Assessment of Left Ventricular Dyssynchrony Using Two-dimensional Strain Echocardiography(2D-Strain): Comparison Between Radial and Longitudinal Approach

Background: Left ventricular (LV) remodeling, characterized by increased LV hypertrophy and depressed function, is observed in strength-trained athletes who use anabolic-androgenic steroids (AAS). Previous studies reported an increase in cardiac fibrosis in these athletes, which could promote intraventricular dyssynchrony. In this context, this study evaluated LV dyssynchrony in strength-trained athletes using AA; hypothesizing that the use of AAS leads to an increase in LV dyssynchrony with an increase in post-systolic shortening. Methods: Forty-four participants (aged 20-40 years) were divided into three age-matched groups: strength-trained athletes using AAS (users, n=14) and those who were not (non-users, n=15), and healthy sedentary men (controls, n=15),. After completing a survey, each participant was assessed with 2D-strain echocardiography. Left ventricular dyssynchrony was quantified using the standard deviation of the time to peak for longitudinal strains (SD), the longitudinal strain delay index (LSDI) and the segmental post-systolic index (PSI). Results: Users exhibited a greater LV mass index and higher systolic and diastolic functions than both controls and non-users. The decrease in LV strains in users was predominantly observed at the interventricular segments. The SD, LSDI and PSI, calculated on the basal inferoseptal, basal anteroseptal and basal inferolateral segments, were higher in users. Conclusion: The results strongly support that the specific LV remodeling observed in young AAS users was associated with an increase in LV dyssynchrony. The correlations with ejection fraction suggested that wasted energy, due to post-systolic shortenings, contributed in part to the decrease in LV function in strength-trained athletes using AAS.

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Comparison of strain and dyssynchrony measurements in fetal two-dimensional speckle tracking echocardiography using Philips and TomTec

Journal of Perinatal Medicine ◽

10.1515/jpm-2019-0424 ◽

2020 ◽

Vol 48 (3) ◽

pp. 266-273

Author(s):

Helen Ann Köster ◽

Kerstin Hammer ◽

Janina Braun ◽

Kathrin Oelmeier de Murcia ◽

Mareike Möllers ◽

...

Keyword(s):

Speckle Tracking ◽

Longitudinal Strain ◽

Speckle Tracking Echocardiography ◽

Left Ventricular ◽

Left Ventricular Dyssynchrony ◽

Two Dimensional ◽

Medical Systems ◽

Ventricular Dyssynchrony ◽

Chamber View ◽

2D Speckle Tracking

AbstractBackgroundThe aim of this study was to compare Philips and TomTec two-dimensional speckle tracking echocardiography (2D-STE) software measurements of strain and dyssynchrony values in healthy fetuses.MethodsThis was an explorative observational study in which the echocardiographic data of 93 healthy fetuses between the 20th and 38th week of gestation were determined from a four-chamber view using 2D speckle tracking. The global and segmental longitudinal strain values of both ventricles, inter-ventricular and left intra-ventricular dyssynchrony were analyzed using QLab version 10.8 (Philips Medical Systems, Andover, MA, USA) and TomTec-Arena version 2.30 (TomTec, Unterschleißheim, Germany).ResultsTomTec showed persistently lower values for all of the assessed strain and dyssynchrony variables. For all variables, the bias between vendors tended to increase with gestational age, though not to a significant extent. Left ventricular dyssynchrony and longitudinal strain within the mid segment of the septum correlated best between vendors; however, the limits of agreement were wide in both cases. None of the variables assessed in the two-chamber view compared well between QLAB and TomTec.ConclusionSpeckle tracking software cannot be used interchangeably between vendors. Further investigations are necessary to standardize fetal 2D-STE.

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