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Updated: Oct 3, 2025
Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
Segmental Tissue Speckle Tracking Predicts the Stenosis Severity in Patients With Coronary Artery Disease
Srisakul Chaichuum1, Shuo-Ju Chiang1,2, Masao Daimon3
1Graduate Institute of Biomedical Materials and Tissue Engineering, Taipei Medical University, Taipei, Taiwan.
Insights
Two-dimensional speckle tracking echocardiography (2D-STE) can assess coronary artery disease (CAD) severity. Lower myocardial strain and strain rate values indicate more severe coronary artery stenosis, aiding in diagnosis.
Area of Science:
- Cardiology
- Medical Imaging
- Diagnostic Techniques
Background:
- Two-dimensional speckle tracking echocardiography (2D-STE) is utilized for diagnosing coronary artery disease (CAD).
- The predictive value of vessel-supplied myocardial strain and strain rate (SR) for coronary artery stenosis severity in CAD patients remains unclear.
Purpose of the Study:
- To investigate the correlation between cardiac mechanical parameters measured by 2D-STE and the severity of coronary artery stenosis.
- To assess the feasibility of using non-invasive 2D-STE for evaluating coronary artery conditions in patients with diagnosed CAD.
Main Methods:
- Coronary angiography and 2D-STE were performed on 59 patients with clinically diagnosed CAD.
- Vessel myocardium strain (VMS) and strain rate (VMSR) were calculated by averaging longitudinal strain and SR in the myocardial segments supplied by each coronary artery.
- Patients were categorized into four groups based on coronary artery stenosis severity (mild, moderate, severe, very severe).
Main Results:
- Significant differences in VMS and VMSR were observed across different stenosis severity groups (p = 0.016 for VMS, p < 0.001 for VMSR).
- Vessels with very severe stenosis (≥75%) showed significantly lower VMS (13.9 ± 4.3) and VMSR (0.9 ± 0.3) compared to those with mild stenosis (≤25%).
- Lower VMS and VMSR values predicted higher likelihood of severe coronary stenosis, while higher values predicted mild or no stenosis.
Conclusions:
- 2D-STE effectively assesses coronary artery condition, correlating with stenosis severity determined by catheterization.
- The non-invasive application of 2D-STE is feasible for evaluating and simplifying the diagnosis of CAD.
Objective:
Two-dimensional speckle tracking echocardiography (2D-STE) has been used as a diagnostic tool for coronary artery disease (CAD). However, whether vessel supplied myocardial strain and strain rate (SR) predict the severity of coronary artery stenosis in patients with CAD is unknown. This study aimed to investigate correlation of cardiac mechanical parameters in tissue speckle tracking measurements with coronary artery stenosis diagnosed by cardiac catheterization in patients with clinically diagnosed CAD.
Methods And Results:
Among 59 patients analyzed, 170 vessels were evaluated by coronary angiography and the corresponding echocardiography to quantify left ventricular myocardial strain and SR. The average longitudinal strain and SR of the segmental myocardium supplied by each coronary artery were calculated to achieve vessel myocardium strain (VMS) and strain rate (VMSR). The VMS and VMSR at each of four severity levels of stenosis showed significant differences among groups (p = 0.016, and p < 0.001, respectively). The strain and SR in vessels with very severe stenosis (≥75%, group IV; n = 29), 13.9 ± 4.3, and 0.9 ± 0.3, respectively, were significantly smaller than those of vessels with mild stenosis ≤ 25%, group I; n = 88, 16.9 ± 4.9, p = 0.023, and 1.2 ± 0.3, p = 0.001, respectively. The SR in vessels with moderate stenosis (26-49%, group II; n = 37), 1.0 ± 0.2, was significantly smaller than that in vessels with mild stenosis vessels (p = 0.021). The lower VMS and VMSR, the higher possibility of severe coronary stenosis is. The VMS and VMSR lower than 13.9 ± 4.3 and 0.9 ± 0.3, respectively predicted the severe coronary stenosis. The VMS and VMSR higher than 16.9 ± 4.9 and 1.2 ± 0.3, respectively predicted mild or no coronary artery stenosis.
Conclusions:
The actual stenosis rate in catheterization demonstrates that this technique was able to assess coronary artery condition. Thus, the application of a non-invasive method of 2D-STE to evaluate and simplify diagnosis of CAD is feasible.
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