Evaluation of Left Ventricular Rotation Using Speckle Tracking Technique in Echocardiographic Images of Coronary Artery Stenosis Patients

Document Type : Original Paper

Authors

1 Department of Medical Physics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran

2 Tarbiat Modares University

3 Echocardiography Research Center, Rajaie Cardiovascular Medical and Research Center

10.22038/ijmp.2024.77249.2359

Abstract

Introduction: Computed Tomography (CT) is nowadays used widely to differentiate normal brain cranium sutures from abnormal ones in pediatric patients with the aim of early treatment. This study tried to develop a low-dose CT protocol with the acceptable image quality of skull bone in order to evaluate craniosynostosis.
Material and Methods: In this study, 68 men with a mean age of 57± 9 years were enrolled with clinical signs of chest pain. All subjects underwent echocardiography before angiography. LV twist was computed using the speckle tracking algorithm, and LV rotation parameters were obtained from the short-axis view at the base and apex. Based on angiographic findings, the subjects were divided into two groups: 50 individuals with coronary artery stenosis and 18 individuals in the control group who did not have coronary artery stenosis.
Results: The study discovered that patients with coronary artery stenosis had a significantly lower maximum systolic torsion parameter than the control group (11.0 ± 2.6o vs. 14.1± 3.3o, p = 0.000). With a sensitivity of 74% and a specificity of 72%, twist was also a more useful criterion for identifying patients with coronary artery stenosis.
Conclusion: Quantifying the rotational and torsional movement of LV is a non-invasive and useful method for detecting LV dysfunction.

Keywords

Main Subjects


  1. Hajar R. Risk factors for coronary artery disease: historical perspectives. Heart views. 2017 Jul 1;18(3):109-14.
  2. Levine GN, Bates ER, Blankenship JC, Bailey SR, Bittl JA, Cercek B, Chambers CE, Ellis SG, Guyton RA, Hollenberg SM, Khot UN. 2015 ACC/AHA/SCAI focused update on primary percutaneous coronary intervention for patients with ST-elevation myocardial infarction: an update of the 2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention and the 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction. Journal of the American College of Cardiology. 2016 Mar 15;67(10):1235-50.
  3. Liu C, Li J, Ren M, Wang ZZ, Li ZY, Gao F, Tian JW. Multilayer longitudinal strain at rest may help to predict significant stenosis of the left anterior descending coronary artery in patients with suspected non-ST-elevation acute coronary syndrome. The international journal of cardiovascular imaging. 2016 Dec;32:1675-85.
  4. Arab Z, Mokhtari-Dizaji M, Roshanali F, Moladoust H. Assessment of left ventricular torsion in short axis view between healthy subjects and significant coronary artery disease patients. Zahedan J Res Med Sci. 2013 Jan 1; 15:39-46.
  5. Ahmadi ZA, Mokhtari Dizaji M, Sadeghpour A, Khesali H, Firouzi A. Estimation of the segmental left ventricular physical and mechanical parameters using echocardiographic imaging for stent candidate patients. Journal of Clinical Ultrasound. 2023 Jan;51(1):20-8.
  6. Mora V, Roldán I, Romero E, Romero D, Bertolín J, Ugalde N, Pérez-Olivares C, Rodriguez-Israel M, Pérez-Gozalbo J, Lowenstein JA. Comprehensive assessment of left ventricular myocardial function by two-dimensional speckle-tracking echocardiography. Cardiovascular ultrasound. 2018 Dec;16:1-8.
  7. Van Mil AC, Pearson J, Drane AL, Cockcroft JR, McDonnell BJ, Stoehr EJ. Interaction between left ventricular twist mechanics and arterial haemodynamics during localised, non‐metabolic hyperaemia with and without blood flow restriction. Experimental Physiology. 2016 Apr 1;101(4):509-20.
  8. Klaeboe LG, Edvardsen T. Echocardiographic assessment of left ventricular systolic function. Journal of echocardiography. 2019 Mar 15;17:10-6.
  9. Haggerty CM, Kramer SP, Binkley CM, Powell DK, Mattingly AC, Charnigo R, Epstein FH, Fornwalt BK. Reproducibility of cine displacement encoding with stimulated echoes (DENSE) cardiovascular magnetic resonance for measuring left ventricular strains, torsion, and synchrony in mice. Journal of cardiovascular magnetic resonance. 2013 Jan 16;15(1):71.
  10. Notomi Y, Shiota T, Popović ZB, Weaver JA, Oryszak SJ, Greenberg NL, White RD, Thomas JD, Setser RM, White RD, Lysyansky P. Measurement of ventricular torsion by two-dimensional ultrasound speckle tracking imaging. Journal of the American College of Cardiology. 2005 Jun 21;45(12):2034-41.
  11. Aurich M, Keller M, Greiner S, Steen H, aus dem Siepen F, Riffel J, Katus HA, Buss SJ, Mereles D. Left ventricular mechanics assessed by two-dimensional echocardiography and cardiac magnetic resonance imaging: comparison of high-resolution speckle tracking and feature tracking. European Journal of Echocardiography. 2016 Mar 24;17(12):1370-8.
  12. Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, Flachskampf FA, Foster E, Goldstein SA, Kuznetsova T, Lancellotti P. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. European Heart Journal-Cardiovascular Imaging. 2015 Mar 1;16(3):233-71.
  13. Scanlon PJ, Faxon DP, Audet AM, Carabello B, Dehmer GJ, Eagle KA, Legako RD, Leon DF, Murray JA, Nissen SE, Pepine CJ. ACC/AHA guidelines for coronary angiography: executive summary and recommendations: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Coronary Angiography) developed in collaboration with the Society for Cardiac Angiography and Interventions. Circulation. 1999 May 4;99(17):2345-57.
  14. Omar AM, Vallabhajosyula S, Sengupta PP. Left ventricular twist and torsion: research observations and clinical applications. Circulation: Cardiovascular Imaging. 2015 Jun;8(6):e003029.
  15. Awadalla H, Saleh MA, Abdel Kader M, Mansour A. Left ventricular torsion assessed by two‐dimensional echocardiography speckle tracking as a predictor of left ventricular remodeling and short‐term outcome following primary percutaneous coronary intervention for acute myocardial infarction: A single‐center experience. Echocardiography. 2017 Aug;34(8):1159-69.
  16. Jabari A, Mokhtari-Dizaji M, Arab-Bafrani Z, Mosavi E, Mahani L, Hashemi MM. Assessment of left ventricular torsion in long axis view in patients with chronic stenosis of coronary arteries. Caspian Journal of Internal Medicine. 2020;11(1):21.
  17. Mobasheri M, Mokhtari-Dizaji M, Roshanali F. Estimating the Myocardium's Angle of Three-Dimensional Trajectory, Using the Tracking of Sequential Two-Dimensional Echocardiography Images. Journal of Cardiovascular Ultrasound. 2014 Mar 1;22(1):14-22.
  18. Gustafsson U, Lindqvist P, Mörner S, Waldenström A. Assessment of regional rotation patterns improves the understanding of the systolic and diastolic left ventricular function: an echocardiographic speckle-tracking study in healthy individuals. European Journal of Echocardiography. 2009 Jan 1;10(1):56-61.
  19. Han W, Xie MX, Wang XF, Lü Q, Wang J, Zhang L, Zhang J. Assessment of leftventricular torsion in patients with anterior wall myocardial infarction before and afterrevascularization using speckle tracking imaging. Chinese medical journal. 2008 Aug 20;121(16):1543-8.
  20. Stöhr EJ, Shave RE, Baggish AL, Weiner RB. Left ventricular twist mechanics in the context of normal physiology and cardiovascular disease: a review of studies using speckle tracking echocardiography. American Journal of Physiology-Heart and Circulatory Physiology. 2016 Sep 1;311(3):H633-44.
  21. Sengupta PP, Tajik AJ, Chandrasekaran K, Khandheria BK. Twist mechanics of the left ventricle: principles and application. JACC: Cardiovascular Imaging. 2008 May;1(3):366-76.
  22. Huang SJ, Orde S. From speckle tracking echocardiography to torsion: research tool today, clinical practice tomorrow. Current opinion in critical care. 2013 Jun 1;19(3):250-7.