Evaluation of left ventricular rotation by two-dimensional speckle tracking method and real-time three-dimensional echocardiography: Comparison with MRI tagging method

Background: Recently, it has become possible to evaluate left ventricular (LV) torsion by two-dimensional (2D) speckle tracking images. However, LV torsion is a three-dimensional (3D) performance, which per se cannot be assessed by the 2D speckle tracking method. The present study investigated the accuracy of the 2D speckle tracking method and real-time 3D echocardiography in measuring LV rotation, comparing with the MRI tagging method. Methods: We assessed LV apical rotation using the 2D speckle tracking method, real-time 3D echocardiography, and MRI tagging method in 26 normal subjects, and compared the results of these three methods. LV apical rotation was measured just before the level in which the posterior papillary muscle was absorbed into the free wall. Results: The degree of LV apical rotation evaluated by the 2D speckle tracking method (Δθ2D) was significantly smaller than that evaluated by 3D echocardiography (Δθ3D) and the MRI tagging method (ΔθMRI) (Δθ2D 7.3 ± 2.8° Δθ3D 8.8 ± 3.4° ΔθMRI 9.0 ± 3.4° Δθ2D vs. Δθ3D, p = 0.0001; Δθ2D vs. ΔθMRI, p < 0.0001). There were good correlations among Δθ2D, Δθ3D, and ΔθMRI, but agreement between Δθ3D and ΔθMRI (mean difference 0.14 ± 1.43°) was better than that between Δθ2D and ΔθMRI (mean difference 1.68 ± 1.89°). Conclusion: The degree of LV apical rotation was underestimated with the 2D speckle tracking method compared with the MRI tagging method, whereas it could be precisely measured by 3D echocardiography. © 2010 Japanese Society of Echocardiography.