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The value of 2D strain imaging during stress testing
Marie Moonen1, Patrizio Lancellotti, Dimitrios Zacharakis
1CHU Sart Tilman, Department of Cardiology, Liege, Belgium.
Echocardiography (Mount Kisco, N.Y.)
|March 18, 2009
Summary
Two-dimensional (2D) strain echocardiography offers objective myocardial deformation analysis, overcoming subjective interpretations in stress tests. Further research is needed to confirm its clinical value in various cardiac conditions.
Area of Science:
- Cardiology
- Medical Imaging
- Echocardiography
Background:
- Stress echocardiography interpretation is subjective, limiting its widespread use.
- Speckle tracking echocardiography allows objective assessment of myocardial deformation (radial, longitudinal, circumferential).
- Two-dimensional (2D) strain shows reliability comparable to sonomicrometry for left ventricular (LV) regional function assessment.
Purpose of the Study:
- To evaluate the role and reliability of 2D strain echocardiography during stress testing.
- To explore the potential of 2D strain in identifying myocardial ischemia and viability.
- To assess the clinical utility of 2D strain in specific patient populations.
Main Methods:
- Utilizing speckle tracking to analyze myocardial deformation during dobutamine or exercise stress.
- Comparing 2D strain parameters with traditional wall motion scoring and other assessment methods.
- Investigating optimal cutoffs for 2D strain rate (SR) in predicting coronary artery disease.
Main Results:
- Longitudinal and circumferential strain abnormalities precede radial changes during inducible ischemia.
- Optimal 2D strain rate cutoffs at peak dobutamine stress can predict coronary artery disease.
- 2D strain rate currently does not offer incremental accuracy over expert visual interpretation.
- Preliminary data suggest 2D strain during exercise may benefit asymptomatic patients with severe aortic stenosis or mitral regurgitation.
Conclusions:
- 2D strain echocardiography provides objective myocardial function assessment during stress.
- Its clinical significance and reliability in stress testing require further investigation.
- Future studies will define the precise role of 2D strain in managing cardiac conditions.
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