Purpose: We evaluated the utility of 2D and 3D LV global myocardial deformity parameters in assessing diastolic function by comparing invasive measures of LV performance.
Methods: Echocardiography and LV pressure measures were performed in 27 patients (age=61±11yrs; LVEF=40±18%). Myocardial longitudinal, circumferential, and radial deformation as well as area strain (AS) were assessed utilizing 2D and 3D speckle tracking software (ArtidaR, Toshiba). 2D global diastolic strain rate (2D-SRe) was measured by averaging the values from each of the 3 apical and 3 short axis views. 3D diastolic strain was obtained at the one-third of diastolic period and diastolic index (DI) was calculated by % change of global strain during the first one-third of diastolic period. On the same day, LV end diastolic (LVEDP) and the rate of LV pressure change (dP/dt) were collected using the pressure wire catheter and tau was calculated.
Results: Tau was related to 2D longitudinal (2D-SRelong) and radial strain rate (2D-SReradial) as well as 3D longitudinal DI (3D-DIlong) and area strain DI (3D-DIas) (p=0.01 for 2D-SRelong and 2D-SReradial; p=0.02 for 3D-DIlong; p=0.03 for 3D-DIas). Minimal dP/dt was also related to 2D-SRelong, 2D-SReradial, 3D-DIlong and 3D-DIas (p=0.05 for 2D-SRelong; p=0.04 for 2D-SReradial; p=0.02 for 3D-DIlong; p=0.05 for 3D-DIas). LVEDP was associated with ratio of mitral early diastolic velocity (E) to 2D-SRelong, 2D-SReradial, 3D-DIlong, 3D-DIas and Em (p=0.01 for 2D-SRelong; p=0.01 for 2D-SReradial; p=0.01 for 3D-DIlong; p=0.02 for 3D-DIas), p<0.01 for E/Em). Areas under the curves for predicting LVEDP>15 mmHg were comparable among E/2D-SRelong, E/2D-SReradial, E/3D-DIlong, E/3D-DIas and E/Em.
Conclusions: 2D-SRelong, 2D-SReradial, 3D-DIlong and 3D-DIas were related to LV relaxation. E/2D-SRelong, E/2D-SReradial, E/3D-DIlong and E/3D-DIas can reflect elevated LV filling pressure, suggesting that they may provide additional information in evaluating LV diastolic function.
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