title: Three-dimensional speckle strain echocardiography is more accurate and efficient than 2D strain in the evaluation of left ventricular function.
abstract: BACKGROUND
  Two-dimensional speckle tracking echocardiography (2DSTE) has been used widely in research, but rarely in clinical practice because data acquisition and analysis are time-consuming. By reducing the acquisition and analysis time, 3-dimensional STE may improve clinical impact. We investigated the feasibility of 3DSTE myocardial deformation, with comparison to 2DSTE.
  
  
  METHODS
  Transthoracic 3DSTE and 2DSTE were performed in 230 adults (138 men, 51 ± 14 years, and 142 hypertension, 10 heart failure and 78 normotensive subjects). The variables of LV deformation were analyzed using EchoPAC software.
  
  
  RESULTS
  The 3D LV longitudinal (LS) analysis was feasible in 84.9% of the study subjects, which was lower than the 2D analysis (97.2%). The success rates for circumferential strain (CS) and radial strain (RS) were similar between the 2D and 3D techniques. All magnitude of strains measured by 2DSTE and 3DSTE were significantly correlated. The magnitude of 3D LS and CS was lower, but the 3D RS is higher than that of 2DSTE (-18.5 ± 2.8 vs. -21.2 ± 3.5; 20.8 ± 4.1 vs. 21.7; and 50.0 ± 11.2 vs. 37.7 ± 12.6, respectively). Strains measured by 3DSTE exhibited stronger correlation with LV ejection fraction (EF) than that by 2DSTE. In inter- and intra-observer reproducibility for 3D LS, CS, RS and AS were acceptable. The mean time of analysis for LV volume, EF and strains was 116s by 3DSTE, which was significantly shorter than that by 2DSTE (5 min, P<0.0001).
  
  
  CONCLUSIONS
  Three-dimensional STE is feasible and reproducible in the estimation of LV function, requires substantially less time than 2DSTE and is a more feasible technique for LV function assessment in clinical practice.
authors.affiliation: The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Ting-Yan
authors.initials: TY
authors.lastname: Xu
authors.affiliation: Division of Cardiology, S.H. Ho Cardiovascular and Stroke Centre, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Jing Ping
authors.initials: JP
authors.lastname: Sun
authors.affiliation: Division of Cardiology, S.H. Ho Cardiovascular and Stroke Centre, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Alex Pui-wai
authors.initials: AP
authors.lastname: Lee
authors.affiliation: Division of Cardiology, S.H. Ho Cardiovascular and Stroke Centre, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Xing Sheng
authors.initials: XS
authors.lastname: Yang
authors.affiliation: Division of Cardiology, S.H. Ho Cardiovascular and Stroke Centre, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Zhiqing
authors.initials: Z
authors.lastname: Qiao
authors.affiliation: Division of Cardiology, S.H. Ho Cardiovascular and Stroke Centre, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Xiuxia
authors.initials: X
authors.lastname: Luo
authors.affiliation: Division of Cardiology, S.H. Ho Cardiovascular and Stroke Centre, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Fang
authors.affiliation: The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.affiliation: Division of Cardiology, S.H. Ho Cardiovascular and Stroke Centre, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China. Electronic address: cmyu@cuhk.edu.hk.
authors.forename: Cheuk-man
authors.initials: CM
authors.lastname: Yu
authors.affiliation: The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Ji-Guang
authors.initials: JG
authors.lastname: Wang
mesh_terms: D000368:Aged; D004452:Echocardiography; D019560:Echocardiography, Three-Dimensional / Q000592:standards*; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016277:Ventricular Function, Left / Q000502:physiology*
keywords: Left ventricular strain; Three-dimensional tracking echocardiography; Two-dimensional tracking echocardiography