3D-wall motion tracking: a new tool for myocardial contractility analysis

Abstract

BACKGROUND: Left-ventricular ejection fraction (LVEF), the most frequently used parameter to evaluate left ventricular (LV) systolic function, depends not only on LV contractility, but also on different variables such as pre-load and after-load. Three-dimensional wall motion tracking echocardiography (3D-WMT) is a new technique that provides information regarding different new parameters of LV systolic function. Our aim was to evaluate whether the new 3D-WMT-derived LV systolic function parameters are less dependent on load conditions than LVEF. METHODS: In order to modify the load conditions to study the dependence of the different LV systolic function parameters on them, a group of renal failure patients under chronic hemodialysis treatment was selected. The echocardiographic studies, including the 3D-WMT analysis, were performed immediately before and immediately after the hemodialysis session. RESULTS: Thirty-one consecutive patients were enrolled (mean age 65.5 ± 17.0 years; 74.2% men). There was a statistically significant change in predialysis and postdialysis, pre-load and after-load conditions (E/È ratio and systolic blood pressure) and in the LV end-diastolic volume and LVEF. Nevertheless, the findings did not show any significant change before and after dialysis in the 3D-WMT-derived parameters. CONCLUSIONS: LV 3D-wall motion tracking-derived systolic function parameters are less dependent on load conditions than LVEF. They might measure myocardial contractility in a more direct way than LVEF. Thus, hypothetically, they might be useful to detect early and subtle contractility impairments in a wide number of cardiac patients and they could help to optimize the clinical management of such patients.

Four‐Dimensional Speckle Tracking Echocardiography in Patients with Hypertrophic Cardiomyopathy

“…The percent of displacement of each speckle in 3D was used to quantify the strain value of each segment, which represents the contractility of this segment, 6 and also area strain is a measure of relative area change that combines the effect of longitudinal and circumferential strain 16 ( Fig. 2) with 4DSTE being the evolution of 3DSTE over time.…”

“…Speckle tracking echocardiography (STE) was based on tracking and measurement of tissue displacement, satisfactory for accurate assessment of myocardial mechanics 4 and providing a relatively simple, noninvasive approach to the detection of LV rotation and twist. 6,7 Studies based on magnetic resonance imaging (MRI) 8 or STE 3,[9][10][11] in HCM have documented altered LV strains and twist-untwist mechanics. 6,7 Studies based on magnetic resonance imaging (MRI) 8 or STE 3,[9][10][11] in HCM have documented altered LV strains and twist-untwist mechanics.…”

“…5 The fourdimensional (4D) speckle tracking method acquires a 3D view of the heart and allows for the real-time visualization of change in strain in every segment of the left ventricle using color mapping. 6,7 Studies based on magnetic resonance imaging (MRI) 8 or STE 3,[9][10][11] in HCM have documented altered LV strains and twist-untwist mechanics. All studies reported reduced longitudinal strain but yielded discordant data regarding radial 8,12 and circumferential 12,13 strains.…”