicine, The Chinese University of Hong Kong, Hong Kong.
Alex Pui-Wai
AP
Lee
Division of Cardiology, Department of Medicine and Therapeutics, Prince of Wales Hospital and Institute of Vascular Medicine, The Chinese University of Hong Kong, Hong Kong.
Jing-Ping
JP
Sun
Division of Cardiology, Department of Medicine and Therapeutics, Prince of Wales Hospital and Institute of Vascular Medicine, The Chinese University of Hong Kong, Hong Kong.
Shuang
S
Li
Division of Cardiology, Department of Medicine and Therapeutics, Prince of Wales Hospital and Institute of Vascular Medicine, The Chinese University of Hong Kong, Hong Kong.
Zhi-Hua
ZH
Zhang
Division of Cardiology, Department of Medicine and Therapeutics, Prince of Wales Hospital and Institute of Vascular Medicine, The Chinese University of Hong Kong, Hong Kong.
John E
JE
Sanderson
Division of Cardiology, Department of Medicine and Therapeutics, Prince of Wales Hospital and Institute of Vascular Medicine, The Chinese University of Hong Kong, Hong Kong.
Joey S W
JS
Kwong
Division of Cardiology, Department of Medicine and Therapeutics, Prince of Wales Hospital and Institute of Vascular Medicine, The Chinese University of Hong Kong, Hong Kong.
Qing
Q
Zhang
Division of Cardiology, Department of Medicine and Therapeutics, Prince of Wales Hospital and Institute of Vascular Medicine, The Chinese University of Hong Kong, Hong Kong.
Jing
J
Wang
Division of Cardiology, Department of Medicine and Therapeutics, Prince of Wales Hospital and Institute of Vascular Medicine, The Chinese University of Hong Kong, Hong Kong. Electronic address: cmyu@cuhk.edu.hk.
Cheuk-Man
CM
Yu
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004452:Echocardiography / Q000379:methods* / Q000592:standards* / Q000706:statistics & numerical data; D019560:Echocardiography, Three-Dimensional / Q000379:methods* / Q000592:standards* / Q000706:statistics & numerical data; D005240:Feasibility Studies; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015203:Reproducibility of Results; D013318:Stroke Volume; D013599:Systole; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*
Area strain; Heart failure; Systolic function; Three-dimensional speckle-tracking echocardiography