Real-time quantitative automatic assessment of left ventricular ejection fraction and regional wall motion by speckle...

Echocardiographic assessment of left ventricular function includes calculation of ejection fraction and regional wall motion analysis. Recently, speckle imaging was introduced for quantification of left ventricular function.

To assess LVEF by speckle imaging and compare it with Simpson's method, and to assess the regional LV strain obtained by speckle imaging in relation to conventional echocardiographic scores.

Thirty consecutive patients, 28 with regional LV dysfunction, underwent standard echocardiographic evaluation. LV end-diastolic volume, LV end-systolic volume and EF were calculated independently by speckle imaging and Simpson's rule. The regional peak systolic strain presented by speckle imaging as a bull's-eye map was compared with the conventional visual estimate of echo score.

Average EDV obtained by speckle imaging and by Simpson's method was 85.1 vs. 92.7 ml (P = 0.38), average ESV was 49.4 vs. 48.8 ml (P = 0.94), calculated EF was 43.9 vs. 50.5% (P = 0.08). The correlation rate with Simpson's rule was high: 0.92 for EDV, 0.96 for ESV, and 0.89 for EF. The peak systolic strain in two patients without wall motion abnormality was 17.3 +/- 4.7; in normal segments of patients with regional dysfunction, peak systolic strain (13.4 +/- 4.9) was significantly higher than in hypokinetic segments (10.5 +/- 4.5) (P < 0.000001). The strain in hypokinetic segments was significantly higher than in akinetic segments (6.2 +/- 3.6) (P < 0.000001).

Speckle imaging can be successfully used for the assessment of LV volumes and EF. Bull's-eye strain map, created by speckle imaging, can achieve an accurate real-time segmental wall motion analysis.