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Updated: May 25, 2026
Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
[Left ventricular longitudinal rotation changes in patients with dilated cardiomyopathy detected by two-dimensional
Jun Huang1, Xian-da Ni, Yuan-ping Hu
1Department of Ultrasound, First Affiliated Hospital of Wenzhou Medical College, Wenzhou 325000, China.
Insights
Dilated cardiomyopathy (DCM) patients exhibit clockwise left ventricular longitudinal rotation (LR), unlike healthy individuals who show counterclockwise LR. This clockwise rotation in DCM may stem from timing delays within the left ventricle.
Area of Science:
- Cardiology
- Medical Imaging
Context:
- Dilated cardiomyopathy (DCM) is a significant cause of heart failure.
- Assessing left ventricular (LV) function is crucial for managing DCM.
- Longitudinal rotation (LR) is an emerging parameter for evaluating LV mechanics.
Purpose:
- To evaluate left ventricular longitudinal rotation (LR) in patients diagnosed with dilated cardiomyopathy (DCM).
- To compare LR patterns between DCM patients and healthy controls.
- To investigate the relationship between LR and other echocardiographic parameters in DCM.
Summary:
- Conventional echocardiography and 2D speckle tracking imaging (2D-STI) were used to assess LV mechanics in 42 DCM patients and 35 healthy controls.
- DCM patients demonstrated significantly reduced radial strain and strain rate compared to healthy subjects.
- A prominent clockwise LR was observed in DCM patients, contrasting with the counterclockwise LR in healthy individuals. A correlation was found between time delays in LV wall motion and peak LR in DCM patients.
Impact:
- 2D-STI is a viable method for assessing LR in DCM.
- The identification of clockwise LR in DCM provides new insights into myocardial dysfunction.
- Understanding these mechanical alterations can potentially lead to improved diagnostic and therapeutic strategies for DCM.
Objective:
To assess the left ventricular longitudinal rotation (LR) in patients with dilated cardiomyopathy (DCM).
Methods:
Conventional echocardiography (GE-Vivid7) was performed in 35 healthy subjects and 42 DCM patients. Left atrial diameter was measured by M-mode echocardiography, left ventricular end-systolic, end-diastolic volume and left ventricular ejection fraction (LVEF) were calculated by bi-plane simpson's method. The peak velocity during early diastole (Ve) and late diastole (Va) of anterior mitral valve were measured by pulse-waved doppler, and the ratio Ve/Va was calculated. The peak radial systolic strain, strain rate in systolic, early and late diastolic periods were measured. Segmental LR and global LR were assessed using two-dimensional speckle tracking imaging (2D-STI).
Results:
The peak radial systolic strain, strain rate in systolic, early and late diastolic periods in DCM group were significantly lower than in healthy subjects, the rotation degrees of the middle and base lateral, the apex and the base septum walls were significantly lower than those of the healthy subjects. A prominent counterclockwise LR (0.76° ± 2.63°) was shown in healthy subjects while prominent clockwise LR (-1.58° ± 3.42°) was present in DCM patients. The time delay between the left ventricular lateral wall and the base septum wall in DCM patients significantly correlated with the peak LR of the left ventricular (r = 0.409, P < 0.01; r = 0.396, P < 0.01).
Conclusions:
2D-STI can be used to assess the LR in DCM patients and a clockwise LR is present in DCM patients which might be caused by the time delay between the left ventricular lateral wall and the base-septum wall.
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