Real-time three-dimensional speckle tracking echocardiography: technical aspects and clinical applications

Abstract

Three-dimensional speckle tracking echocardiography (3D STE) is a novel technique for the quantification of cardiac deformation based on tracking of ultrasonic speckles in gray scale full-volume 3D images. Developments in ultrasound technologies have made 3D speckle tracking widely available. Two-dimensional echocardiography has intrinsic limitations regarding estimation of left ventricular (LV) volumes, ejection fraction, and LV mechanics, due to its inherent foreshortening errors and dependency on geometric models. The development of 3D echocardiography has improved reproducibility and accuracy. Data regarding the feasibility, accuracy, and clinical applications of 3D STE are rapidly assembling. From the tracking results, 3D STE derives several parameters, including longitudinal, circumferential and radial strain, as well as a combined assessment of longitudinal and circumferential strain, termed area strain. 3D STE can also quantify LV rotational movements such as rotation, twist, and torsion. 3D STE provides a better insight on global and regional myocardial deformation. Main applications include detection of subclinical myocardial involvement in heart failure, arterial hypertension, dyssynchrony, and ischemic heart disease. Emerging areas of application include a large spectrum of heart-involving systemic conditions, such as prediction of rejection in heart transplant patients, early detection of cardiotoxicity in patients receiving chemotherapy for cancer, and deeper physiological understanding of LV contraction mechanics in different types of athletes. Aim of this review is to discuss background, technical acquisition and processing aspects as well as recognized and developing clinical applications of this emerging ultrasound technology.

Mitral Annular Plane Systolic Excursion: An Early Marker of Subclinical Left Ventricular Function in COVID-19 Survivors

“…This software tracks the movement of specific points in the myocardium (the muscle layer of the heart) throughout the cardiac cycle, allowing for calculation of longitudinal strain. Particularly in patients with subclinical or early-stage cardiac disease [19,20].…”

My Approach to 3-Dimensional Left Ventricular Strain

“…Rafael Bonafim Piveta, 1,2 Miguel Osman Dias Aguiar, 1,2 Liria Lima Maria da Silva, 1,2,3 Marcelo Luiz Campos Vieira 1,4 Introduction Echocardiographic analysis of myocardial deformation (strain) is a robust tool that adds important information regarding conventional parameters in relation to prognosis, specific parametric patterns of different cardiomyopathies, and detection of subclinical or incipient injury in different clinical scenarios. Strain reflects myocardial deformation, which represents the percentage of shortening or lengthening of a determined myocardial segment in relation to its initial measurement, in systole or diastole.…”

“…Strain can also be assessed using the 3-dimensional speckle tracking (3DST) technique, which, in theory, has greater anatomical correspondence and minimizes many limitations related to the 2-dimensional technique. 3 3DST does not depend on geometric assumptions, as 2-dimensional imaging does, and speckle tracking is conducted by means of a homogeneous spatial distribution of each component of the myocardial displacement vector, minimizing errors related to tracking, which often occur with the 2-dimensional technique, in which the analysis of real cardiac mechanics is technically limited. 4 Furthermore, 3DST analysis is less time-consuming (one third shorter than 2DST), and it calculates all components of myocardial deformation in the same cardiac cycle, under the same hemodynamic condition.…”

Como Eu Faço Strain 3D do Ventrículo Esquerdo

“…Rafael Bonafim Piveta, 1,2 Miguel Osman Dias Aguiar, 1,2 Liria Lima Maria da Silva, 1,2,3 Marcelo Luiz Campos Vieira 1,4 Hospital Israelita Albert Einstein, 1 São Paulo, SP -Brasil Hospital Beneficência Portuguesa, 2 São Paulo, SP -Brasil Hospital Dante Pazzanese de Cardiologia, 3 São Paulo, SP -Brasil Universidade de São Paulo, Instituto do Coração, Ecocardiografia Adultos, 4 São Paulo, SP -Brasil…”