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Comparison of two-dimensional and three-dimensional echocardiographic strain in children with CHD

Published online by Cambridge University Press:  15 May 2017

Bethany L. Wisotzkey ,
Brian D. Soriano  and
Sujatha Buddhe
Bethany L. Wisotzkey
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, Seattle Children’s Hospital, Seattle, Washington, United States of America
Brian D. Soriano
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, Seattle Children’s Hospital, Seattle, Washington, United States of America
Sujatha Buddhe*
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, Seattle Children’s Hospital, Seattle, Washington, United States of America
*
Correspondence to: S. Buddhe, MD, MS, Department of Pediatrics, Division of Pediatric Cardiology, Seattle Children’s Hospital, 4800 Sand Point Way NE, Seattle, WA 98105, United States of America. Tel: +1 206 987 1083; Fax: +1 206 987 3839; E-mail: Sujatha.buddhe@seattlechildrens.org
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Abstract

Background

In CHD, three-dimensional strain analysis may overcome limitations of Doppler and two-dimensional strain of the left ventricle. The aims of this study were to evaluate feasibility and reproducibility of three-dimensional longitudinal, circumferential, and radial systolic strain by three-dimensional speckle-tracking echocardiography compared with two-dimensional echocardiography.

Methods

Patients with CHD, biventricular circulation with a systemic left ventricle, and who had two- and three-dimensional imaging performed on the same day from 2010 to 2014 were included. Quantitative two- and three-dimensional strain analyses were performed (two-dimensional cardiac performance analysis version 1.2 and four-dimensional left ventricular analysis version 3.1). Intra- and inter-observer variabilities were calculated on 25 studies.

Results

A total of 30 patients, including 19 (61%) males, with a median age of 3.6 years (0.1–22 years) were included. The mean fractional shortening was 34.6±5.3%, and the mean ejection fraction was 62.0±6.4%. Measurement of two- and three-dimensional strain was feasible in >95% of segments. Good correlation was observed between longitudinal and circumferential strain (r=0.92, p⩽0.001 and r=0.87, p⩽0.001), but not radial strain (r=0.29, p=0.2). Intra- and inter-observer agreements were better for three-dimensional compared with two-dimensional strain, and better for both two- and three-dimensional longitudinal and circumferential strains compared with radial strain.

Conclusion

Left ventricular three-dimensional strain analysis is feasible in children with CHD. The reproducibility of longitudinal and circumferential strain by three-dimensional analyses is better. Further longitudinal studies are warranted for the potential clinical application of this new technology.

Keywords

CHD3D speckle-tracking imagingstrainechocardiogram
Type
Original Articles
Information
Cardiology in the Young , Volume 27 , Issue 8 , October 2017 , pp. 1557 - 1565
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Copyright
© Cambridge University Press 2017 

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