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Comparative Study
. 2017 Sep 12;15(1):22.
doi: 10.1186/s12947-017-0111-x.

The impact of preload on 3-dimensional deformation parameters: principal strain, twist and torsion

Hyo-Suk Ahn  1 , Yong-Kyun Kim  2 , Ho Chul Song  2 , Euy Jin Choi  2 , Gee-Hee Kim  1 , Jung Sun Cho  1 , Sang-Hyun Ihm  1 , Hee-Yeol Kim  1 , Chan Seok Park  3 , Ho-Joong Youn  1
Affiliations
Comparative Study

The impact of preload on 3-dimensional deformation parameters: principal strain, twist and torsion

Hyo-Suk Ahn et al. Cardiovasc Ultrasound. .

Abstract

Background: Strain analysis is feasible using three-dimensional (3D) echocardiography. This approach provides various parameters based on speckle tracking analysis from one full-volume image of the left ventricle; however, evidence for its volume independence is still lacking.

Methods: Fifty-eight subjects who were examined by transthoracic echocardiography immediately before and after hemodialysis (HD) were enrolled. Real-time full-volume 3D echocardiographic images were acquired and analyzed using dedicated software. Two-dimensional (2D) longitudinal strain (LS) was also measured for comparison with 3D strain values.

Results: Longitudinal (pre-HD: -24.57 ± 2.51, post-HD: -21.42 ± 2.15, P < 0.001); circumferential (pre-HD: -33.35 ± 3.50, post-HD: -30.90 ± 3.22, P < 0.001); and radial strain (pre-HD: 46.47 ± 4.27, post-HD: 42.90 ± 3.61, P < 0.001) values were significantly decreased after HD. The values of 3D principal strain (PS), a unique parameter of 3D images, were affected by acute preload changes (pre-HD: -38.10 ± 3.71, post-HD: -35.33 ± 3.22, P < 0.001). Twist and torsion values were decreased after HD (pre-HD: 17.69 ± 7.80, post-HD: 13.34 ± 6.92, P < 0.001; and pre-HD: 2.04 ± 0.86, post-HD:1.59 ± 0.80, respectively, P < 0.001). The 2D LS values correlated with the 3D LS and PS values.

Conclusion: Various parameters representing left ventricular mechanics were easily acquired from 3D echocardiographic images; however, like conventional parameters, they were affected by acute preload changes. Therefore, strain values from 3D echocardiography should be interpreted with caution while considering the preload conditions of the patients.

Keywords: Hemodialysis; Myocardial strain; Three-dimensional echocardiography.

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Conflict of interest statement

Ethics approval and consent to participate

This study was approved by the Institutional Review Board of Bucheon St. Mary’s Hospital and was in compliance with the Declaration of Helsinki. Written consent was obtained from the subjects before performing the screening echocardiography.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Global principal, longitudinal, circumferential and radial strain before and after hemodialysis. Twist and torsion according to hemodialysis status are also presented. GPS: global principal strain; GLS: global longitudinal strain; GCS: global circumferential strain; and GRS: global radial strain
Fig. 2
Fig. 2
Comparison of the volume, principal strain and torsion of the left ventricle based on the acute preload reduction. Pre-hemodialysis (a, c and e); and post-hemodialysis (b, d and f).
Fig. 3
Fig. 3
Correlation between 3-dimensional principal and longitudinal strains and 2-dimensional longitudinal strain. Pre-hemodialysis (a and b); and post-hemodialysis (c and d). GPS: global principal strain; and GLS: global longitudinal strain
Fig. 4
Fig. 4
Correlation between 3-dimensional principal and area strains. GPS: global principal strain; and GAS: global area strain
Fig. 5
Fig. 5
Reliability test for global principal strain of the left ventricle. Bland-Altman analyses for prehemodialysis (a: intra-observer; and b: inter-observer) and post-hemodialysis (c: intra-observer; and d: inter-observer) patients
See this image and copyright information in PMC

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