Speckle tracking: distinction of physiologic from pathologic LVH?

Excerpt

Over the past years, echocardiography and magnetic resonance imaging (MRI) have become important imaging modalities in patients with a broad spectrum of cardiomyopathies [1‐20]. Both imaging modalities have been shown to play a pivotal role in the accurate evaluation of left ventricular function particularly in patients with ischemic heart disease and different forms of cardiomyopathy [21‐36]. These methods are needed to accurately identify and characterize patients with various manifestations of left ventricular hypertrophy (LVH) [37‐49]. The important question should be resolved whether training-induced LVH in athletes is a physiological rather than a pathophysiological phenomenon [50‐57]. In a meta-analysis using MRI, involving 59 studies and 1,451 athletes (both endurance-trained and strength-trained athletes), it was reported that the athlete’s heart demonstrated normal systolic and diastolic cardiac function, implying that training-induced LVH in athletes is predominantly a physiological phenomenon [58]. With respect to echocardiography, two-dimensional strain has become a novel method to measure strain from standard two-dimensional echocardiographic images by speckle tracking. Speckle tracking offers the advantage of being less angle-dependent and more reproducible than conventional Doppler-derived strain [59‐61]. This echocardiographic imaging technique allows quantification of global and regional myocardial deformation on the basis of tracking of acoustic markers from frame-to-frame. …