Capability of three-dimensional speckle tracking radial strain for identification of patients with cardiac sarcoidosis

Abstract

Since cardiac sarcoidosis (CS) leads to substantial morbidity and sudden death, early diagnosis and appropriate management are crucial for patients with CS. Echocardiography used to be considered a useful diagnostic tool for patients with CS, but CS may clinically present as dilated cardiomyopathy (DCM). Our objective was to investigate whether a novel three-dimensional (3-D) speckle-tracking strain can identify patients with CS more accurately. We studied 23 CS patients with an ejection fraction (EF) of 46 ± 10 %, and 16 EF-matched patients with DCM (EF 45 ± 11 %). Global radial (GRS), circumferential (GCS) and longitudinal (GLS) strain was assessed using 3-D speckle-tracking system. GRS of patients with CS was significantly lower than that of patients with DCM (18.5 ± 8.4 vs. 28.5 ± 8.3 %, p < 0.01), but GCS and GLS in patients with CS and DCM were similar. GRS ≦ 21.1 could differentiate CS from DCM with a sensitivity of 70 %, specificity of 88 % and area under the curve of 0.79. An additional noteworthy findings was that, patients with CS showed more negative radial strain curves than did those with DCM (1.7 ± 2.3 vs. 0.1 ± 0.5, p < 0.01). In conclusion, 3-D speckle-tracking radial strain shows good potential to distinguish CS from DCM. Our observations can thus be expected to have clinical implications for management of CS patients.

Improved detection of myocardial damage in sarcoidosis using longitudinal strain in patients with preserved left ventricular ejection fraction

“…Our study expands on recent publications that have suggested that indices of myocardial deformation, such as GLS, are abnormal in the presence of CS, even when other TTE parameters are within normal limits. Similarly, others have reported reduced radial 3D strain in CS patients when compared to individuals with dilated cardiomyopathy with matched LV EF …”

Three‐Dimensional Speckle Tracking Echocardiography–Derived Left Atrial Strain Parameters Are Reduced in Patients with Atrial Fibrillation (Results from the MAGYAR‐Path Study)

“…Strain imaging has shown promising results in detecting impaired LA function and predicting recurrence of AF after anti-arrhythmic treatment. 21,[34][35][36][37] We hypothesized that in addition to volumetric LA differences, 3DSTE is also capable of detecting LA deformation changes in patients suffering from AF compared to normal healthy controls. 32,33 The more recently developed 3DSTE tries to combine the two methods by not only being able to measure volumetric changes over time in different heart chambers, but also by providing strain data based on a 3D speckle tracking algorithm.…”

Evaluation of Known or Suspected Cardiac Sarcoidosis

“…Although requiring further validation, 1 group suggested that there may be a role for 3-dimensional (3D) speckle tracking radial strain in distinguishing CS from dilated cardiomyopathy 27 although in a different study impaired radial strain by 2D speckle tracking was not useful in identifying LGE detected by CMR, whereas circumferential and longitudinal strain exhibited a significant association. 28 Ultimately, strain imaging by echocardiography may provide a useful method to assess response to therapy 29 although to date there are no studies supporting this application.…”