The International Journal of Cardiovascular Imaging

, Volume 32, Issue 12, pp 1707–1714 | Cite as

In-vivo validation of a new clinical tool to quantify three-dimensional myocardial strain using ultrasound

  • S. BouchezEmail author
  • B. Heyde
  • D. Barbosa
  • M. Vandenheuvel
  • H. Houle
  • Y. Wang
  • J. D’hooge
  • P. F. Wouters
Original Paper


Three-dimensional (3D) strain analysis based on real-time 3-D echocardiography (RT3DE) has emerged as a novel technique to quantify regional myocardial function. The goal of this study was to evaluate accuracy of a novel model-based 3D tracking tool (eSie Volume Mechanics, Siemens Ultrasound, Mountain View, CA, USA) using sonomicrometry as an independent measure of cardiac deformation. Thirteen sheep were instrumented with microcrystals sutured to the epi- and endocardium of the inferolateral left ventricular wall to trace myocardial deformation along its three directional axes of motion. Paired acquisitions of RT3DE and sonomicrometry were made at baseline, during inotropic modulation and during myocardial ischemia. Accuracy of 3D strain measurements was quantified and expressed as level of agreement with sonomicrometry using linear regression and Bland–Altman analysis. Correlations between 3D strain analysis and sonomicrometry were good for longitudinal and circumferential strain components (r = 0.78 and r = 0.71) but poor for radial strain (r = 0.30). Accordingly, agreement (bias ± 2SD) was −5 ± 6 % for longitudinal, −5 ± 7 % for circumferential, and 15 ± 19 % for radial strain. Intra-observer variability was low for all components (intra-class correlation coefficients (ICC) of respectively 0.89, 0.88 and 0.95) while inter-observer variability was higher, in particular for radial strain (ICC = 0.41). The present study shows that 3D strain analysis provided good estimates of circumferential and longitudinal strain, while estimates of radial strain were less accurate between observers.


Cardiology Ultrasound imaging Ventricular mechanics In-vivo validation Sonomicrometry Strain 



The work of B. Heyde was funded by the FWO-Flanders Research Fund under Grant G.0693.09.

Compliance with ethical standards

Conflict of interest

H. Houle and Y. Wang are part of the Ultrasound Division of Siemens Medical Solutions. The other authors declare they have no conflict of interest.

Ethical approval

This study conformed with the Public Health Service Policy on Humane Care and Use of Laboratory Animals published by the Office of Laboratory Animal Welfare of the United States National Institutes of Health [16] and was approved by the local ethics committee (Ethische Commissie Dierproeven, Ghent University, Ghent, Belgium).


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Copyright information

© Springer Science+Business Media Dordrecht 2016

Authors and Affiliations

  1. 1.Department of AnesthesiologyGhent University HospitalGhentBelgium
  2. 2.Laboratory on Cardiovascular Imaging and DynamicsKU LeuvenLeuvenBelgium
  3. 3.Ultrasound DivisionSiemens Medical SolutionsMountain ViewUSA

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