CLINICAL RESEARCH: CARDIAC IMAGING
Measurement of Ventricular Torsion by Two-Dimensional Ultrasound Speckle Tracking Imaging
Yuichi Notomi, MD*,
Peter Lysyansky, PhD ,
Randolph M. Setser, DSc ,
Takahiro Shiota, MD, FACC*,
Zoran B. Popovi , MD*,
Maureen G. Martin-Miklovic,
Joan A. Weaver, RT*,
Stephanie J. Oryszak*,
Neil L. Greenberg, PhD, FACC*,
Richard D. White, MD*, and
James D. Thomas, MD, FACC*,*
* Department of Cardiovascular Medicine, The Cleveland Clinic Foundation, Cleveland, Ohio
Department of Radiology, The Cleveland Clinic Foundation, Cleveland, Ohio
GE Ultrasound Israel Ltd, Tirat Hacarmel, Israel
Manuscript received December 13, 2004;
revised manuscript received February 7, 2005,
accepted February 22, 2005.
* Reprint requests and correspondence to: Dr. James D. Thomas, Department of Cardiovascular Medicine/F15, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, Ohio 44195. (Email: thomasj{at}ccf.org).
OBJECTIVES: We sought to examine the accuracy/consistency of a novel ultrasound speckle tracking imaging (STI) method for left ventricular torsion (LVtor) measurement in comparison with tagged magnetic resonance imaging (MRI) (a time-domain method similar to STI) and Doppler tissue imaging (DTI) (a velocity-based approach).
BACKGROUND: Left ventricular torsion from helically oriented myofibers is a key parameter of cardiac performance but is difficult to measure. Ultrasound STI is potentially suitable for measurement of angular motion because of its angle-independence.
METHODS: We acquired basal and apical short-axis left ventricular (LV) images in 15 patients to estimate LVtor by STI and compare it with tagged MRI and DTI. Left ventricular torsion was defined as the net difference of LV rotation at the basal and apical planes. For the STI analysis, we used high-frame (104 ± 12 frames/s) second harmonic two-dimensional images.
RESULTS: Data on 13 of 15 patients were usable for STI analysis, and LVtor profile estimated by STI strongly correlated with those by tagged MRI (y = 0.95x + 0.19, r = 0.93, p < 0.0001, analyzed by repeated-measures regression models). The STI torsional velocity profile also correlated well with that by the DTI method (y = 0.79x + 2.4, r = 0.76, p < 0.0001, by repeated-measures regression models) with acceptable bias.
CONCLUSIONS: The STI estimation of LVtor is concordant with those analyzed by tagged MRI (data derived from tissue displacement) and also showed good agreement with those by DTI (data derived from tissue velocity). Ultrasound STI is a promising new method to assess LV torsional deformation and may make the assessment more available in clinical and research cardiology.
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Abbreviations and Acronyms
| | CV = coefficient of variation | | DTI = Doppler tissue imaging | | LV = left ventricular | | LVrot = left ventricular rotation | | LVrot-v = left ventricular rotational velocity | | LVtor = left ventricular torsion | | LVtor-v = left ventricular torsional velocity | | MRI = magnetic resonance imaging | | STI = speckle tracking imaging |
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B. T. Esch and D. E. R. Warburton
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T. Nishikage, H. Nakai, V. Mor-Avi, R. M. Lang, I. S. Salgo, S. H. Settlemier, S. Husson, and M. Takeuchi
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J. Wang, D. S. Khoury, Y. Yue, G. Torre-Amione, and S. F. Nagueh
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