The goal of this document is to focus on the currently available techniques that allow quantitative assessment of myocardial function via image-based analysis of local myocardial dynamics, including Doppler tissue imaging and speckle-tracking echocardiography, as well as integrated back- scatter analysis. Both types of measurements lend themselves to the derivation of multiple parameters of myocardial function. Two such techniques have dominated the research arena of echocardiography: (1) Doppler-based tissue velocity measurements, frequently referred to as tissue Doppler or myocardial Doppler, and (2) speckle tracking on the basis of displacement measurements. Some were widely embraced by echocardiographers around the world and became part of the clinical routine, whereas others remained limited to research and exploration of new clinical applications. Several such techniques have emerged over the past decades to address the issue of reader's experience and inter-measurement variability in interpretation. Because for decades, echocardiography has been the only imaging modality that allows dynamic imaging of the heart, it is only natural that new, increasingly automated techniques for sophisticated analysis of cardiac mechanics have been driven by researchers and manufacturers of ultrasound imaging equipment. This study demonstrates that in patients with DCM in sinus rhythm, the evaluation of LV function can be accurately accomplished by using a new speckle tracking index, LVtor × LVε.Įchocardiographic imaging is ideally suited for the evaluation of cardiac mechanics because of its intrinsically dynamic nature. Log-transformed NTproBNP correlated significantly with LVε (r=0.56, p900 pg/ml (sensitivity 73%, specificity 82%) than LVε, E/E', LVtw, LVtor and LV ejection fraction (each p<0.05). LVε was obtained by averaging longitudinal peak systolic strain of all 17 LV-segments (from apical planes). LVtw (net difference between rotation angles at base and apex) was obtained from parasternal apical and basal short-axis planes. LVtor was defined as the ratio between LV twist (LVtw) and LV enddiastolic longitudinal length. The ratio of early diastolic transmitral velocity to early mitral annular diastolic velocity (E/E') was measured. Therefore, we investigated with speckle tracking echocardiography the value of a new parameter, LVtor × LVε, for assessing LV function in dilated cardiomyopathy (DCM) and validated it against N-terminal pro-brain natriuretic peptide (NTproBNP).Įchocardiography was performed simultaneously with NTproBNP determination in 55 consecutive patients with DCM in sinus rhythm. We believe that a precise assessment of LV function must take into account both LV torsion (LVtor) and global longitudinal strain (LVε). Torsional and longitudinal deformations are essential components of left ventricular (LV) performance.
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