Speckle tracking - ein neues Ultraschallverfahren zur Beurteilung der fetalen Myokardfunktion

Abstract

Speckle tracking is a new ultrasound tool to assess 2D ventricular global and segmental myocardial velocity and deformation (strain, strain rate). Multiple factors such as fetal motion, high heart rates, low blood pressure, small size of the heart, physiological cardiac translation, filling and maturational changes of myocardium, polyhydramnion, maternal obesity and aortic pulsation can degrade the image quality and result in artifacts and measurement errors which may have an impact on the final analysis. Therefore deformation indices such as strain and strain rate offer a quantitative technique for the estimation of global and segmental myocardial function and contractility. At present longitudinal peak systolic strain is the most commonly applied deformation parameter used to analyse segmental and global myocardial contractility in adults. When obtained using Doppler methods, these measurements are angle dependent, whereas speckle tracking techniques overcome the limitations of Doppler echocardiography which is a particular advantage in foetal echocardiography. Nevertheless, the time and training necessary to acquire high-quality video clips limit the implementation of speckle tracking into clinical routine. It is not yet clear whether this new technique will identify subclinical myocardial impairment earlier than with current techniques or allow for better discrimination between healthy fetuses and fetuses with congenital heart disease. The clinical use of speckle tracking will have to be demonstrated in larger groups of complicated pregnancies.

Rescue operations lead to increased cardiovascular stress in HEMS Crew Members - A prospective pilot study of a German HEMS cohort

“…Recent clinical studies report that frequent VES cause myocardial dysfunction (30,31). Using the speckle tracking echocardiography technique, an ultrasound procedure for the objective representation of the myocardial function, Barutcu et al (32) decreased left ventricular cardiac function after VES (33). In healthy people, 5-9% SVES were described in the exercise test with an age-related increase in prevalence.…”

Speckle-Tracking Echocardiography in Right Ventricular Function of Clinically Well Patients with Heart Transplantation

“…However, considering the complexity of RV structure and contraction and the altered cardiac anatomy after HT, it is challenging to reveal subclinical cardiac impairment in HT patients by conventional echocardiography. Speckle-tracking echocardiography (STE) is a non-invasive, attractive, and angle-independent approach for measuring cardiac mechanical function by tracking the spatial motion of echo speckles within the myocardium in response to real-time motion and deformation of myocardial tissue [ 25 , 26 , 27 , 28 , 29 , 30 , 31 ]. STE evaluation of myocardium function was found to be a superior discriminator, which can differentiate the cardiac function between HT patients and normal individuals.…”