Three-dimensional simultaneous strain-volume analysis describes left ventricular remodelling and its progression: a pilot study

Abstract

AimsThree-dimensional (3D)-echocardiography speckle imaging allows the evaluation of frame-by-frame strain and volume changes simultaneously. The aim of the present investigation was to describe the strain–volume combined assessment in different patterns of cardiac remodelling.Methods and resultsFifty patients received a 3D acquisition. Patients were classified as follows: healthy subjects (CNT), previous AMI, and normal ejection fraction (EF; group A); ischaemic cardiomyopathy with reduced EF (group B); hypertrophic/infiltrative cardiomyopathy (group C). Values of 3D strain were plotted vs. volume for each frame to build a strain–volume curve for each case. Peak of radial, longitudinal, and circumferential systolic strain (Rɛp, Lɛp, and Cɛp, respectively), slopes of the curves (RɛSl, LɛSl, CɛSl), and strain to end-diastolic volume (EDV) ratio (Rɛ/V, Lɛ/V, Cɛ/V) were computed for the analysis. Strain–volume curves of the CNT group were steep and clustered, whereas, due to progressive dilatation and reduction of strains, progressive flattening could be demonstrated in groups A and B. Quantitative data supported visual assessment with progressive lower slopes (P< 0.05 for RɛSl, CɛSl, P= 0.06 for LɛSl) and significantly lower ratios (P< 0.01 for Rɛ/V, Lɛ/V, and Cɛ/V). Group C showed an opposite behaviour with slopes and ratios close to those of normal subjects. Correlation coefficients between EDV and slopes of the curves were significant for all the directions of strain (CɛSl: r = 0.891; RєSl: r = 0.704; LєSl: r = 0.833; P< 0.0001 for all).ConclusionWe measured left ventricular volumes and strain by 3D-echo and obtained strain–volume curve to evaluate their behaviour in remodelling. A distinctive and progressive pattern consistent with pathophysiology was observed. The analysis here shown could represent a new non-invasive method to assess myocardial mechanics and its relationship with volumes.

Left Ventricular Rotation and Twist Assessed by Four‐Dimensional Speckle Tracking Echocardiography in Healthy Subjects and Pathological Remodeling: a Single Center Experience

“…Rotation can be computed by speckle analysis as in 2D imaging . When using a 3D acquisition, the method has been shown to be reliable and reproducible also when compared with CMR …”

“…20 When using a 3D acquisition, the method has been shown to be reliable and reproducible also when compared with CMR. [20][21][22] Three-dimensional STE recognizes several strengths: first, rotation of the base and apex are recorded and analyzed simultaneously in the same cycle; second, full-volume analysis implies that speckles never leave the plane of acquisition and can be followed continuously; third, it can be performed in few minutes with concurrent analysis of LV volumes, mass, and strain. These features are now easily available and appear to be cost effective in the new echocardiographic platforms.…”

The value of left ventricular strain–volume loops in predicting response to cardiac resynchronization therapy

“…The new method based on simultaneous strain–load (volume or area) analysis has been applied in certain physiological state [23, 24] and pathological LV remodeling [25, 26]. Besides, it has been recently validated the same method with tagging cardiac magnetic resonance [27].…”

Strain–volume loops in severe aortic valve disease

“…Our group had presented for the first time the strain–volume analysis for the description of left ventricular (LV) remodelling in 2011 (Lilli et al . ) (previously presented at ESC Congress 2010, Lilli et al . ) and we have recently validated the same method with tagging cardiac magnetic resonance (Lilli et al .…”