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Updated: Feb 21, 2026
Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
Assessment of left ventricular performance in heart transplant recipients by three-dimensional speckle tracking
Dan Wang1, Li Zhang, Qingyu Zeng
1Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Hubei Province Key Lab of Molecular Imaging, Wuhan, China.
Insights
Heart transplant recipients show reduced left ventricular (LV) global performance initially, but it improves over time. Global performance index (GPI) and global longitudinal strain (GLS) predict LV function post-transplant.
Area of Science:
- Cardiology
- Biomedical Engineering
- Transplantation Medicine
Background:
- Heart transplantation (HT) is a life-saving procedure for end-stage heart failure.
- Assessing long-term left ventricular (LV) function post-HT is crucial for patient management.
- Three-dimensional speckle tracking imaging (3D-STI) offers advanced methods for evaluating cardiac mechanics.
Purpose of the Study:
- To calculate LV global performance in heart transplant recipients using 3D-STI.
- To observe changes in LV global performance over time after HT.
- To identify factors correlating with LV global performance post-transplant.
Main Methods:
- 3D-STI was used to assess LV torsion, systolic dyssynchrony index (SDI), and global strain (GS) in 30 HT recipients (at 1 and 6 months post-op) and 30 controls.
- Global Performance Index (GPI) was calculated.
- Multivariate stepwise regression analysis identified predictors of LV GPI.
Main Results:
- HT recipients exhibited higher heart rate, left atrium size, and LV mass compared to controls.
- SDI was significantly higher in HT groups, decreasing from 1 to 6 months post-op.
- LV apical rotation, twist, and torsion were reduced in HT recipients, while GS also decreased.
- GPI was lower in HT recipients, but improved from 1 to 6 months post-op.
- Global longitudinal strain (GLS), time since surgery, LV mass, and apical rotation predicted LV GPI.
Conclusions:
- 3D-STI derived parameters like LV rotation, twist, and SDI effectively assess LV systolic function and dyssynchrony post-HT.
- The GPI derived from 3D-STI accurately reflects LV performance changes over time after HT.
- GLS, time since surgery, LV mass, and apical rotation are key predictors of LV global performance, which tends to stabilize and improve post-transplant if LVEF is preserved.
Abstract:
To calculate left ventricular (LV) global performance values in heart transplant (HT) recipients by three-dimensional speckle tracking imaging (3D-STI) and to observe the changes in LV global performance over time after HT and investigate the correlated factors.The 30 HT patients were divided into 2 groups according to postoperative time: 1 month postoperatively (HT-1) group and 6 months postoperatively (HT-2) group. Thirty healthy subjects were enrolled as control group. 3D-STI was performed to assess LV torsion, LV systolic dyssynchrony index (SDI), and LV global strain (GS). Global performance index (GPI) was calculated, and correlations factors with GPI were studied.Heart rate (HR), left atrium (LA), interventricular septum thickness (IVST), left ventricular posterior wall thickness (LVPWT), and left ventricular mass (LVM) in both HT groups were higher than those in the control group. Compared with the control group, SDI was significantly higher in both HT groups, and SDI of the HT-1 group was much higher than that of HT-2 group. Compared with the control group, apical rotation (RoA), twist and torsion in the both HT groups decreased significantly. There were no significant differences in these values between the 2 HT groups; Basal rotation (RoB) showed no significantly difference among the 3 groups. GS in the both HT groups decreased significantly compared with the control group, and there were no significant differences in these values between the 2 HT groups. GPI of the both HT groups was significantly lower than that of the control group; however, GPI of HT-2 group was higher than that of HT-1 group. Multivariate stepwise regression analysis identified global left ventricular longitudinal peak systolic strain (GLS), the time length since surgery, left ventricular mass (LVM), and RoA as predictors of LV GPI. GLS was the most influential to GPI.The values of LV rotation, twist and SDI can be used to assess the LV systolic function and dyssynchrony. The GPI value based on 3D-STI may accurately reflect LV performance changes over time after HT. The GPI value has potential applications in clinical practice. GLS, the time length since surgery, LVM and RoA values can be the predictors of LV global performance, and as long as the left ventricular ejection fraction (LVEF) is preserved, the left ventricular global performance of HT recipients remains stable, and tends to improve over time after HT.
