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Three-dimensional speckle-tracking echocardiography: benefits and limitations of
integrating myocardial mechanics with three-dimensional imaging
#MMPMID29541615
Muraru D
; Niero A
; Rodriguez-Zanella H
; Cherata D
; Badano L
Cardiovasc Diagn Ther
2018[Feb]; 8
(1
): 101-117
PMID29541615
show ga
Three-dimensional (3D) speckle-tracking echocardiography (3DSTE) is an advanced
imaging technique designed for left ventricular (LV) myocardial deformation
analysis based on 3D data sets. 3DSTE has the potential to overcome some of the
intrinsic limitations of two-dimensional STE (2DSTE) in the assessment of complex
LV myocardial mechanics, offering additional deformation parameters (such as area
strain) and a comprehensive quantitation of LV geometry and function from a
single 3D acquisition. Albeit being a relatively young technique still undergoing
technological developments, several experimental studies and clinical
investigations have already demonstrated the reliability and feasibility of
3DSTE, as well as several advantages of 3DSTE over 2DSTE. This technique has
provided new insights into LV mechanics in several clinical fields, such as the
objective assessment of global and regional LV function in ischemic and
non-ischemic heart diseases, the evaluation of LV mechanical dyssynchrony, as
well as the detection of subclinical cardiac dysfunction in cardiovascular
conditions at risk of progression to overt heart failure. However, 3DSTE
generally requires patient's breathhold and regular rhythm for enabling an
ECG-gated multi-beat 3D acquisition. In addition, the measurements, normal limits
and cut-off values pertaining to 3D strain parameters are currently
vendor-specific and highly dependent on the 3D ultrasound equipment used.
Technological advances with improvement in spatial and temporal resolution and a
standardized methodology for obtaining vendor-independent 3D strain measurements
are expected in the future for a widespread application of 3DSTE in both clinical
and research arenas. The purpose of this review is to summarize currently
available data on 3DSTE methodology (feasibility, accuracy and reproducibility),
strengths and weaknesses with respect to 2DSTE, as well as the main clinical
applications and future research priorities of this emerging technology.
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