Abstract
BackgroundMyocardial contractility can be investigated using longitudinal peak strain. It can be calculated using the Doppler-derived TDI method and the non-Doppler method based on tissue tracking on B-mode images. Both are validated and show good reproducibility, but no comparative analysis of their results has yet been conducted. This study analyzes the results obtained from the basal segments of the ventricular chambers in a group of athletes.Methods30 regularly-trained athletes were submitted to an echocardiography at rest and after handgrip. Starting from the four-chamber view, overall myocardial function and regional velocities were evaluated. The images obtained were processed to determine strain in left and right ventricle basal segments. Strain was calculated using the TDI method and a validated "speckle tracking" or, more correctly, "feature tracking" algorithm. The statistical analysis included a Student's t-test (p < 0.05).ResultsThe range of strain values obtained is in agreement with the data reported in the literature. In the left ventricle (LV) the average strain values of the basal segments calculated with TDI on IVS and LW at rest and after stress were: -21.05 ± 3.31; -20.41 ± 2.99 and -20.05 ± 2.61; -21.20 ± 2.37, respectively. In the right ventricle (RV) the same method gave IVS and LW strain values at rest of -22.22 ± 2.58 ; -24.42 ± 5.84, and after HG of -22.02 ± 5.20 ;-23.93 ± 6.34. The values obtained using feature tracking were: LV at rest -20.48 ± 2.65 for IVS, and -21.25 ± 2.85 for LW; LV after HG: -19.48 ± 3 for IVS and -21.69 ± 3.85 for LW. In RV at rest: -21.46 ± 3.25 for IVS and -24.13 ± 5.86 for LW; RV after HG: -24.79 ± 7.9 for IVS and -24.13 ± 7.0 for LW. Tissue Doppler and "feature tracking" methods showed the respective consistency of the results in the basal segments of myocardial ventricle walls.ConclusionProvided that echographic imaging is good, strain can be computed in athletes by both Doppler-derived and tracking methods. It is technically feasible to use both -interchangeably, at least in basal segments.
Highlights
Myocardial contractility can be investigated using longitudinal peak strain
This study aims at evaluating the uniformity of the results on longitudinal peak strain values obtained with feature tracking and Doppler-derived methods in left and right ventricle basal segments, in a group of athletes at rest and after an isometric stress test
One reason for exclusion was inability to obtain the region of interest (ROI) closely enough to the shape of the left and right ventricular endocardium, which would result in underestimation of data and their contamination by sig
Summary
Myocardial contractility can be investigated using longitudinal peak strain. It can be calculated using the Doppler-derived TDI method and the non-Doppler method based on tissue tracking on B-mode images. Mirsky and Parmely defined "strain" as a dimensionless quantity that represents the percentage change in dimension from a rest state to one achieved after application of a force (stress) [4], and myocardial longitudinal strain is negative in the shortening and positive in the lengthening of a myocardial segment from its reference "R" state Both methods provide reproducible results [5,6,7], depending mostly on the high quality of the images and experience of the operator, but they present different strengths and limitations. A new scanning technology has been proposed which simultaneously acquires high-quality 2-dimensional images with an adequate frame rate for grey scale imaging, and high frame rate tissue Doppler data [8,9] This automated analysis method cannot analyze as many segments as can be done manually [10], and the combined use of both methods is still not a viable solution. There is no direct evidence in literature of the consistency of the two non-automated methods, at least in basal segments where angle dependence is not influential, ruling out the possibility of employing the two methods interchangeably
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