TY - JOUR
T1 - Comparison of left ventricular manual versus automated derived longitudinal strain
T2 - implications for clinical practice and research
AU - Kobayashi, Yukari
AU - Ariyama, Miyuki
AU - Kobayashi, Yuhei
AU - Giraldeau, Genevieve
AU - Fleischman, Dominik
AU - Kozelj, Mirta
AU - Vrtovec, Bojan
AU - Ashley, Euan
AU - Kuznetsova, Tatiana
AU - Schnittger, Ingela
AU - Liang, David
AU - Haddad, Francois
N1 - Publisher Copyright:
© 2015, Springer Science+Business Media Dordrecht.
PY - 2016/3/1
Y1 - 2016/3/1
N2 - Systolic global longitudinal strain (GLS) is emerging as a useful metric of ventricular function in heart failure and usually assessed using post-processing software. The purpose of this study was to investigate whether longitudinal strain (LS) derived using manual-tracings of ventricular lengths (manual-LS) can be reliable and time efficient when compared to LS obtained by post-processing software (software-LS). Apical 4-chamber view images were retrospectively examined in 50 healthy controls, 100 patients with dilated cardiomyopathy (DCM), and 100 with hypertrophic cardiomyopathy (HCM). We measured endocardial and mid-wall manual-LS and software-LS, using peak of average regional curve [software-LS(a)] and global ventricular lengths [software-LS(l)] according to definition of Lagragian strain. We compared manual-LS and software-LS by using Bland–Altman plot and coefficient of variation (COV). In addition, test–retest was also performed for further assessment of variability in measurements. While manual-LS was obtained in all subjects, software-LS could be obtained in 238 subjects (95 %). The time spent for obtaining manual-LS was significantly shorter than for the software-LS (94 ± 39 s vs. 141 ± 79 s, P < 0.001). Overall, manual-LS had an excellent correlation with both software-LS (a) (R2 = 0.93, P < 0.001) and software-LS(l) (R2 = 0.84, P < 0.001). The bias (95 %CI) between endocardial manual-LS and software-LS(a) was 0.4 % [−2.8, 3.6 %] in absolute and 3.5 % [−17.0, 24.0 %] in relative difference while it was 0.4 % [−2.5, 3.3 %] and 3.4 % [−16.2, 23.1 %], respectively with software-LS(l). Mid-wall manual-LS and mid-wall software-LS(a) also had good agreement [a bias (95 % CI) for absolute value of 0.1 % [−2.1, 2.5 %] in HCM, and 0.2 % [−2.2, 2.6 %] in controls]. The COV for manual and software derived LS were below 6 %. Test–retest showed good variability for both methods (COVs were 5.8 and 4.7 for endocardial and mid-wall manual-LS, and 4.6 and 4.9 for endocardial and mid-wall software-LS(a), respectively. Manual-LS appears to be as reproducible as software-LS; this may be of value especially when global strain is the metric of interest.
AB - Systolic global longitudinal strain (GLS) is emerging as a useful metric of ventricular function in heart failure and usually assessed using post-processing software. The purpose of this study was to investigate whether longitudinal strain (LS) derived using manual-tracings of ventricular lengths (manual-LS) can be reliable and time efficient when compared to LS obtained by post-processing software (software-LS). Apical 4-chamber view images were retrospectively examined in 50 healthy controls, 100 patients with dilated cardiomyopathy (DCM), and 100 with hypertrophic cardiomyopathy (HCM). We measured endocardial and mid-wall manual-LS and software-LS, using peak of average regional curve [software-LS(a)] and global ventricular lengths [software-LS(l)] according to definition of Lagragian strain. We compared manual-LS and software-LS by using Bland–Altman plot and coefficient of variation (COV). In addition, test–retest was also performed for further assessment of variability in measurements. While manual-LS was obtained in all subjects, software-LS could be obtained in 238 subjects (95 %). The time spent for obtaining manual-LS was significantly shorter than for the software-LS (94 ± 39 s vs. 141 ± 79 s, P < 0.001). Overall, manual-LS had an excellent correlation with both software-LS (a) (R2 = 0.93, P < 0.001) and software-LS(l) (R2 = 0.84, P < 0.001). The bias (95 %CI) between endocardial manual-LS and software-LS(a) was 0.4 % [−2.8, 3.6 %] in absolute and 3.5 % [−17.0, 24.0 %] in relative difference while it was 0.4 % [−2.5, 3.3 %] and 3.4 % [−16.2, 23.1 %], respectively with software-LS(l). Mid-wall manual-LS and mid-wall software-LS(a) also had good agreement [a bias (95 % CI) for absolute value of 0.1 % [−2.1, 2.5 %] in HCM, and 0.2 % [−2.2, 2.6 %] in controls]. The COV for manual and software derived LS were below 6 %. Test–retest showed good variability for both methods (COVs were 5.8 and 4.7 for endocardial and mid-wall manual-LS, and 4.6 and 4.9 for endocardial and mid-wall software-LS(a), respectively. Manual-LS appears to be as reproducible as software-LS; this may be of value especially when global strain is the metric of interest.
KW - Dilated cardiomyopathy
KW - Echocardiography
KW - Global longitudinal strain
KW - Heart failure
KW - Hypertrophic cardiomyopathy
KW - Post-processing software
KW - Strain imaging
KW - Vendor-independent
KW - Ventricular function
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U2 - 10.1007/s10554-015-0804-x
DO - 10.1007/s10554-015-0804-x
M3 - Article
C2 - 26578468
AN - SCOPUS:84957943448
SN - 1569-5794
VL - 32
SP - 429
EP - 437
JO - International Journal of Cardiovascular Imaging
JF - International Journal of Cardiovascular Imaging
IS - 3
ER -