Möglichkeiten und Grenzen der myokardialen Strain-Analyse mittels Speckle-Tracking-Echokardiografie

Abstract

Two-dimension strain (2D-strain) and strain rate imaging by speckle tracking echocardiography (STE) is a promising new diagnostic tool for the evaluation of global and regional cardiac function. The assessment of myocardial velocities and deformation by STE has been used for objective quantitative assessment of myocardial function and sophisticated analysis of cardiac mechanics in a wide range of clinical and scientific applications.

This new techniques are of increasing clinical importance, but their strengths and weaknesses must be taken into account for the interpretation of the acquired data.

This document describes the principles of the assessment of myocardial velocities and deformation by tissue Doppler imaging and 2D-Strain-analysis by STE. Moreover, the growing body of evidence as well as relevant information for the clinical application of these emerging techniques are highlighted and discussed in this report.

• Literatur

• 1 Buck T, Breithardt OA, Faber L et al. Manual zur Indikation und Durchführung der Echokardiographie. Clin Res Cardiol 2009; (Suppl. 04) 3-51
• 2 Mor-Avi V, Lang RM, Badano LP et al. Current and evolving echocardiographic techniques for the quantitative evaluation of cardiac mechanics: ASE/EAE consensus statement on methodology and indications endorsed by the Japanese Society of Echocardiography. Eur J Echocardiography 2011; 12: 167-205
• 3 Geyer H, Caracciolo G, Abe H et al. Assessment of myocardial mechanics using speckle tracking echocardiography: fundamentals and clinical applications. J Am Soc Echocardiography 2010; 23: 351-369
• 4 Gorcsan 3rd J, Tanaka H. Echocardiographic assessment of myocardial strain. J Am Coll Cardiol 2011; 58: 1401-1413
• 5 Dandel M, Hetzer R. Echocardiographic strain and strain rate imaging – clinical applications. Int J Cardiol 2009; 132: 11-24
• 6 Paulus WJ, Tschope C, Sanderson JE et al. How to diagnose diastolic heart failure: A consensus statement on the diagnosis of heart failure with normal left ventricular ejection fraction by the Heart Failure and Echocardiography Associations of the European Society of Cardiology. Eur Heart J 2007; 28: 2539-2550
• 7 Reckefuss N, Butz T, Horstkotte D et al. Evaluation of longitudinal and radial leftventricular function by two-dimensional speckle-tracking echocardiography in a large cohort of normal probands. Int J Cardiovasc Imaging 2011; 27: 515-526
• 8 Butz T, Buuren F, Mellwig KP et al. Two-dimensional strain analysis of the global and regional myocardial function for the differentiation of pathologic and physiologic left ventricular hypertrophy: a study in athletes and in patients with hypertrophic cardiomyopathy. Int J Cardiovasc Imaging 2011; 27: 91-100
• 9 Weidemann F, Störk S, Herrmann S et al. Verschiende Formen der linksventrikulären Hypertrophie – Differentialdiagnostischer Beitrag der Echokardiographie. Herz 2011; 36: 713-723
• 10 Faber L, Prinz C, Welge D et al. Peak systolic longitudinal strain of the lateral left ventricular wall improves after septal ablation for symptomatic hypertrophic obstructive cardiomyopathy: A follow-up study using speckle tracking echocardiography. Int J Cardiovasc Imaging 2011; 27: 325-333