The clinical usefulness of novel myocardial deformation imaging in daily echocardiographic examinations
Abstract
Myocardial deformation derived by speckle tracking imaging (STI) is a novel method in echocardiography, that provides an insight into cardiac mechanics and is becoming more widely used in daily clinical practice. With this method a new global parameter of left ventricular longitudinal deformation (global longitudinal strain -GLS) has been introduced, which has been shown to be more sensitive for early detection of myocardial impairment compared to conventional echocardiographic systolic function parameters. It has been proved that myocardial deformation parameters have diagnostic as well as prognostic value in several cardiac diseases. Typical findings that can be demonstrated by STI in ischemic heart disease are lower values of systolic deformation, early systolic lengthening and post-systolic shortening in ischemic myocardium. STI can be helpful in early detection of systolic dysfunction in patients with left ventricular hypertrophy and in differentiation of the causes of left ventricular hypertrophy. With STI we can detect early subclinical myocardial impairment after chemotherapy, therefore European recommendations have given priority to STI over classical echocardiographic parameters in further decision-making. In asymptomatic patients with moderate to severe valvular heart disease lower GLS values suggest subtle myocardial damage and predict higher risk of postoperative complications. In patients with myocarditis STI can identify lower values of segmental myocardial deformation, reflecting focal damage of the left ventricle. Additionally, myocardial deformation can also successfully predict response in patitents treated with cardiac resynchronization therapy.
The present paper provides detailed step-by-step description of the GLS analysis, that can be used regardless of the type of ultrasound machine and software package. The use of STI is presented on particular cardiac diseases where clinical usefulness of STI has been confirmed.
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