Comparative feasibility of myocardial velocity and strain measurements using two different methods with transesophageal echocardiography during cardiac surgery

Abstract

Objective: To assess the feasibility and correlation between tissue Doppler and speckle tracking imaging when measuring myocardial velocity, strain, and strain rate with transesophageal echocardiography. Design: A prospective, observational study. Setting: An academic tertiary-referral hospital. Participants: Patients undergoing elective heart surgery. Interventions: None. Measurements and Main Results: Velocity, strain, and strain rate were measured using both techniques in the inferior and anterior walls in transgastric views for radial motion and in the lateral, septal, anterior, and inferior walls in midesophageal views for longitudinal motion. Nineteen patients and 304 myocardial segments were studied. Overall, tissue Doppler was found to be more successful than speckle tracking in measuring myocardial velocity, whereas strain and strain rate measurements were achieved with comparable success using either method. Tissue Doppler was more successful than speckle tracking for radial cardiac motion, and the highest success rates were achieved with this method (93.4% v 59.2% for velocity, p < 0.001; 78.9% v 59.2% for strain, p = 0.01; and 73.7% v 59.2% for strain rate, p = 0.09). Good correlation between tissue Doppler and speckle tracking was shown in 4 myocardial segments: radial midinferior, radial basal inferior, radial basal anterior, and longitudinal basal septum (R = 0.6-0.82, p < 0.05). Conclusions: The correlation between tissue Doppler and speckle tracking with transesophageal echocardiography appears valid when predominantly confined to segments moving in a radial direction adjacent to the ultrasound transducer. Tissue Doppler echocardiography of radial cardiac motion appears to be the most feasible technique of measuring myocardial velocity, strain, and strain rate during cardiac surgery.