Real-Time 3-Dimensional Global Speckle Tracking: A New Tool for Quantitative Stress Echocardiography

Abstract

Background: Global longitudinal strain (GLS) by 2D speckle tracking (2D-ST) improves diagnostic accuracy of wall motion analysis during dobutamine stress echocardiography (DSE), but limited by time consumption and expertise. 3D speckle tracking (3D-ST) is a new method that may improve diagnostic usefulness and reduce study times. We examine the validity of GLS by 3D-ST during DSE. Methods: Twenty-six patients (mean age 72 ± 8, EF 58 ± 11%) underwent DSE as per clinical indication. Measurements of GLS by 2D-ST and 3D-ST were obtained at rest, low dose (LD), and peak dose (PD) dobutamine. 2D-ST data were acquired by three standard apical planes. 3D-ST data were obtained in a single apical 3D full volume acquisition over four cardiac cycles. GLS, EF, and wall motion were analysed offline using EchoPAC. Time for image acquisition and analysis were recorded. Results: There is good correlation of GLS between 3D-ST and 2D-ST at rest and LD but only modest correlation at PD (table). GLS by 3D-ST correlated well with EF (rest r = 0.66, p = 0.002; LD r = 0.8, p < 0.0001; PD r = 0.66, p = 0.001). Mean times for acquisition and analysis were 3.8 ± 0.5 min with 3D-ST and 5.9 ± 0.3 min with 2D-ST (p = 0.004).Tabled 13D-ST vs. 2D-ST GLSRESTLDPDR0.750.810.53p value<0.0001<0.00010.01 Open table in a new tab Conclusions: GLS by 3D-ST provide a faster, more effective method to quantify LV function during DSE compared with 2D-ST. Reduced correlation at peak dose reflects increased signal noise. 3D-STE is a potential bedside clinical tool for quantifying GLS.