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Updated: Mar 20, 2026
Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
Comprehensive left ventricular mechanics analysis by speckle tracking echocardiography in Chagas disease
Marcio Silva Miguel Lima1, Hector R Villarraga2, Maria Cristina Donadio Abduch3
1Serviço de Ecocardiografia, Instituto do Coração (InCor), University of Sao Paulo Medical School, Av Dr Eneas de Carvalho Aguiar, 44, Cerqueira Cesar, 05.403-000, Sao Paulo, SP, Brazil. marcio.lima@incor.usp.br.
Insights
Chagasic cardiomyopathy (CMP) shows altered heart muscle contraction, with reduced movement in some areas and increased movement in others. Early stages may reveal reduced longitudinal velocity, indicating potential early heart injury.
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Imaging
Background:
- Chagas disease (CD) is a leading cause of dilated cardiomyopathy (CMP) and heart failure in endemic regions.
- Understanding the evolution of Chagasic CMP is crucial for patient prognosis.
- Previous studies lacked comprehensive assessment of left ventricular (LV) myocardial mechanics.
Purpose of the Study:
- To comprehensively assess left ventricular (LV) mechanics in Chagasic cardiomyopathy (CMP) using echocardiography.
- To characterize the evolution of myocardial contraction patterns in CD.
- To identify early indicators of myocardial injury in CD.
Main Methods:
- Speckle tracking echocardiography was used to analyze LV mechanics.
- 47 chagasic patients and 84 controls were included, grouped by LV ejection fraction.
- Global and segmental LV myocardial displacements, strain, and strain rate were evaluated.
Main Results:
- Chagasic patients exhibited significantly lower global longitudinal velocity in the indeterminate form.
- Severe systolic dysfunction showed paradoxical increases in longitudinal and apical radial displacements.
- Inferior and inferolateral walls displayed reduced radial displacement and strain, while septal and anterior walls showed increased values.
Conclusions:
- Chagasic CMP presents a vicarious contraction pattern, with reduced strain in posterior/inferior walls and compensatory increases in septal/anterior walls.
- Lower longitudinal velocities in the indeterminate CD form suggest incipient myocardial injury.
- Echocardiographic assessment of LV mechanics aids in understanding CD progression.
Background:
Chagas disease (CD) is a frequent cause of dilated cardiomyopathy (CMP) in developing countries, leading to clinical heart failure and worse prognosis. Therefore, the development and evolution of this CMP has always been a major topic in numbers of previous studies. A comprehensive echocardiographic study of left ventricular (LV) mechanics, fully assessing myocardial contraction, has never been done before. This could help characterize and improve the understanding of the evolution of this prevalent CMP.
Methods:
A total of 47 chagasic and 84 control patients were included in this study and allocated in groups according to LV ejection fraction. 2D-Echocardiogram was acquired for LV mechanics analysis by speckle tracking echocardiography.
Results:
Mean age of chagasic individuals was 55y and 16 (34 %) were men. Significant difference was found in global longitudinal velocity analysis, with lower values in indeterminate form. In the group with severe systolic dysfunction, a paradoxical increase in longitudinal and apical radial displacements were demonstrated. In parallel, segmental analyzes highlighted lower values of radial displacement, strain and strain rate into inferior and inferolateral walls, with increase of these values in septal and anterior walls.
Conclusion:
Chagasic CMP has a vicarious pattern of contraction in the course of its evolution, defined by reduced displacement and strain into inferior and posterior walls with paradoxical increase in septal and anterior segments. Also, lower longitudinal velocities were demonstrated in CD indeterminate form, which may indicate an incipient myocardial injury.
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