The impact of preload on 3-dimensional deformation parameters: principal strain, twist and torsion

Abstract

Background: Strain analysis is feasible using three-dimensional (3D) echocardiography. This approach provides various parameters based on speckle tracking analysis from one full-volume image of the left ventricle; however, evidence for its volume independence is still lacking. Methods: Fifty-eight subjects who were examined by transthoracic echocardiography immediately before and after hemodialysis (HD) were enrolled. Real-time full-volume 3D echocardiographic images were acquired and analyzed using dedicated software. Two-dimensional (2D) longitudinal strain (LS) was also measured for comparison with 3D strain values. Results: Longitudinal (pre-HD: −24.57 ± 2.51, post-HD: −21.42 ± 2.15, P < 0.001); circumferential (pre-HD: −33. 35 ± 3.50, post-HD: −30.90 ± 3.22, P < 0.001); and radial strain (pre-HD: 46.47 ± 4.27, post-HD: 42.90 ± 3.61, P < 0. 001) values were significantly decreased after HD. The values of 3D principal strain (PS), a unique parameter of 3D images, were affected by acute preload changes (pre-HD: −38.10 ± 3.71, post-HD: −35.33 ± 3.22, P < 0.001). Twist and torsion values were decreased after HD (pre-HD: 17.69 ± 7.80, post-HD: 13.34 ± 6.92, P < 0.001; and pre-HD: 2.04 ± 0.86, post-HD:1.59 ± 0.80, respectively, P < 0.001). The 2D LS values correlated with the 3D LS and PS values. Conclusion: Various parameters representing left ventricular mechanics were easily acquired from 3D echocardiographic images; however, like conventional parameters, they were affected by acute preload changes. Therefore, strain values from 3D echocardiography should be interpreted with caution while considering the preload conditions of the patients.

Acute stunning effect of hemodialysis on myocardial performance: A three‐dimensional speckle tracking echocardiographic study

“…In 2017, Hyo et al reported results of their study conducted with 3DSTE and concluded that HD deteriorated GLS, GCS, GRS, and AREA strain. 15 Our results were not fully in concordance with theirs as they also reported worsening in twist and torsion. The somewhat small strain data we observed can be attributed to the different software we used.…”

“…This negative effect was not related to ultrafiltration volume, Kt/V, and demographic and biochemical data. In 2017, Hyo et al reported results of their study conducted with 3DSTE and concluded that HD deteriorated GLS, GCS, GRS, and AREA strain 15 . Our results were not fully in concordance with theirs as they also reported worsening in twist and torsion.…”

Circumferential and radial deformation assessment in premature infants: Ready for primetime?

“…In addition, those infants also demonstrated a decrease in radial strain and SR following ligation, providing further evidence of differential load dependency of deformation parameters based on the plane assessed. In human adults undergoing hemodialysis (HD, resulting in a decrease in LV preload), “circumferential and radial strain values were significantly decreased after HD.” The group did not assess strain rate values. In adult patients undergoing aortic valve replacement for severe aortic stenosis (resulting in a reduction in LV afterload and an increase in LV preload), radial/circumferential strain and systolic strain rate significantly improve immediately following the procedure with a further improvement 6 months postprocedure.…”

Cardiac mechanostructure: Using mechanics and anisotropy as inspiration for developing epicardial therapies in treating myocardial infarction

“…Recently, techniques to quantify local mechanics, such as strain profiles, degree of rotation and angular velocity within the ventricular wall, have proven to be sensitive indices in detecting ventricular performance [ 16 ]. These metrics can be measured by tracking myocardial motion non-invasively through speckle tracking echocardiography [ 17 , 18 ], tagged-MRI [ 19 ], 4D ultrasound with 3D strain mapping [ 20 ] as well as tracking transmural myocardial fiber organization through diffusion tensor MRI [ [21] , [22] , [23] ] and 3D ultrasound backscatter tensor imaging [ 24 ]. These techniques are especially important when considering cardiovascular diseases such as heart failure with preserved ejection fraction (HFpEF), recently declared by the National Heart, Lung and Blood Institute as the “greatest unmet need in cardiovascular medicine” [ 25 ].…”