Left ventricular hypertrophy or storage disease? the incremental value of speckle tracking strain bull's-eye

Echocardiography. 2017 May;34(5):746-759. doi: 10.1111/echo.13506. Epub 2017 Mar 19.

Abstract

Left ventricular hypertrophy (LVH) develops in response to a variety of physical, genetic, and biochemical stimuli and represents the early stage of ventricular remodeling. In patients with LVH, subclinical left ventricular (LV) dysfunction despite normal ejection fraction (EF) may be present before the onset of symptoms, which portends a dismal prognosis. Strain measurement with two-dimensional speckle tracking echocardiography (STE) represents a highly reproducible and accurate alternative to LVEF determination. The present review focuses on current available evidence that supports the incremental value of STE in the diagnostic and prognostic workup of LVH. When assessing the components of LV contraction, STE has an incremental value in differentiating between primary and secondary LVH and in the differential diagnosis with storage diseases. In addition, STE provides unique information for the stratification of patients with LVH, enabling to detect intrinsic myocardial dysfunction before LVEF reduction.

Keywords: amyloidosis; anabolic steroids; aortic stenosis; arterial hypertension; athlete's heart; hypertrophic cardiomyopathy; left ventricular hypertrophy; speckle tracking echocardiography; two-dimensional strain.

Publication types

  • Review

MeSH terms

  • Cardiomegaly, Exercise-Induced*
  • Cardiomyopathies / diagnostic imaging*
  • Cardiomyopathies / pathology
  • Diagnosis, Differential
  • Echocardiography / methods*
  • Elasticity Imaging Techniques / methods*
  • Evidence-Based Medicine
  • Humans
  • Hypertrophy, Left Ventricular / diagnostic imaging*
  • Hypertrophy, Left Ventricular / pathology
  • Image Enhancement / methods
  • Metabolism, Inborn Errors / diagnostic imaging*
  • Metabolism, Inborn Errors / pathology
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Stroke Volume*