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European Heart Journal Advance Access originally published online on November 19, 2008
European Heart Journal 2009 30(5):608-617; doi:10.1093/eurheartj/ehn511
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Assessment of subendocardial vs. subepicardial left ventricular rotation and twist using two-dimensional speckle tracking echocardiography: comparison with tagged cardiac magnetic resonance

Céline Goffinet1, Fabien Chenot1, Annie Robert2, Anne-Catherine Pouleur1, Jean-Benoît le Polain de Waroux1, David Vancrayenest1, Olivier Gerard3, Agnès Pasquet1, Bernhard L. Gerber1 and Jean-Louis Vanoverschelde1,*

1 Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Avenue Hippocrate 10, Boite 2881, B-1200 Brussels, Belgium
2 Ecole de santé publique, Epidemiology and Biostatistics, Université Catholique de Louvain, Brussels, Belgium
3 Philips Medical System, Paris, France

Received 6 March 2008; revised 9 October 2008; accepted 23 October 2008; online publish-ahead-of-print 19 November 2008.

* Corresponding author. Tel: +32 2 764 2803, Fax: +32 2 764 2811, Email: vanoverschelde{at}card.ucl.ac.be

Aims: The aim of this article is to evaluate the accuracy and reproducibility of two-dimesional speckle tracking echocardiography (2D-STE) for the estimation of left ventricular (LV) twist, using tagged cardiac magnetic resonance (cMR) as the reference standard, and to assess how much 2D-STE rotational parameters are affected by the level at which measurements are made within the LV.

Methods and results: Forty-three patients with various heart diseases and 10 healthy volunteers underwent cMR and 2D-STE on the same day. With both methods, basal and apical time–rotation curves were generated at endocardial, midwall, and epicardial levels. By using the most apical cMR short-axis cross-section as a comparator, apical rotation was significantly underestimated by 2D-STE. When 2D-STE and cMR short-axis cross-sections were matched for their internal dimensions, measurements of endocardial, midwall, and epicardial twists no longer differ between cMR and 2D-STE (12.6 ± 5.9 vs. 12.5 ± 5.7°, 10.5 ± 4.6 vs. 9.7 ± 4.1°, and 8.9 ± 4.0 vs. 8.4 ± 3.7°, respectively, all P = ns).

Conclusion: Compared with tagged cMR, 2D-STE underestimates apical rotation and LV twist. This is related to the inability of 2D-STE to image the real LV apex in most of the patients. However, when 2D-STE and cMR data are compared at similar acquisition levels, both techniques provide similar values.

Key Words: LV twist • Speckle tracking • MRI • Comparative studies


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 Eur J EchocardiogrHome page
B. M. van Dalen, O. I.I. Soliman, W. B. Vletter, F. Kauer, H. B. van der Zwaan, F. J. ten Cate, and M. L. Geleijnse
Feasibility and reproducibility of left ventricular rotation parameters measured by speckle tracking echocardiography
Eur J Echocardiogr, July 1, 2009; 10(5): 669 - 676.
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