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Updated: Aug 17, 2026
Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
Detection of left ventricle systolic dysfunction from shape deformity
J Manivannan1, M Ramasubba Reddy, S Thanikachalam
1Biomedical Engineering Division, IIT Madras, Chennai, India.
Insights
Systolic dysfunction in the left ventricle, often caused by coronary artery disease, alters heart shape and function. Echocardiogram analysis reveals distinct changes in sphericity and eccentricity indices, aiding diagnosis.
Area of Science:
- Cardiology
- Medical Imaging
- Biomedical Engineering
Background:
- Coronary artery disease is the primary cause of left ventricular systolic dysfunction, leading to impaired heart contractility and shape.
- Non-ischemic cardiomyopathies, both inherited and sporadic, also contribute to systolic dysfunction.
- Left ventricular dysfunction significantly impacts cardiac function, wall motion, and cavity dynamics.
Purpose of the Study:
- To analyze 2D echocardiograms for quantifying left ventricular systolic dysfunction.
- To investigate changes in left ventricular shape and function using Sphericity Index (SI) and Normalized Eccentricity Index (NEI).
- To differentiate between normal and dysfunctional left ventricles based on echocardiographic parameters.
Main Methods:
- Acquisition of 2D echocardiogram apical views (two and four chamber) from normal and systolic dysfunction subjects.
- Image pre-processing and fuzzy system-based segmentation of the left ventricle.
- Measurement of ventricular volumes, perimeter, and axis lengths to calculate SI and NEI.
Main Results:
- Systolic dysfunction is characterized by a shortened diastolic phase and non-uniform volume variation.
- Reduced variation (<0.5 cm) in long or short axis length indicates akinesis in systolic dysfunction.
- Systolic dysfunction shows SI values less than 2 and distinct NEI plot patterns compared to normal LVEF (>45%) subjects.
Conclusions:
- Echocardiographic analysis of left ventricular shape indices (SI and NEI) can effectively identify systolic dysfunction.
- Quantitative assessment of ventricular dynamics provides insights into the severity and nature of cardiac dysfunction.
- These imaging biomarkers offer potential for improved diagnosis and monitoring of heart conditions.
Abstract:
Coronary artery disease producing ischemic cardiomyopathy is the most frequent cause of left ventricular systolic dysfunction. Non-ischemic cardiomyopathies can also produce systolic dysfunction; they may be inherited as genetic disorders or occur sporadically. These coronary injuries have repercussions on the left ventricle producing changes on wall contractility, the shape of the cavity and also changes on ventricular function. This study is focused on the 2D echocardiograms of the left ventricle. Apical two chamber and four chamber view recordings were performed on normal and systolic dysfunction subjects. Individual frames were extracted for at least five cardiac cycles. After pre-processing these images, segmentation of the left ventricle was performed by Fuzzy systems. Then the volumes were measured by single and biplane methods along with the perimeter, short axis length and long axis length in each frame, from which the two indices Sphericity Index (SI) and Normalized Eccentricity Index (NEI) was determined. It was found that the diastolic phase is short in the case of systolic dysfunction, and its volume variation is not uniform as in the normal case. Also, in the case of systolic dysfunction, the span of either the long or short axis length variation is less than 0.5 cm. This depicts that akinesis is in the corresponding direction; the value of SI is less than 2 for systolic dysfunction. A sharp peak is seen at each systole point in the NEI plot and also its variation is smooth in subjects having LVEF > 45%, which is not the case for dysfunction.
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