Echocardiographic assessment of left ventricular untwist rate: comparison of tissue Doppler and speckle tracking methodologies

Abstract

AIMS: The study was designed to test the influence of the temporal resolution, at which tissue Doppler imaging (TDI) and speckle tracking imaging (STI) operate, on the accurate assessment of left ventricular (LV) untwist rate (UR). METHODS AND RESULTS: Echo imaging and invasive LV pressure measurements were performed during right atrial (RA) pacing and dobutamine challenge in eight pigs. LV torsion and torsional rate profiles were analysed from grey scale and tissue Doppler data (apical and basal short axis) at frame rates of 82 +/- 17 and 183 +/- 14 Hz, respectively. Temporal subsampling of TDI data sets was performed at 82 +/- 6 Hz in order to mimic the mean temporal resolution of STI and the LV torsional curves were again extracted. At rest, LV UR values were comparable for both imaging techniques. However, during dobutamine stimulation, TDI estimated peak UR was predominantly higher than UR measured by STI (-112.1 +/- 64.5 degrees /s vs. -75.5 +/- 31.4 degrees /s, P < 0.05). The similarity of LV UR measurements with respect to the STI/TDI data was examined by a Bland-Altman analysis. CONCLUSION: Although both methods regarding LV UR correlated well, these methods cannot be interchanged. STI showed a bias to underestimate UR at high values.