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European Journal of Echocardiography Advance Access originally published online on July 23, 2008
European Journal of Echocardiography 2009 10(2):229-237; doi:10.1093/ejechocard/jen201
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org.

Regional myocardial long-axis strain and strain rate measured by different tissue Doppler and speckle tracking echocardiography methods: a comparison with tagged magnetic resonance imaging

Brage H. Amundsen1,*, Jonas Crosby1, Per Arvid Steen2, Hans Torp1, Stig A. Slørdahl1,3 and Asbjørn Støylen1,3

1 Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, MTFS, N-7489 Trondheim, Norway
2 Department of Medical Imaging, St Olavs Hospital/Trondheim University Hospital, Trondheim, Norway
3 Department of Cardiology, St Olavs Hospital/Trondheim University Hospital, Trondheim, Norway

Received 4 March 2008; accepted after revision 25 June 2008; online publish-ahead-of-print 23 July 2008.

* Corresponding author. Tel: +47 73 59 88 88 (work)/+47 99 52 14 96 (home); fax: +47 73 59 86 13. E-mail address: brage.h.amundsen{at}ntnu.no


  Abstract

Aims: Compare four different echocardiographic methods, based on tissue Doppler imaging (TDI) and speckle tracking (ST) separately or combined, for long-axis strain and strain rate (SR) measurements, using magnetic resonance imaging (MRI) tagging as a reference.

Methods and results: In 21 subjects (10 with myocardial infarction) peak systolic strain and systolic and early diastolic SR were measured by four different echo methods: (i) two-dimensional (2D) strain (B-mode); (ii) ST (custom software) of segment end-points (B-mode); (iii) similar to (ii), but combining ST with tissue Doppler tracking; (iv) strain from tissue Doppler velocity gradients (VG). Agreement with MRI tagging was better for strain than for SR. Ninety-five per cent limits of agreement were wider for the TDI-VG method, and 2D strain showed negative bias compared with MRI tagging and the other echo methods. Reproducibility was better for 2D strain than for MRI tagging and the other echo methods.

Conclusion: ST alone or combined with TDI seems to be suitable for automated measurements of regional myocardial deformation. The study gives important information on the strengths and weaknesses of the different methods, which is important for further development to increase accuracy and applicability.

Keywords: Echocardiography; Method comparison; MRI; Strain; Speckle tracking; Tissue Doppler


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