Comparison of apical left ventricular segments strain imaging by tissue Doppler and speckle tracking echocardiography

Spatial orientation of left ventricular (LV) apical segments is a potential limitation to assessment by tissue Doppler echocardiography (TDE). Speckle tracking echocardiography (STE) is a recently developed quantification technique and has the advantage of being angle-independent as compared to TDE.

To assess matching apical segments' longitudinal strain data from TDE and STE.

A 16-segment LV model was used. The study was based on a dataset of 306 myocardial segments from 22 consecutive patients with various degrees of wall motion abnormalities. 82 available apical lateral, septal, anterior and inferior segments from 2-chamber and 4-chamber views were selected for further assessment. The Bland-Altman method was used for comparison of mean strain values of corresponding segments.

An acceptable overall agreement between the two modalities was shown by the Bland-Altman method. The correlation ratio was 0.7. The measurements of apical lateral and anterior segments' longitudinal strain showed no significant difference. Speckle tracking echocardiography tended to produce lower strain results than TDE with mean values of -9 and -14%, respectively, p=0.0025.

Although angle-dependency of TDE may be a potential limitation in the strain imaging of apical LV segments, the overall agreement between TDE and angle independent STE technique is still acceptable.