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Updated: Jan 27, 2026
Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
Diagnostic utility of two-dimensional speckle tracking echocardiography to identify ischemic etiology of left
Ewelina Kowalczyk1, Jarosław D Kasprzak1, Paulina Wejner-Mik1
1Department of Cardiology, Medical University of Lodz, Lodz, Poland.
Insights
Coronary artery disease (CAD) causes more varied early diastolic strain rates in the heart muscle than dilated cardiomyopathy (DCM). Two-dimensional speckle tracking echocardiography (2DSTE) can help differentiate these conditions.
Area of Science:
- Cardiology
- Medical Imaging
- Echocardiography
Background:
- Distinguishing dilated cardiomyopathy (DCM) from coronary artery disease (CAD)-induced systolic dysfunction is clinically challenging.
- Echocardiographic assessment is crucial for evaluating left ventricular ejection fraction (LVEF).
Purpose of the Study:
- To identify differences in myocardial function between ischemic (CAD) and non-ischemic (DCM) etiologies of reduced LVEF.
- To evaluate the utility of 2D speckle tracking echocardiography (2DSTE) in differentiating these conditions.
Main Methods:
- Retrospective analysis of 90 patients with newly diagnosed reduced LVEF (≤45%).
- Patients were categorized into significant CAD (n=45) and no CAD (n=45) groups based on coronary angiography.
- 2DSTE was used to assess regional longitudinal strain and strain rate in 18 left ventricular segments.
Main Results:
- The standard deviation of regional peak early diastolic strain rate was significantly higher in the CAD group (P=0.01).
- A cutoff value of >0.37/s for this parameter showed 73% sensitivity and 53% specificity for diagnosing CAD.
- Other assessed parameters did not show significant differences between groups.
Conclusions:
- Systolic dysfunction due to CAD is associated with more heterogeneous regional longitudinal early diastolic strain rates compared to DCM.
- 2DSTE can provide valuable insights into differentiating the causes of reduced LVEF.
Background:
The differentiation between dilated cardiomyopathy (DCM) and systolic dysfunction caused by coronary artery disease (CAD) based on clinical and echocardiographic presentation can be difficult in some cases.
Aim:
Our study aimed to define differences in myocardial function between patients with ischemic and nonischemic etiology of reduced left ventricular ejection fraction using 2D speckle tracking echocardiography (STE).
Material And Methods:
We retrospectively analyzed 90 patients (mean age 65 ± 11 years, 70% male) with de novo diagnosed reduced left ventricular ejection fraction (≤45% as determined by the transthoracic echocardiography), who were referred for coronary angiography to determine the presence of significant CAD. On the basis of coronary angiography results, patients were divided into two subgroups as follows: 45 subjects with significant CAD (group A) and 45 subjects without CAD (group B). Acquired transthoracic echocardiographic images were assessed off-line using 2DSTE. In each patient, we calculated arithmetic mean, median value, and standard deviation of regional longitudinal strain and strain rate of 18 left ventricular segments.
Results:
Standard deviation of the regional peak early diastolic strain rate was significantly higher in group A than in group B (P = 0.01). The cutoff value with the highest diagnostic value was >0.37/s-its sensitivity and specificity for the diagnosis of CAD were 73% and 53%, respectively. The remaining parameters did not differ significantly between the study groups.
Conclusions:
Patients with systolic dysfunction resulting from CAD have significantly more heterogeneous regional longitudinal early diastolic strain rate assessed by 2DSTE than patients with DCM.
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