Assessment of Myocardial Contractility using 2D and 3D Speckle Tracking
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Assessment of Myocardial Contractility Using 2D and 3D Speckle Tracking V. E. Oleynikov*, Yu. G. Smirnov, A. V. Golubeva, L. Yu. Krivonogov, V. A. Galimskaya, and E. A. Gundarev
Early detection of myocardial damage in patients without clinical symptoms is an important advantage of myocardial strain detection methods. This review addresses contemporary aspects of the assessment of left ven tricular myocardial contractile function using ultrasound investigations with additional methods. Overcoming the limitations of the previous method, i.e., tissue Doppler imaging, twodimensional and threedimensional speck le tracking methods provide rapid, semiautomatic, and highly reproducible evaluation of myocardial strain. These methods provide unique information on the orientation of myocardial fibers, providing for evaluation of a novel parameter — strain area — to which the attention of Russian manufacturers of ultrasound equipment should be drawn. In addition, the limitations and potentials of these diagnostic methods are discussed.
Introduction Studies of cardiac biomechanics are extremely important in evaluating the function of the whole of the cardiovascular system in health and disease. Previous attempts to assess myocardial function using hemody namic indexes have been described. However, these have not found wide use, as they provide indirect evaluation of cardiac contractility and have quite low prognostic value. Introduction of a variety of methods (MRI, scintigraphy, tissue Doppler, speckle tracking) have provided some improvements to assessments of contractile function, as they provide for observation of the movement of cardiac structures in real time. Knowledge of the anatomical structure and three dimensional mechanics of the left ventricular (LV) myocardium is the key to understanding and interpreting threedimensional information in clinical practice. The LV wall is made up of transverse and longitudinal muscle fibers. The longitudinal fibers of the LV myocardium are orientated in a righthanded spiral in the subendocardi um and a lefthanded spiral in the subepicardium, while the transverse fibers lie between them.
Penza State University, Penza, Russia; Email: [email protected] * To whom correspondence should be addressed.
The complex anatomical structure of the myocardi um explains various aspects of myocardial strain. Changes in the strain characteristics of the LV myocardium may be a sign for early detection of myocar dial dysfunction of various etiologies. Measurement of these parameters provides a topical assessment of myo cardial lesions following infarction, allows the effective ness of revascularizing treatments to be evaluated, and can be used for prognostication of cardiac failure [2].
Myocardial Strain and its Parameters When two neighboring points in the myocardium move at different velocities, the myocardium changes its shape (is deformed, undergoes strain). Otherwise, the myocardium moves without undergoing strain. Know ledge of the velocity of movement of the myocardial wa
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