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European Journal of Echocardiography 2006 7(4):315-321; doi:10.1016/j.euje.2005.07.003
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Copyright © 2005, The European Society of Cardiology

Two-dimensional acoustic pattern derived strain parameters closely correlate with one-dimensional tissue Doppler derived strain measurements

Karen M. Modestoa, Sanderson Cauduroa, Angela Dispenzierib, Bijoy Khandheriaa, Marek Belohlaveka, Peter Lysyanskyc, Zvi Friedmanc, Morie Gertzb and Theodore P. Abrahama,*

aDivision of Cardiology, Mayo Clinic College of Medicine, Rochester, MN, United States
bDivision of Hematology, Mayo Clinic College of Medicine, Rochester, MN, United States
cGE Ultrasound, Haifa, Israel

Received 17 January 2005; received in revised form 21 June 2005; accepted after revision 7 July 2005.

* Corresponding author. Johns Hopkins University, Cardiology Department, 600 North Wolfe Street, Carnegie 568, Baltimore, MD 21287, United States. Tel.: +1 410 955 6173; fax: +1 410 955 1509. tabraha3{at}jhmi.edu


  Abstract

Background Two-dimensional strain echocardiography (2D-SE) calculates tissue velocities via frame-to-frame tracking of unique acoustic markers within the image and provides strain parameters in two dimensions. Novel 2D-SE software allows semi-automated strain measurements and increased averaging capabilities optimizing signal–noise ratio.

Aim We tested whether 2D-SE and the currently used and well-validated tissue Doppler derived strain echocardiography (TD-SE) yield similar information in the clinical setting.

Methods and results We performed 2D-SE and TD-SE on 17 patients with amyloid cardiomyopathy and 10 age-matched healthy volunteers. Single walls from standard apical views (2- and 4-chamber) were acquired at high frame rates (~200fps). Offline analysis was performed by observers blinded to clinical data using the EchoPAC program with custom 2D-SE software. Longitudinal strain rate and strain from the basal, mid and apical segments of the septal and lateral walls were determined by each method (TD-SE and 2D-SE). Ejection fraction was >0.55 in healthy volunteers and ranged from 0.30 to 0.80 in cardiomyopathy group. A total of 54 walls (162 segments) were examined. Acceptable quality strain data was available in 92% and 85% segments by 2D-SE and TD-SE, respectively. Two-dimensional strain echocardiography values correlated closely with TD-SE values (r=0.94 and 0.96 for strain rate and strain, respectively).

Conclusions Deformation analysis by 2D-SE is feasible in a clinical setting and 2D-SE values correlate closely with TD-SE measurements over a wide range of global systolic function. Two-dimensional strain echocardiography may help to facilitate the routine clinical implementation of deformation analysis.

Keywords: Tissue Doppler; Strain; Two-dimensional strain echocardiography


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