Global longitudinal strain demonstrated significantly higher inter-observer reproducibility than left ventricular ejection fraction (ICC 0.89 vs 0.63, p<0.001) regardless of echocardiographic training.
Cross-Sectional (n=47)
Blinded to clinical data and each other's findings
No
Does global longitudinal strain provide better reproducibility than left ventricular ejection fraction for evaluating left ventricular function regardless of echocardiographic training in patients with recent ACS?
Global longitudinal strain provides a more reproducible assessment of left ventricular function than ejection fraction, even when performed by operators with different levels of training.
Absolute Event Rate: 0.89% vs 0.63%
p-value: p=<0.001
BACKGROUND: Left ventricular ejection fraction (LVEF) is an established method for evaluation of left ventricular (LV) systolic function. Global longitudinal strain (GLS) by speckle tracking echocardiography seems to be an important additive method for evaluation of LV function with improved reproducibility compared with LVEF. Our aim was to compare reproducibility of GLS and LVEF between an expert and trainee both as echocardiographic examiner and analyst. METHODS: Forty-seven patients with recent Acute Coronary Syndrome (ACS) underwent echocardiographic examination by both an expert echocardiographer and a trainee. Both echocardiographers, blinded for clinical data and each other's findings, performed image analysis for evaluation of intra- and inter- observer variability. GLS was measured using speckle tracking echocardiography. LVEF was calculated by Simpson's biplane method. RESULTS: The trainee measured a GLS of - 19.4% (±3.5%) and expert - 18.7% (±3.2%) with an Intra class correlation coefficient (ICC) of 0.89 (0.74-0.95). LVEF by trainee was 50.3% (±8.2%) and by expert 53.6% (±8.6%), ICC coefficient was 0.63 (0.32-0.80). For GLS the systematic difference was 0.21% (- 4.58-2.64) vs. 4.08% (- 20.78-12.62) for LVEF. CONCLUSION: GLS is a more reproducible method for evaluation of LV function than LVEF regardless of echocardiographic training.
Karlsen et al. (Mon,) conducted a cross-sectional in Suspected non-ST elevation acute coronary syndrome (NSTE-ACS) (n=47). Global longitudinal strain (GLS) by speckle tracking echocardiography vs. Left ventricular ejection fraction (LVEF) by Simpson's biplane method was evaluated on Inter-observer reproducibility (Intra class correlation coefficient) when each operator analyzed their own images (95% CI 0.74-0.95, p=<0.001). Global longitudinal strain demonstrated significantly higher inter-observer reproducibility than left ventricular ejection fraction (ICC 0.89 vs 0.63, p<0.001) regardless of echocardiographic training.