Key result
Mid-myocardial tracking with the novel 2DE strain software provided less bias of LV volumes and high coverage probability values for LVEF (0.94) and GLS (0.92) compared to CMR feature tracking.
Why the study?
To determine whether novel semi-automated 2DE layer strain software is reliable for LV volume quantification compared to CMR.
Does novel semi-automated 2DE layer specific speckle tracking software accurately quantify left ventricular volumes and function compared to cardiac magnetic resonance?
Observational (n=84)
No
Does novel semi-automated 2DE layer specific speckle tracking software accurately quantify left ventricular volumes and function compared to cardiac magnetic resonance?
Mid-myocardial layer speckle tracking using novel semi-automated 2DE software closely approximates CMR-derived left ventricular volumes and functional parameters, offering a reliable alternative for LV quantification.
Supports mid-myocardial 2DE tracking for LV quantification; leaves open prospective validation before clinical adoption.
PURPOSE: To determine whether the semi-automated two-dimensional echocardiography (2DE) layer strain software, compared to cardiac magnetic resonance (CMR), is reliable for left ventricular (LV) volume quantification. METHODS AND RESULTS: We retrospectively selected 84 patients who underwent CMR and 2DE on the same day. Novel 2DE layer strain software automatically provides LV contour in 3 myocardial layers and performs layer specific speckle tracking analysis, which calculates LV volumes, ejection fraction (LVEF), and global longitudinal strain (GLS) in each layer. These values were compared with reference values from CMR disk-area summation and feature tracking methods. Coverage probability (CP) was determined using predefined cut-off values and absolute differences in LV volumes of 30 mL, those in LVEF of 10%, and those in GLS of 4%. The software did not work in 3 patients (feasibility: 96%). Different layers resulted in different degrees of under- or over-estimation of LV volumes. Epicardial tracking significantly overestimated the LV volumes and significantly underestimated LVEF and GLS. Mid-myocardial tracking had less underestimation of LV volumes and equivalent CP values of LVEF (0.77 vs. 0.75 using the disk-area summation method and 0.90 vs. 0.94 using the feature tracking method) and GLS (0.95 vs. 0.92) compared with endocardial tracking. The new software showed excellent reproducibility, especially endocardial and mid-myocardial tracking. CONCLUSIONS: Mid-myocardial tracking with the novel 2DE strain software provided less bias of LV volumes with high CP values of LVEF and GLS, which suggests that mid-myocardial layer speckle tracking analysis approximates CMR derived LV functional parameters.
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Kitano et al. (2019) conducted an observational in Patients undergoing clinically indicated CMR (n=84). Semi-automated 2DE layer specific speckle tracking software (ACT method) vs. Cardiac magnetic resonance (CMR) was evaluated on Coverage probability of LVEF (mid-myocardial tracking vs CMR feature tracking). Mid-myocardial tracking with the novel 2DE strain software provided less bias of LV volumes and high coverage probability values for LVEF (0.94) and GLS (0.92) compared to CMR feature tracking.
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