Abstract 13585: Validation of Real-Time 3-Dimensional Global Speckle Tracking during Dobutamine Stress Echocardiography

Abstract

Background: Global longitudinal strain (GLS) by 2D speckle tracking (2D-ST) is a useful measurement to quantify LV function during dobutamine stress echocardiography (DSE), but limited by time consumption and expertise. 3D speckle tracking (3D-ST) is a new method that may improve diagnostic utility and reduce study times. We examine the validity of 3D-ST during DSE.

Methods: Thirty six patients (mean age 68+10 years, EF 57+12%) underwent DSE as per clinical indication. Measurements of GLS and area strain (AS) by 3D-ST were validated against GLS by 2D-ST during rest, low dose (LD), and peak dose (PD) dobutamine. 2D-ST data were acquired by 3 standard apical planes at frame rate of 50-80 frames/sec. 3D-ST data were obtained in a single apical 3D full volume acquisition over 4 cardiac cycles at frame rate > 25 frames/sec. Echo data were analyzed offline using EchoPAC. Total time for image acquisition and strain analysis at rest were recorded.

Results: Both GLS and AS by 3D-ST had excellent correlation with GLS by 2D-ST at rest and LD, but only modest correlation at PD (table). GLS and AS by 3D-ST correlated well with LV function measured by ejection fraction using 3D echo (3D-EF) during all stages of DSE. Average time for acquisition and analysis were 3.7+1.0 minutes with 3D-ST and 4.6+1.5 minutes with 2D-ST (p = 0.04).

Conclusions: 3D-ST provide a fast and effective method to quantify LV function during DSE compared with 2D-ST. Reduced correlation at peak dose reflects increased signal noise and limitation of frame rate. 3D-ST is a potential bedside clinical tool for quantifying global strain.