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Updated: Aug 18, 2026
Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
[Circularity index of left ventricular shape in the assessment of heart disease]
M Yamazoe1, Y Tamura, T Matsubara
1First Department of Internal Medicine, Niigata University School of Medicine.
Insights
This study introduces a new method to quantify left ventricular shape, finding that changes in shape correlate with heart function and wall stress. This quantitative shape analysis aids in understanding cardiovascular disease and predicting ejection fraction.
Area of Science:
- Cardiology
- Biomedical Engineering
- Medical Imaging
Background:
- Left ventricular volume and ejection fraction are key metrics for assessing global left ventricular function.
- Left ventricular shape changes significantly in various heart diseases, including hypertrophic and dilated cardiomyopathy, and myocardial infarction.
- Current methods for evaluating left ventricular function do not fully capture the nuances of regional shape alterations.
Purpose of the Study:
- To develop and validate a novel method for quantifying regional and global left ventricular shape.
- To investigate the relationship between quantitative left ventricular shape parameters and established measures of cardiac function and stress.
- To explore the clinical utility of left ventricular shape analysis in understanding cardiovascular disease.
Main Methods:
- Development of a new method to quantify regional and global left ventricular shape using the Regional Circularity Index (RCI) and Global Circularity Index (GCI).
- Calculation of RCI based on the distance from the endocardial margin to the center of gravity relative to the ventricular area.
- Derivation of GCI from the sum of the magnitude of RCI-1, and correlation analysis with left ventricular wall stress and ejection fraction.
Main Results:
- The end-systolic Global Circularity Index (GCI) showed a strong correlation with end-systolic left ventricular wall stress (r = 0.71, p < 0.001).
- The change in GCI during systole was significantly related to left ventricular ejection fraction (r = 0.79, p < 0.001).
- End-systolic left ventricular moment around the minor axis also correlated well with left ventricular ejection fraction (r = 0.81, p < 0.001).
Conclusions:
- Quantification of regional and global left ventricular shape provides a valuable tool for estimating left ventricular wall stress.
- Left ventricular shape changes during systole and the moment around the short axis are significant contributors to left ventricular ejection.
- This novel shape analysis method offers potential for improved assessment and understanding of various cardiac conditions.
Abstract:
Left ventricular volume and ejection fraction obtained by cineangiography are useful to evaluate global left ventricular function in humans. Left ventriculography provides evidence of the effect of coronary artery stenosis on regional wall motion in patients with coronary artery disease. Changes in left ventricular shape are also found in various heart diseases. The left ventricular cavity is normally ellipsoid in shape, but becomes flat in hypertrophic cardiomyopathy, globular in dilated cardiomyopathy, and aneurysmal in some patients with myocardial infarction. This study developed a new method to quantify regional and global left ventricular shape. Regional circularity index (RCI) was defined as GD divided by r (GD = distance from each 5-degree endocardial margin to the center of gravity, r = radius of the circle equal to left ventricular area). The global circularity index (GCI) was derived from the sum of magnitude of RCI-1. The end-systolic GCI was related to end-systolic left ventricular wall stress (r = 0.71, p < 0.001). The change in GCI during systole was related to left ventricular ejection fraction (r = 0.79, p < 0.001). In severe cases of dilated cardiomyopathy, the left ventricle became more spherical during ejection. End-systolic left ventricular moment around the minor axis had a good correlation with left ventricular ejection fraction (r = 0.81, p < 0.001). Quantification of regional and global left ventricular shape can be used to estimate left ventricular wall stress from left ventricular shape. Left ventricular shape change during systole and the moment around the left ventricular short axis contributes to left ventricular ejection.
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