Strain and Strain Rate Imaging in Cardiomyopathy

Abstract

The most common indication for an echocardiogram is for the assessment of left ventricular (LV) function and, in the evaluation of cardiomyopathy (CM), this becomes even more important. However, conventional echocardiographic measures of ventricular function are insensitive at detecting subtle perturbations in contractility. In patients with CM, the ability to detect abnormalities early in the course of the disease to establish a diagnosis can be critical and often may influence specific treatments administered as well as establish important prognostic information. Technologic advances in echocardiographic imaging during the last decade now allow for the measurement of LV strain and strain rate (SR) imaging. Strain and SR imaging allow for a more precise characterization of the mechanics of myocardial contraction and relaxation (deformation imaging) and emerging data are establishing the use of these techniques in a variety of different cardiomyopathic conditions. After establishing a common understanding of strain imaging as well as defining the methods by which these measures can be incorporated into an echocardiographic examination, we will review the accumulating information illustrating the great promise that this imaging modality has in the care of patients with CM. This review will focus on the role of strain and SR imaging in CM.

Preliminary clinical study of left ventricular myocardial strain in patients with non-ischemic dilated cardiomyopathy by three-dimensional speckle tracking imaging

“…Therefore, the tissue Doppler imaging is mainly used to detect one-dimensional myocardial motion and strain in the long axis parallel to ultrasound beam [14]. Unlike Doppler derived strain, Two-dimensional speckle tracking (2D-STE) is angle independent, which measures the strain by tracking speckles, which are acoustic backscatter generated by ultrasound interactions with the myocardium [15]. However, 2D-STE has limitations for its 2D imaging-based method.…”

Independent Role of Left Ventricular Global Longitudinal Strain in Predicting Prognosis of Chronic Heart Failure Patients

“…strain and strain rate. 2,6,7 Various studies have shown its greater sensitivity in detecting myocardial dysfunction early 2,6-11 and its possible usefulness in stratifying prognosis of CHF patients. 12,13 The aim of the study was to evaluate the independent role of 2D speckle tracking LV longitudinal strain in predicting cardiovascular death, heart transplantation, hospitalization due to acute decompensated heart failure (ADHF) and the occurrence of ventricular arrhythmic events in a large series of outpatients with CHF.…”

Myocardial Tissue Doppler, Derived Techniques, and Speckle Tracking Imaging

“…Therefore only active or intrinsic motions of the myocardium are considered. In humans as well as in various animal models of myocardial ischemia, these indices (especially peak systolic strain and strain rate) often prove to be more discriminating than classical TDI parameters for the appreciation of myocardial viability after an ischemic accident, the assessment of myocardial function, or walls synchronism [18,[50][51][52][53][54].…”

“…These parameters represent the basis for techniques of strain imaging and strain rate imaging, respectively [27,[48][49][50][51][52][53][54]. …”