Defining cardiac function by use of 3D-speckle-tracking-echo – 3D-speckle-tracking-echo in healthy hearts

Aims: Various cardiac function-parameters have been studied by use of different 2D echocardiographic approaches, including TDI and speckle tracking, which have method-inherent limitations such as angle dependency and through-plane motion. 3D speckle-tracking echocardiography is a novel method which may overcome some of these limitations. The aim of our 3D-study was to examine strain, rotation and twist in healthy hearts. Methods: 49 healthy volunteers were included (age 44±13 years, systolic ejection fraction 61.5±3.0%). An ECG-gated full volume data-set was recorded with a 3D probe from an apical window (Toshiba ArtidaTM). Wall motion analysis was performed using the ASE–16-segment-model. Results: strain, including radial (RS) and longitudinal strain (LS), rotation (ROT) and twist (TWT) were normally distributed. Comparison of different localizations within individual hearts disclosed significant regional heterogeneity for RS, LS, ROT and TWT. The base of the heart was “dominated“ by radial strain (RS: basal 30.5±12.0; apical 16±9.0; p<0.0001), whereas the apex was "dominated" by maximum values for LS, ROT and TWT each. (LS: basal –15±5.2; apical –19.3±4.8; p<0.0001; ROT: basal –1.1±3.8; apical 8.07±6.0; p<0.0001; TWT: basal 1.7±2.4; apical 10.8±6.5; p<0.0001). Conclusion: 3D speckle-tracking echocardiography is quick and feasible and may overcome some limitations of 2D-techniques. RS, LS, ROT and TWT were normally distributed in healthy hearts. Significant regional heterogeneity was detected with respect to basal and apical function. The clinical value of 3D speckle tracking derived parameters in diseased hearts needs to be further investigated. The herewith presented normalized values may serve as a reference.