122 3D Speckle tracking for characterizing transmurality of myocardial necrosis

Abstract

The aim of the study was to compare the accuracy of 3D strain for characterizing myocardial transmurality necrosis. The study included 17 patients (12 males, 64 ± 14 years) with ischemic left ventricular dysfunction (38 ± 9%). Longitudinal, circumferential, and radial strain by 3D speckle tracking, 3D area strain were computed from baseline 3D echocardiography data and compared to transmural necrosis by MRI. On the whole, 232 segments (85%, 232/272) were analyzable by 3D and MRI. Decrease in radial strain occurred lately when transmural necrosis was >75% (9 ± 9% vs.18 ± 14%, p < 0.001). In contrast, longitudinal strain decreased early when transmural necrosis was >25% (−9 ± 6% vs. – 6 ± 5%, p = 0.001) and remained stable thereafter without significant difference between 25% and 75%. Interestingly, circumferential and 3D area strain were able to differentiate all stages of necrosis <25%, 25–75% and >75% (See Figure). 3D strain values by speckle tracking analysis are consistent with the anatomical fibers distribution and correlates with the transmurality of myocardial necrosis assessed by MRI. Circumferential and 3D area strain provides a continuous assessment of transmural necrosis.