Abstract 17415: Speckle-Tracking Longitudinal Strain Assessment in the Presence of Myocardial Contrast Agents is Feasible After Microbubble Destruction
BACKGROUND: Speckle-tracking longitudinal strain (STLS) is an important tool for quantification of LV function. STLS assessment is challenging in the presence of echo contrast agents (CA). This is a problem because CA are increasingly used to improve endocardial definition for quantification of LV volumes in patients with poor endocardial border definition. We hypothesized that the use of different timing intervals and image settings could allow the measurement of STLS despite the presence of CA.
METHODS: We studied 15 consecutive individuals who had a clinically indicated transthoracic echocardiogram requiring CA. STLS was measured from apical 4-, 2- and 3-chamber views before and after CA was given. Four different settings were tested: A) baseline STLS without contrast; B) STLS with low MI (0.3); C) STLS 1 minute post-contrast administration with high MI; D) STLS 1 minute post-contrast administration at high MI using three-dimensional imaging for microbubble destruction.
RESULTS: Feasibility of STLS assessment was significantly reduced post CA with low MI (35% of uninterpretable segments vs 1.1% at baseline, p<0.0001), but not statistically different with high MI (3%, p=0.27) or high MI with microbubble destruction (1.1%, p=NS). When comparing the global longitudinal strain, significant underestimation biases were observed for post CA with low MI (-2.3; Figure 1, Panel A) and high MI settings (-1.8) but not for high MI with microbubble destruction (-0.4; Figure 1, Panel B), which had the best measurement agreement with baseline values.
CONCLUSION: STLS cannot be performed after CA administration using the conventional contrast settings. The calculation of STLS is feasible, if three-dimensional imaging is used as a tool for microbubble destruction 1 minute after the administration of contrast.
- © 2011 by American Heart Association, Inc.