Speckle tracking echocardiography-derived indices, such as E/Ds and E/10 DSr, provide a more accurate estimation of left ventricular filling pressures compared to traditional tissue Doppler E/Ea.
Does speckle tracking echocardiography improve the noninvasive estimation of left ventricular filling pressures compared to tissue Doppler imaging?
Speckle tracking echocardiography provides novel strain-based indices that may offer more accurate noninvasive estimation of left ventricular filling pressures than traditional tissue Doppler, particularly in patients with preserved ejection fraction.
Diastolic dysfunction is common in cardiac disease and an important finding independent of systolic function as it contributes to the signs and symptoms of heart failure. Tissue Doppler mitral early diastolic velocity (Ea) combined with peak transmitral early diastolic velocity (E) to obtain E/Ea ratio provides an estimate of the left ventricular (LV) filling pressure. However, E/Ea has a significant gray zone and less reliable in patients with preserved ejection fraction (>50%). Two-dimensional echocardiographic speckle tracking measure myocardial strain and strain rate (Sr) avoiding the Doppler-associated angulation errors and tethering artifacts. Global myocardial peak diastolic strain (Ds) and diastolic Sr (DSr) at the time of E and isovolumic relaxation combined with E (E/Ds and E/10 DSr) have been recently proposed as novel indices to determine LV filling pressure. The present article elucidates the methodology of studying diastology with strain echocardiography along with the advantages and limitations of the novel technique in light of the available literature.
Malik et al. (Sun,) conducted a review in Diastolic dysfunction. Speckle tracking echocardiography (strain and strain rate) vs. Tissue Doppler echocardiography (E/Ea) was evaluated on Estimation of left ventricular filling pressures. Speckle tracking echocardiography-derived indices, such as E/Ds and E/10 DSr, provide a more accurate estimation of left ventricular filling pressures compared to traditional tissue Doppler E/Ea.