Inter-observer and Inter-vendor Variability in Strain Measurements in Patients with Single Right Ventricular Anatomy.

Published on Apr 23, 2021in Pediatric Cardiology1.655
· DOI :10.1007/S00246-021-02617-X
Alex J. Thompson2
Estimated H-index: 2
(Mayo Clinic),
Patrick W. O'Leary41
Estimated H-index: 41
(Mayo Clinic)
+ 6 AuthorsWanek Family Program for Hypoplastic Left Heart Syndrome Imaging Pipeline1
Estimated H-index: 1
Sources
Abstract
Myocardial strain offers new insights into ventricular performance, There are software packages from several different companies used to ascertain this, and little data is available in patients with single right ventricle (sRV) physiology. We aimed to compare the analysis of two strain software applications using a cohort of patients with sRV for both inter-vendor and inter-observer variability. Echocardiograms from 85 patients with sRV (122 separate studies) were prospectively evaluated. All had Glenn and/or Fontan palliation. Longitudinal 4-chamber (4LS), inflow/outflow (IO), circumferential, and radial strain were assessed using Velocity Vector Imaging (VVI, Seimens, Munich) and Automated Functional Imaging (AFI, General Electric, Boston) software. In a subset of 45 patients (61 separate studies), strain measurements were obtained by two sonographers so a paired "inter-observer" analysis could be performed. A moderate correlation between measurements made by the two systems was observed. Circumferential strain assessment had the highest R value (0.77) with all others having R values < 0.6. Both software packages showed modest inter-observer reproducibility for longitudinal and circumferential strain. VVI intraclass correlation coefficients (ICC) for 4LS and average circumferential strain (ACS) were 0.6 and 0.58, compared to 0.68 and 0.59 for AFI. Other than radial strain and VVI IO inferior strain, mean strain differences between AFI and VVI were ≤ 1%. Inter-observer variability is modest, however, mean differences are minimal suggesting reasonable clinical reliability. Inter-vendor variability is greater and not as clinically reliable. In patients with sRV, serial assessments with strain should be performed using the same software.
📖 Papers frequently viewed together
References33
Newest
#1Concetta Zito (UNIME: University of Messina)H-Index: 28
#2Luca Longobardo (UNIME: University of Messina)H-Index: 9
Last. Scipione Carerj (UNIME: University of Messina)H-Index: 30
view all 13 authors...
In recent years, the role of left ventricular ejection fraction (EF) as the gold standard parameter for the evaluation of systolic function has been questioned, and many efforts have been concentrated in the clinical validation of new noninvasive tools for the study of myocardial contractility. Improvement in the accuracy of speckle-tracking echocardiography has resulted in a large amount of research showing the ability of two-dimensional strain to overcome EF limitations in the majority of prim...
Source
#1Ju-Hee Lee (CBNU: Chungbuk National University)H-Index: 1
#2Jae-Hyeong Park (CNU: Chungnam National University)H-Index: 1
: Right ventricular (RV) systolic dysfunction has been identified as an independent prognostic marker of many cardiovascular diseases. However, there are problems in measuring RV systolic function objectively and identification of RV dysfunction using conventional echocardiography. Strain echocardiography is a new imaging modality to measure myocardial deformation. It can measure intrinsic myocardial function and has been used to measure regional and global left ventricular (LV) function. Althou...
Source
#1Zachary J. Il’Giovine (Duke University)H-Index: 2
#2Hillary Mulder (Duke University)H-Index: 14
Last. Sudarshan Rajagopal (Duke University)H-Index: 31
view all 10 authors...
Background Right ventricular peak systolic longitudinal strain (RVLS) has emerged as an approach for quantifying right ventricular function in diseases such as pulmonary hypertension and congenital heart disease. A major limitation in applying RVLS is that strain imaging and analysis are proprietary, which may result in systematic differences from vendor to vendor. The goal of this study was to test the reproducibility of right ventricular strain analysis among selected vendor-specific software ...
Source
#1Oana Mirea (Katholieke Universiteit Leuven)H-Index: 13
#2Efstathios D. Pagourelias (Katholieke Universiteit Leuven)H-Index: 20
Last. Willem GorissenH-Index: 6
view all 8 authors...
Abstract Objectives The purpose of this study was to compare the accuracy of vendor-specific and independent strain analysis tools to detect regional myocardial function abnormality in a clinical setting. Background Speckle tracking echocardiography has been considered a promising tool for the quantitative assessment of regional myocardial function. However, the potential differences among speckle tracking software with regard to their accuracy in identifying regional abnormality has not been st...
Source
#1Luca Longobardo (UNIME: University of Messina)H-Index: 9
#2Valentin Suma (UW: University of Wisconsin-Madison)H-Index: 2
Last. Bijoy K. Khandheria (UW: University of Wisconsin-Madison)H-Index: 81
view all 7 authors...
Despite the already well-known role the right side of the heart plays in many diseases, right ventricular (RV) function has only recently been carefully considered. Echocardiography is the first-line diagnostic technique for the assessment of the right ventricle and right atrium, whereas cardiac magnetic resonance is considered the gold standard but is limited by cost and availability. According to the current guidelines, systolic RV function should be assessed by several conventional measuremen...
Source
#1Daniel A. Morris (Charité)H-Index: 16
#2Xin-Xin Ma (SJTU: Shanghai Jiao Tong University)H-Index: 1
Last. Elisabeth Pieske-Kraigher (Charité)H-Index: 14
view all 14 authors...
Background The purpose of this meta-analysis was to confirm if the global longitudinal systolic function of the left ventricle (LV) is altered in patients with heart failure with preserved ejection fraction (HFpEF). Methods We searched in different databases (Medline, Embase and Cochrane) studies that analysed LV global longitudinal systolic strain (GLS) in patients with HFpEF and in controls (such as healthy subjects or asymptomatic patients with arterial hypertension, diabetes mellitus or coro...
Source
#1Patsy W. Park (MUSC: Medical University of South Carolina)H-Index: 1
#2Andrew M. Atz (MUSC: Medical University of South Carolina)H-Index: 55
Last. Shahryar M. Chowdhury (MUSC: Medical University of South Carolina)H-Index: 11
view all 4 authors...
Introduction Single-ventricle patients with elevated pulmonary vascular resistance (PVR) or end-diastolic pressure (EDP) are excluded from undergoing total cavopulmonary connection (TCPC). However, a subset of patients deemed to be at acceptable risk experience prolonged length of stay (LOS) after TCPC. Routine assessment of ventricular function has been inadequate in identifying these high-risk patients. Speckle-tracking echocardiography (STE) is a novel method for assessment of myocardial defo...
Source
#1Patrick CollierH-Index: 17
#2Dermot Phelan (Cleveland Clinic Lerner College of Medicine)H-Index: 1
Last. Allan L. Klein (Cleveland Clinic Lerner College of Medicine)H-Index: 2
view all 3 authors...
Abstract Strain-based imaging techniques (and specifically speckle-tracking echocardiography) have been shown to have clinical utility in a variety of settings. This technique is being embraced and increasingly adopted in many echocardiography laboratories worldwide. This review appraised speckle-tracking echocardiography in a clinical context by providing a critical evaluation of the prognostic and diagnostic insights that this technology can provide. In particular, we discuss the use of speckl...
Source
#1Rodrigo Rios (Children's Hospital of Wisconsin)H-Index: 3
#2Salil Ginde (Children's Hospital of Wisconsin)H-Index: 14
Last. Peter C. Frommelt (Children's Hospital of Wisconsin)H-Index: 39
view all 6 authors...
Background Quantitative echocardiographic measurements of single ventricular (SV) function have not been incorporated into routine clinical practice. Methods A clinical protocol, which included quantitative measurements of SV deformation (global circumferential and longitudinal strain and strain rate), standard deviation of time to peak systolic strain, myocardial performance index (MPI), dP/dT from an atrioventricular valve regurgitant jet, and superior mesenteric artery resistance index, was i...
Source
#1Yidan Li (Capital Medical University)H-Index: 9
#2Yidan WangH-Index: 9
Last. Xiuzhang LuH-Index: 7
view all 6 authors...
This study aimed to appraise the application of right ventricular longitudinal strain for assessing right ventricular dysfunction and severe hemodynamic changes in pulmonary hypertension. The study included 53 patients clinically diagnosed with PH. Tissue Doppler–derived tricuspid lateral annular systolic velocity (s’), early diastolic peak velocity (e’), late diastolic peak velocity (a’), tricuspid annular plane systolic excursion (TAPSE), RV index of myocardial performance (RIMP), and right ve...
Source
Cited By0
Newest
This website uses cookies.
We use cookies to improve your online experience. By continuing to use our website we assume you agree to the placement of these cookies.
To learn more, you can find in our Privacy Policy.