Test-retest Reliability of New and Conventional Echocardiographic Parameters of Left Ventricular Systolic Function

Overview

Journal Clin Res Cardiol

Specialty Cardiology & Vascular Diseases

Date 2018 Oct 29

PMID 30368567

Citations 18

Authors

Tomasz Baron

Lars Berglund

Eva-Maria Hedin

Frank A Flachskampf

Affiliations

Soon will be listed here.

Abstract

Background: Reliability of left ventricular function measurements depends on actual biological conditions, repeated registrations and their analyses.

Objective: To investigate test-retest reliability of speckle-tracking-derived strain measurements and its determinants compared to the conventional parameters, such as ejection fraction (EF), LV volumes and mitral annular plane systolic excursion (MAPSE).

Methods: In 30 patients with a wide range of left ventricular function (mean EF 46.4 ± 16.4%, range 14-73%), standard echo views were acquired independently in a blinded fashion by two different echocardiographers in immediate sequence and analyzed off-line by two independent readers, creating 4 data sets per patient. Test-retest reliability of studied parameters was calculated using the smallest detectable change (SDC) and a total, inter-acquisition and inter-reader intra-class correlation coefficient (ICC).

Results: The smallest detectable change normalized to the mean absolute value of the measured parameter (SDCrel) was lowest for MAPSE (10.7%). SDCrel for EF was similar to GLS (14.2 and 14.7%, respectively), while SDCrel for CS was much higher (35.6%). The intra-class correlation coefficient was excellent (> 0.9) for all measures of the left ventricular function. Intra-patient inter-acquisition reliability (ICCacq) was significantly better than inter-reader reliability (ICCread) (0.984 vs. 0.950, p = 0.03) only for EF, while no significant difference was observed for any other LV function parameter. Mean intra-subject standard deviations were significantly correlated to the mean values for CS and LV volumes, but not for the other studied parameters.

Conclusions: In a test-retest setting, both with normal and impaired left ventricular function, the smallest relative detectable change of EF, GLS and MAPSE was similar (11-15%), but was much higher for CS (35%). Surprisingly, reliability of GLS was not superior to that of EF. Acquisition and reader to a similar extent influenced the reliability of measurements of all left ventricular function measures except for ejection fraction, where the reliability was more dependent on the reader than on the acquisition.

Citing Articles

Low-Volume and High-Intensity Aerobic Interval Training May Attenuate Dysfunctional Ventricular Remodeling after Myocardial Infarction: Data from the INTERFARCT Study.

Aispuru-Lanche G, Gallego-Munoz M, Jayo-Montoya J, Villar-Zabala B, Maldonado-Martin S Rev Cardiovasc Med. 2024; 24(1):20.

PMID: 39076876 PMC: 11270403. DOI: 10.31083/j.rcm2401020.

Real-time guidance by deep learning of experienced operators to improve the standardization of echocardiographic acquisitions.

Sabo S, Pasdeloup D, Pettersen H, Smistad E, Ostvik A, Olaisen S Eur Heart J Imaging Methods Pract. 2024; 1(2):qyad040.

PMID: 39045079 PMC: 11195719. DOI: 10.1093/ehjimp/qyad040.

Real-time guiding by deep learning during echocardiography to reduce left ventricular foreshortening and measurement variability.

Sabo S, Pettersen H, Smistad E, Pasdeloup D, Stolen S, Grenne B Eur Heart J Imaging Methods Pract. 2024; 1(1):qyad012.

PMID: 39044792 PMC: 11195768. DOI: 10.1093/ehjimp/qyad012.

Artificial intelligence-assisted evaluation of cardiac function by oncology staff in chemotherapy patients.

Papadopoulou S, Dionysopoulos D, Mentesidou V, Loga K, Michalopoulou S, Koukoutzeli C Eur Heart J Digit Health. 2024; 5(3):278-287.

PMID: 38774364 PMC: 11104473. DOI: 10.1093/ehjdh/ztae017.

Clinical predictors of improvement in left ventricular ejection fraction in U.S. veterans with heart failure.

Nallamshetty S, Castillo A, Nguyen A, Haddad F, Heidenreich P Am Heart J Plus. 2024; 19:100183.

PMID: 38558863 PMC: 10978352. DOI: 10.1016/j.ahjo.2022.100183.

References

Thorstensen A, Dalen H, Amundsen B, Aase S, Stoylen A . Reproducibility in echocardiographic assessment of the left ventricular global and regional function, the HUNT study. Eur J Echocardiogr. 2009; 11(2):149-56. DOI: 10.1093/ejechocard/jep188. View

Kleijn S, Aly M, Terwee C, van Rossum A, Kamp O . Reliability of left ventricular volumes and function measurements using three-dimensional speckle tracking echocardiography. Eur Heart J Cardiovasc Imaging. 2011; 13(2):159-68. DOI: 10.1093/ejechocard/jer174. View

Thavendiranathan P, Grant A, Negishi T, Plana J, Popovic Z, Marwick T . Reproducibility of echocardiographic techniques for sequential assessment of left ventricular ejection fraction and volumes: application to patients undergoing cancer chemotherapy. J Am Coll Cardiol. 2012; 61(1):77-84. DOI: 10.1016/j.jacc.2012.09.035. View

Hu K, Liu D, Niemann M, Herrmann S, Gaudron P, Ertl G . Methods for assessment of left ventricular systolic function in technically difficult patients with poor imaging quality. J Am Soc Echocardiogr. 2012; 26(2):105-13. DOI: 10.1016/j.echo.2012.11.004. View

Negishi K, Negishi T, Hare J, Haluska B, Plana J, Marwick T . Independent and incremental value of deformation indices for prediction of trastuzumab-induced cardiotoxicity. J Am Soc Echocardiogr. 2013; 26(5):493-8. DOI: 10.1016/j.echo.2013.02.008. View

Cheng S, Larson M, McCabe E, Osypiuk E, Lehman B, Stanchev P . Reproducibility of speckle-tracking-based strain measures of left ventricular function in a community-based study. J Am Soc Echocardiogr. 2013; 26(11):1258-1266.e2. PMC: 3812381. DOI: 10.1016/j.echo.2013.07.002. View

Negishi K, Negishi T, Haluska B, Hare J, Plana J, Marwick T . Use of speckle strain to assess left ventricular responses to cardiotoxic chemotherapy and cardioprotection. Eur Heart J Cardiovasc Imaging. 2013; 15(3):324-31. DOI: 10.1093/ehjci/jet159. View

Lang R, Badano L, Mor-Avi V, Afilalo J, Armstrong A, Ernande L . Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015; 28(1):1-39.e14. DOI: 10.1016/j.echo.2014.10.003. View

Barbier P, Mirea O, Cefalu C, Maltagliati A, Savioli G, Guglielmo M . Reliability and feasibility of longitudinal AFI global and segmental strain compared with 2D left ventricular volumes and ejection fraction: intra- and inter-operator, test-retest, and inter-cycle reproducibility. Eur Heart J Cardiovasc Imaging. 2015; 16(6):642-52. DOI: 10.1093/ehjci/jeu274. View

10.

Farsalinos K, Daraban A, Unlu S, Thomas J, Badano L, Voigt J . Head-to-Head Comparison of Global Longitudinal Strain Measurements among Nine Different Vendors: The EACVI/ASE Inter-Vendor Comparison Study. J Am Soc Echocardiogr. 2015; 28(10):1171-1181, e2. DOI: 10.1016/j.echo.2015.06.011. View

11.

Huttin O, Marie P, Benichou M, Bozec E, Lemoine S, Mandry D . Temporal deformation pattern in acute and late phases of ST-elevation myocardial infarction: incremental value of longitudinal post-systolic strain to assess myocardial viability. Clin Res Cardiol. 2016; 105(10):815-26. DOI: 10.1007/s00392-016-0989-6. View

12.

Koneru S, Collier P, Goldberg A, Sanghi V, Grimm R, Rodriguez L . Temporal Variability of Global Longitudinal Strain in Stable Patients Undergoing Chemotherapy With Trastuzumab. Am J Cardiol. 2016; 118(6):930-935. DOI: 10.1016/j.amjcard.2016.06.030. View

13.

Mirea O, Pagourelias E, Duchenne J, Bogaert J, Thomas J, Badano L . Variability and Reproducibility of Segmental Longitudinal Strain Measurement: A Report From the EACVI-ASE Strain Standardization Task Force. JACC Cardiovasc Imaging. 2017; 11(1):15-24. DOI: 10.1016/j.jcmg.2017.01.027. View

14.

Mirea O, Pagourelias E, Duchenne J, Bogaert J, Thomas J, Badano L . Intervendor Differences in the Accuracy of Detecting Regional Functional Abnormalities: A Report From the EACVI-ASE Strain Standardization Task Force. JACC Cardiovasc Imaging. 2017; 11(1):25-34. DOI: 10.1016/j.jcmg.2017.02.014. View

15.

Buckert D, Cieslik M, Tibi R, Radermacher M, Rasche V, Bernhardt P . Longitudinal strain assessed by cardiac magnetic resonance correlates to hemodynamic findings in patients with severe aortic stenosis and predicts positive remodeling after transcatheter aortic valve replacement. Clin Res Cardiol. 2017; 107(1):20-29. PMC: 5760599. DOI: 10.1007/s00392-017-1153-7. View

16.

Aus dem Siepen F, Bauer R, Voss A, Hein S, Aurich M, Riffel J . Predictors of survival stratification in patients with wild-type cardiac amyloidosis. Clin Res Cardiol. 2017; 107(2):158-169. DOI: 10.1007/s00392-017-1167-1. View

17.

Tschope C, Birner C, Bohm M, Bruder O, Frantz S, Luchner A . Heart failure with preserved ejection fraction: current management and future strategies : Expert opinion on the behalf of the Nucleus of the "Heart Failure Working Group" of the German Society of Cardiology (DKG). Clin Res Cardiol. 2017; 107(1):1-19. DOI: 10.1007/s00392-017-1170-6. View

18.

Tilemann L, Heckmann M, Katus H, Lehmann L, Muller O . Cardio-oncology: conflicting priorities of anticancer treatment and cardiovascular outcome. Clin Res Cardiol. 2018; 107(4):271-280. PMC: 5869944. DOI: 10.1007/s00392-018-1202-x. View

19.

Gordon E, Schnittger I, Fitzgerald P, Williams P, Popp R . Reproducibility of left ventricular volumes by two-dimensional echocardiography. J Am Coll Cardiol. 1983; 2(3):506-13. DOI: 10.1016/s0735-1097(83)80278-2. View

20.

Otterstad J, Froeland G, St John Sutton M, Holme I . Accuracy and reproducibility of biplane two-dimensional echocardiographic measurements of left ventricular dimensions and function. Eur Heart J. 1997; 18(3):507-13. DOI: 10.1093/oxfordjournals.eurheartj.a015273. View