Echocardiographic quantification of myocardial function using tissue deformation imaging, a guide to image acquisition and analysis using tissue Doppler and speckle tracking

Arco J Teske¹ , Bart WL De Boeck¹ , Paul G Melman² , Gertjan T Sieswerda¹ , Pieter A Doevendans¹ and Maarten JM Cramer¹

¹Department of Cardiology, University Medical Centre Utrecht, The Netherlands

²Department of Cardiology, St. Elisabeth Hospital Tilburg, The Netherlands

author email corresponding author email

Cardiovascular Ultrasound 2007, 5:27doi:10.1186/1476-7120-5-27


Published:	30 August 2007

Abstract

Recent developments in the field of echocardiography have allowed the cardiologist to objectively quantify regional and global myocardial function. Regional deformation (strain) and deformation rate (strain-rate) can be calculated non-invasively in both the left and right ventricle, providing information on regional (dys-)function in a variety of clinical settings. Although this promising novel technique is increasingly applied in clinical and preclinical research, knowledge about the principles, limitations and technical issues of this technique is mandatory for reliable results and for implementation both in the clinical as well as the scientific field.

In this article, we aim to explain the fundamental concepts and potential clinical applicability of strain and strain-rate for both tissue Doppler imaging (TDI) derived and speckle tracking (2D-strain) derived deformation imaging. In addition, a step-by-step approach to image acquisition and post processing is proposed. Finally, clinical examples of deformation imaging in hypertrophic cardiomyopathy (HCM), cardiac resynchronization therapy (CRT) and arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) are presented.