242Deformation of endocardial surface for the evaluation of LV contraction by 3D echocardiography: a parameter that reflects longitudinal and circumferential strain performance


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Abstract

Backround and Purpose: area strain (Aε) is a new proposed parameter for the quantification of regional and global myocardial function. It can be derived from a full-volume 3D speckle-tracking acquisition and represents changes in endocardial surface of a segment (Figure A). In this analysis we evaluated Aε in healthy subjects, ischemic (IHD) and non-ischemic (non-IHD) cardiomyopathies with normal or reduced ejection fraction (EF).Methods: we studied 14 healthy subjects (CNT), 31 IHD with normal (n=17) or reduced EF (n=14) and 16 non-IHD patients with normal (n=11) or reduced EF (n=5). Images were offline analyzed with 3D wall motion tracking software for the assessment of segmental and global Aε. From the same acquisition LV volumes, EF, radial, longitudinal and circumferential strain (Rε, Lε, Cε respectively) were also assessed.Results: global LV Aε was −44,4±4,7% in CNT and it was significantly higher than in patients with reduced EF (IHD:-14,2±6,8%; non-IHD:-24,7±6,1%; p<0,0001 for all) and sligthly higher then in patients with normal EF (IHD:-39,3±3,8% p<0,01; non-IHD:-39,8±7,9 p=0,08). Global Aε was highly correlated with EF (r=-0,926; p<0,001) and to ESV (r=0,828; p<0,001). For the segmental analysis 979 segments (94%) were available. Mean values within groups were not significantly different from the global analysis. Of note segmental Aε variations are strictly related to Lε (r=0,753;p<0,001) and to Cε (r=0,917; p>0,001) (Figure B) with a lower degree of relation with Rε (r=-532;p<0,001).Conclusions: global Aε is a parameter that effectively reflects changes of EF in IHD and non-IHD with an uncertain additive role. Its main feature is the close segmental correlation with both Lε and Cε that underlines its quantitative and comprehensive role in regional function assessment.

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