Comparison of two-dimensional speckle and tissue Doppler strain measurement during dobutamine stress echocardiography

An angiographic correlation

Lizelle Hanekom, Goo Yeong Cho, Rodel Leano, Leanne Jeffriess, Thomas H. Marwick

Research output: Contribution to journalArticleResearchpeer-review

133 Citations (Scopus)

Abstract

Aims: Two-dimensional (2D)-strain derived from speckle-tracking is an alternative to tissue velocity imaging (TVI)-based strain. We compared their feasibility and accuracy in 150 patients undergoing dobutamine stress echocardiography (DSE) and coronary angiography. Methods and results: 2D- and TVI-strain were obtained in three apical views at rest and peak stress. Peak systolic strain rate (SR), endsystolic strain (εend-sys), and peak strain (εpeak) were measured off-line at rest and peak stress, and results were compared with wall motion analysis and significant coronary artery disease (CAD ≥ 70% diameter stenosis). Optimal cut-offs were derived from receiver operating characteristic (ROC) curves for sentinel segments. The most feasible method was 2D-strain at rest, and TVI-strain at peak stress. The average peak SR and εend-sys at peak stress in segments of patients with significant CAD was less than in segments of patients without CAD (P < 0.0001) and mean PSI at peak stress was higher (P < 0.0001) with both 2D- and TVI-strain. Peak systolic SR at peak stress had the best area under the ROC for both 2D- (AUC 0.67) and TVI-strain (AUC 0.71) for the diagnosis of CAD. The accuracy of WMS (75%) for diagnosis of CAD per patient was similar to 2D-SR (69%) and TVI-SR (74%). The accuracy of 2D-SR and TVI-SR at peak stress was 78 vs. 79% (P = NS) for LAD, 67 vs. 73% (P = NS) for LCX, and 59 vs. 74% (P = 0.008) for RCA disease. Conclusion: Measurement of speckle tracking strain during DSE is feasible and similar in accuracy to TVI-strain in the anterior, but not in the posterior circulation.

Original languageEnglish
Pages (from-to)1765-1772
Number of pages8
JournalEuropean Heart Journal
Volume28
Issue number14
DOIs
StatePublished - 1 Jun 2007

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Stress Echocardiography
ROC Curve
Area Under Curve
Coronary Angiography
Coronary Artery Disease
Pathologic Constriction

Keywords

  • Coronary angiography
  • Dobutamine stress echo
  • Ischaemia
  • Strain rate

Cite this

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title = "Comparison of two-dimensional speckle and tissue Doppler strain measurement during dobutamine stress echocardiography: An angiographic correlation",
abstract = "Aims: Two-dimensional (2D)-strain derived from speckle-tracking is an alternative to tissue velocity imaging (TVI)-based strain. We compared their feasibility and accuracy in 150 patients undergoing dobutamine stress echocardiography (DSE) and coronary angiography. Methods and results: 2D- and TVI-strain were obtained in three apical views at rest and peak stress. Peak systolic strain rate (SR), endsystolic strain (εend-sys), and peak strain (εpeak) were measured off-line at rest and peak stress, and results were compared with wall motion analysis and significant coronary artery disease (CAD ≥ 70{\%} diameter stenosis). Optimal cut-offs were derived from receiver operating characteristic (ROC) curves for sentinel segments. The most feasible method was 2D-strain at rest, and TVI-strain at peak stress. The average peak SR and εend-sys at peak stress in segments of patients with significant CAD was less than in segments of patients without CAD (P < 0.0001) and mean PSI at peak stress was higher (P < 0.0001) with both 2D- and TVI-strain. Peak systolic SR at peak stress had the best area under the ROC for both 2D- (AUC 0.67) and TVI-strain (AUC 0.71) for the diagnosis of CAD. The accuracy of WMS (75{\%}) for diagnosis of CAD per patient was similar to 2D-SR (69{\%}) and TVI-SR (74{\%}). The accuracy of 2D-SR and TVI-SR at peak stress was 78 vs. 79{\%} (P = NS) for LAD, 67 vs. 73{\%} (P = NS) for LCX, and 59 vs. 74{\%} (P = 0.008) for RCA disease. Conclusion: Measurement of speckle tracking strain during DSE is feasible and similar in accuracy to TVI-strain in the anterior, but not in the posterior circulation.",
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Comparison of two-dimensional speckle and tissue Doppler strain measurement during dobutamine stress echocardiography : An angiographic correlation. / Hanekom, Lizelle; Cho, Goo Yeong; Leano, Rodel; Jeffriess, Leanne; Marwick, Thomas H.

In: European Heart Journal, Vol. 28, No. 14, 01.06.2007, p. 1765-1772.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Comparison of two-dimensional speckle and tissue Doppler strain measurement during dobutamine stress echocardiography

T2 - An angiographic correlation

AU - Hanekom, Lizelle

AU - Cho, Goo Yeong

AU - Leano, Rodel

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AU - Marwick, Thomas H.

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N2 - Aims: Two-dimensional (2D)-strain derived from speckle-tracking is an alternative to tissue velocity imaging (TVI)-based strain. We compared their feasibility and accuracy in 150 patients undergoing dobutamine stress echocardiography (DSE) and coronary angiography. Methods and results: 2D- and TVI-strain were obtained in three apical views at rest and peak stress. Peak systolic strain rate (SR), endsystolic strain (εend-sys), and peak strain (εpeak) were measured off-line at rest and peak stress, and results were compared with wall motion analysis and significant coronary artery disease (CAD ≥ 70% diameter stenosis). Optimal cut-offs were derived from receiver operating characteristic (ROC) curves for sentinel segments. The most feasible method was 2D-strain at rest, and TVI-strain at peak stress. The average peak SR and εend-sys at peak stress in segments of patients with significant CAD was less than in segments of patients without CAD (P < 0.0001) and mean PSI at peak stress was higher (P < 0.0001) with both 2D- and TVI-strain. Peak systolic SR at peak stress had the best area under the ROC for both 2D- (AUC 0.67) and TVI-strain (AUC 0.71) for the diagnosis of CAD. The accuracy of WMS (75%) for diagnosis of CAD per patient was similar to 2D-SR (69%) and TVI-SR (74%). The accuracy of 2D-SR and TVI-SR at peak stress was 78 vs. 79% (P = NS) for LAD, 67 vs. 73% (P = NS) for LCX, and 59 vs. 74% (P = 0.008) for RCA disease. Conclusion: Measurement of speckle tracking strain during DSE is feasible and similar in accuracy to TVI-strain in the anterior, but not in the posterior circulation.

AB - Aims: Two-dimensional (2D)-strain derived from speckle-tracking is an alternative to tissue velocity imaging (TVI)-based strain. We compared their feasibility and accuracy in 150 patients undergoing dobutamine stress echocardiography (DSE) and coronary angiography. Methods and results: 2D- and TVI-strain were obtained in three apical views at rest and peak stress. Peak systolic strain rate (SR), endsystolic strain (εend-sys), and peak strain (εpeak) were measured off-line at rest and peak stress, and results were compared with wall motion analysis and significant coronary artery disease (CAD ≥ 70% diameter stenosis). Optimal cut-offs were derived from receiver operating characteristic (ROC) curves for sentinel segments. The most feasible method was 2D-strain at rest, and TVI-strain at peak stress. The average peak SR and εend-sys at peak stress in segments of patients with significant CAD was less than in segments of patients without CAD (P < 0.0001) and mean PSI at peak stress was higher (P < 0.0001) with both 2D- and TVI-strain. Peak systolic SR at peak stress had the best area under the ROC for both 2D- (AUC 0.67) and TVI-strain (AUC 0.71) for the diagnosis of CAD. The accuracy of WMS (75%) for diagnosis of CAD per patient was similar to 2D-SR (69%) and TVI-SR (74%). The accuracy of 2D-SR and TVI-SR at peak stress was 78 vs. 79% (P = NS) for LAD, 67 vs. 73% (P = NS) for LCX, and 59 vs. 74% (P = 0.008) for RCA disease. Conclusion: Measurement of speckle tracking strain during DSE is feasible and similar in accuracy to TVI-strain in the anterior, but not in the posterior circulation.

KW - Coronary angiography

KW - Dobutamine stress echo

KW - Ischaemia

KW - Strain rate

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