Oana Mirea1, Efstathios D Pagourelias1, Jurgen Duchenne1, Jan Bogaert2, James D Thomas3, Luigi P Badano4, Jens-Uwe Voigt5. 1. Department of Cardiovascular Diseases, University Hospital Leuven, Leuven, Belgium. 2. Department of Radiology, University Hospital Leuven, Leuven, Belgium. 3. Bluhm Cardiovascular Institute, Northwestern University, Chicago, Illinois. 4. Cardiac, Thoracic and Vascular Sciences, University Padua, Padua, Italy. 5. Department of Cardiovascular Diseases, University Hospital Leuven, Leuven, Belgium. Electronic address: jens-uwe.voigt@uzleuven.be.
Abstract
OBJECTIVES: In this study, we compared left ventricular (LV) segmental strain measurements obtained with different ultrasound machines and post-processing software packages. BACKGROUND: Global longitudinal strain (GLS) has proven to be a reproducible and valuable tool in clinical practice. Data about the reproducibility and intervendor differences of segmental strain measurements, however, are missing. METHODS: We included 63 volunteers with cardiac magnetic resonance-proven infarct scar with segmental LV function ranging from normal to severely impaired. Each subject was examined within 2 h by a single expert sonographer with machines from multiple vendors. All 3 apical views were acquired twice to determine the test-retest and the intervendor variability. Segmental longitudinal peak systolic, end-systolic, and post-systolic strain were measured using 7 vendor-specific systems (Hitachi, Tokyo, Japan; Esaote, Florence, Italy; GE Vingmed Ultrasound, Horten, Norway; Philips, Andover, Massachusetts; Samsung, Seoul, South Korea; Siemens, Mountain View, California; and Toshiba, Otawara, Japan) and 2 independent software packages (Epsilon, Ann Arbor, Michigan; and TOMTEC, Unterschleissheim, Germany) and compared among vendors. RESULTS: Image quality and tracking feasibility differed among vendors (analysis of variance, p < 0.05). The absolute test-retest difference ranged from 2.5% to 4.9% for peak systolic, 2.6% to 5.0% for end-systolic, and 2.5% to 5.0% for post-systolic strain. The average segmental strain values varied significantly between vendors (up to 4.5%). Segmental strain parameters from each vendor correlated well with the mean of all vendors (r2 range 0.58 to 0.81) but showed very different ranges of values. Bias and limits of agreement were up to -4.6 ± 7.5%. CONCLUSIONS: In contrast to GLS, LV segmental longitudinal strain measurements have a higher variability on top of the known intervendor bias. The fidelity of different software to follow segmental function varies considerably. We conclude that single segmental strain values should be used with caution in the clinic. Segmental strain pattern analysis might be a more robust alternative.
OBJECTIVES: In this study, we compared left ventricular (LV) segmental strain measurements obtained with different ultrasound machines and post-processing software packages. BACKGROUND: Global longitudinal strain (GLS) has proven to be a reproducible and valuable tool in clinical practice. Data about the reproducibility and intervendor differences of segmental strain measurements, however, are missing. METHODS: We included 63 volunteers with cardiac magnetic resonance-proven infarct scar with segmental LV function ranging from normal to severely impaired. Each subject was examined within 2 h by a single expert sonographer with machines from multiple vendors. All 3 apical views were acquired twice to determine the test-retest and the intervendor variability. Segmental longitudinal peak systolic, end-systolic, and post-systolic strain were measured using 7 vendor-specific systems (Hitachi, Tokyo, Japan; Esaote, Florence, Italy; GE Vingmed Ultrasound, Horten, Norway; Philips, Andover, Massachusetts; Samsung, Seoul, South Korea; Siemens, Mountain View, California; and Toshiba, Otawara, Japan) and 2 independent software packages (Epsilon, Ann Arbor, Michigan; and TOMTEC, Unterschleissheim, Germany) and compared among vendors. RESULTS: Image quality and tracking feasibility differed among vendors (analysis of variance, p < 0.05). The absolute test-retest difference ranged from 2.5% to 4.9% for peak systolic, 2.6% to 5.0% for end-systolic, and 2.5% to 5.0% for post-systolic strain. The average segmental strain values varied significantly between vendors (up to 4.5%). Segmental strain parameters from each vendor correlated well with the mean of all vendors (r2 range 0.58 to 0.81) but showed very different ranges of values. Bias and limits of agreement were up to -4.6 ± 7.5%. CONCLUSIONS: In contrast to GLS, LV segmental longitudinal strain measurements have a higher variability on top of the known intervendor bias. The fidelity of different software to follow segmental function varies considerably. We conclude that single segmental strain values should be used with caution in the clinic. Segmental strain pattern analysis might be a more robust alternative.
Authors: Serkan Ünlü; Oana Mirea; Stéphanie Bézy; Jürgen Duchenne; Efstathios D Pagourelias; Jan Bogaert; James D Thomas; Luigi P Badano; Jens-Uwe Voigt Journal: Int J Cardiovasc Imaging Date: 2021-01-16 Impact factor: 2.357
Authors: Jian-Fang Ren; Shiquan Chen; David J Callans; Qiang Liu; Gregory Supple; David S Frankel; Pasquale Santangeli; Ruhong Jiang; David Lin; Matthew Hyman; Lu Yu; Michael Riley; Yaxun Sun; Zuwen Zhang; Chan Yu; Robert D Schaller; Sanjay Dixit; Bei Wang; Chenyang Jiang; Francis E Marchlinski Journal: J Atr Fibrillation Date: 2021-02-28
Authors: Sorin Giusca; Grigorios Korosoglou; Moritz Montenbruck; Blaž Geršak; Arne Kristian Schwarz; Sebastian Esch; Sebastian Kelle; Pia Wülfing; Susan Dent; Daniel Lenihan; Henning Steen Journal: Circ Cardiovasc Imaging Date: 2021-06-15 Impact factor: 7.792