Two‐ and Three‐Dimensional Speckle Tracking Echocardiography: Clinical Applications and Future Directions

Abstract

Two-dimensional speckle tracking echocardiography (2D STE) is a novel technique of cardiac imaging for quantifying complex cardiac motion based on frame-to-frame tracking of ultrasonic speckles in gray scale 2D images. Two-dimensional STE is a relatively angle independent technology that can measure global and regional strain, strain rate, displacement, and velocity in longitudinal, radial, and circumferential directions. It can also quantify rotational movements such as rotation, twist, and torsion of the myocardium. Two-dimensional STE has been validated against hemodynamics, tissue Doppler, tagged magnetic resonance imaging, and sonomicrometry studies. Two-dimensional STE has been found clinically useful in the assessment of cardiac systolic and diastolic function as well as providing new insights in deciphering cardiac physiology and mechanics in cardiomyopathies, and identifying early subclinical changes in various pathologies. A large number of studies have evaluated the role of 2D STE in predicting response to cardiac resynchronization therapy in patients with severe heart failure. However, the clinical utility of 2D STE in the above mentioned conditions remains controversial because of conflicting reports from different studies. Emerging areas of application include prediction of rejection in heart transplant patients, early detection of cardiotoxicity in patients receiving chemotherapy for cancer, and effect of intracoronary injection of bone marrow stem cells on left ventricular function in patients with acute myocardial infarction. The emerging technique of three-dimensional STE may further extend its clinical usefulness.

The importance of speckle tracking echocardiography in the early detection of left ventricular dysfunction in patients with polycystic ovary syndrome

“…Two-dimensional (2D) speckle tracking echocardiography (STE) is a more effective method for objectively evaluating both the systolic and diastolic functions of the myocardium in detail [9][10][11]. STE assessment might be useful for identifying patients with subclinical LV dysfunction when the LV ejection fraction (LVEF) is normal on conventional echocardiography [12,13]. The aim of this study was to evaluate LV dysfunction in the early period in patients with PCOS at risk of developing LV dysfunction using STE.…”

Left ventricular function after takotsubo is not fully recovered in long-term follow-up: A speckle tracking echocardiography study

“…This method analyzes myocardial velocities and deformations and is, therefore, useful in assessing LV systolic and diastolic function [5,6,[39][40][41][42]. 2D STE has, in previous studies, been used to assess the functional recovery of LV systolic function after the acute phase of TTC.…”

Short-Term Prognostic Value of Strain Echocardiography in Patients with STEMI

“…A new echocardiographic technique, strain echocardiography, has been developed to reflect true myocardial deformation not influenced by tethering effect [11]. Furthermore, strain echocardiography using a two dimensional (2D) speckle-tracking algorithm is angle-independent unlike the tissue Doppler derived measurements [12,13].…”