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Updated: Sep 17, 2025
Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
Assessment of pit viper associated subclinical myocardial injury by speckle tracking imaging
Jing Chen1,2, Yang Feng1, Jiaqi Chen1
1Department of Ultrasound, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatric Metabolism and Inflammatory Diseases, Children's Hospital of Chongqing Medical University, Chongqing, China.
Insights
Early detection of cardiac dysfunction after snakebite is crucial. Two-dimensional speckle tracking echocardiography (2D-STE) using global longitudinal strain (GLSendo) shows high sensitivity in identifying myocardial injury, improving patient management.
Area of Science:
- Cardiology
- Toxicology
- Medical Imaging
Background:
- Traditional Left Ventricular Ejection Fraction (LVEF) assessment via echocardiography has limitations in detecting early systolic dysfunction post-snakebite.
- Early detection of myocardial damage is vital for effective management and prognosis in snakebite victims.
Purpose of the Study:
- To evaluate the diagnostic efficacy of two-dimensional speckle tracking echocardiography (2D-STE) strain parameters for myocardial injury following venomous snakebite.
- To correlate serological markers with 2D-STE findings and assess the sensitivity of global longitudinal strain (GLSendo) in diagnosing envenomation-induced cardiac dysfunction.
Main Methods:
- A study involving 37 snakebite patients, categorized by the Snakebite Severity Scale (SSS).
- Analysis of correlations between serological markers and 2D-STE strain parameters (GLSendo, apical circumferential strain - ACS).
- Receiver Operating Characteristic (ROC) curves were used to determine diagnostic effectiveness.
Main Results:
- A significant decrease in left ventricular endocardial global longitudinal strain (GLSendo) was observed post-snakebite (p < 0.01).
- Apical circumferential strain (ACS) was also reduced in affected patients (p < 0.05), with severity correlating to strain reduction.
- GLSendo demonstrated a high sensitivity (0.935) with a cut-off of 18.7% for diagnosing myocardial injury.
Conclusions:
- GLSendo measured by 2D-STE is a sensitive indicator of early myocardial injury in snakebite patients.
- Incorporating GLSendo into standard echocardiographic assessments can provide early insights into cardiac damage, guiding treatment and patient management.
Abstract:
In post-snakebite patient care, cardiac function is chiefly monitored through Left Ventricular Ejection Fraction (LVEF) via traditional echocardiography. This approach fails to detect early systolic dysfunction sensitively, which is key for managing envenomation-induced myocardial damage and impacts treatment and prognosis. In a study of 37 snakebite patients, individuals were grouped by severity using the Snakebite Severity Scale (SSS). Correlations between serological markers and two-dimensional speckle tracking echocardiography (2D-STE) strain parameters were analyzed, with ROC curves assessing the diagnostic effectiveness for myocardial injury. After a venomous snakebite, the study found a significant decrease in the left ventricular endocardial global longitudinal strain (GLSendo) compared to the middle and epicardium layer (p < 0.01). The circumferential strain of the apical segment (ACS) was also lower in the affected group than in the control group (p < 0.05), with more severe envenomation associated with a great reduction in both GLSendo and the ACS (p < 0.01). The sensitivity of GLSendo for diagnosing myocardial injury due to venomous snakebite was 0.935, with the cut-off was 18.7%. The finding underscores the importance of using GLSendo as part of the standard echocardiographic assessment in patient. By providing early insight into the extent of myocardial injury and informed decisions regarding treatment and patient management.
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