Two-dimensional (2D) Speckle tracking strain curve:
Myocardial deformation imaging by two-dimensional (2D) strain based on
speckle tracking deformation imaging, as an index of contractile
function, was assessed on grey-scale echocardiographic images. (17)
Electrocardiogram was contacted to the patient’s chest till proper
adjustment of the heart rate recording on the echocardiography machine.
A frame rate of 80-100 frames/sec was utilized for storage and analysis.
At least three consecutive cardiac cycles of 2D apical four-chamber
images were documented at each plane and were introduced into the GE
Echo-PAC (BT 09, Horten, Norway) workstation to select the best Speckle
tracking analysis images. The images were optimized to visualize the
myocardial walls. 2D speckle tracking offline analysis software was
automatically tracked the endocardial, epicardial borders and the
myocardial movement of the RV frame by frame, thus delineating a region
of interest composed of six segments including (Basal-lateral,
mid-lateral, apico-lateral, apico-septal, mid-septal and basal-septal).
The analysis was established when adequate tracking was confirmed by
visual inspection and the software. If the tracking of the RV
endocardium was unsatisfactory, manual adjustments of the region of
interest size were achieved to confirm optimal tracking. RV systolic
strain curves were assessed in the longitudinal direction for each
segment by the software. Once approved, the software displayed an
average which is the global longitudinal strain (GLS) to assess the
global RV myocardial function automatically. (18-20) These
echocardiographic measures were recorded and reported at rest and after
dobutamine stress.