Influence of ultrasound image quality on the left ventricle strain and rotation parameters

Objective: to compare the values of longitudinal and circumferential strain, rotation, twist, and untwist of the left ventricle in patients with acute coronary syndrome depending on the quality of ultrasound images.

Material and methods: depending on the quality of ultrasound images in a short axis planes 320 patients with acute coronary syndrome (unstable angina, myocardial infarction) were divided into two groups. The 1st group consisted of 210 patients with good quality of ultrasound images of the heart (decrease of image clarity less than 4 segments at all levels), the 2nd group – 110 patients with excellent quality of ultrasound images of the heart (high image clarity of all segments). There were clear images of heart structures in apical planes in both groups in all cases. The image quality assessed with the use of the 16-segment model of the left ventricle. The modules of the obtained values of global, average and regional strain, rotation, twist, and untwist were compared.

Results: the body mass index in the 1st group of patients (good quality of image) was significantly higher. The frequency of disorders of left ventricle regional strain in the groups was comparable. The values of circumferential strain (global, average, and regional, except for the apical inferior segment) were significantly lower in the 1st group of patients. The values of global longitudinal strain, average longitudinal strain at the level of the mid segments, and regional longitudinal strain of the mid segments of the left ventricle (except for the mid inferoseptal) were significantly lower in the 1st group of patients. There were no significant differences of left ventricle rotation (except for basal in systole), twist and untwist, and their indices between the groups. As well as no significant differences were obtained for standard echocardiography parameters between the groups.

Conclusion: the values of circumferential strain (global, average, and regional, except for the apical inferior segment) and longitudinal strain (global, average at the level of the mid segments, and regional for all mid segments except for the mid inferoseptal) depends on quality of ultrasound image in our study. The values of rotation (except for basal left ventricle rotation in systole), left ventricle twist and untwist does not depend on ultrasound images quality (good versus excellent).

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