Key result
Semi-automatic RapLSI assessment matches manual analysis for predicting ATTR-CM.
Why the study?
LV apical sparing by TTE has not been widely accepted to diagnose ATTR-CM because it is time-consuming and requires expertise, leading researchers to evaluate automatic assessment as a potential solution.
Does semi-automatic assessment of relative apical longitudinal strain index provide comparable diagnostic accuracy and greater rapidity than manual assessment for identifying ATTR-CM?
Observational (n=63)
Blinded assessors
No
Does semi-automatic assessment of relative apical longitudinal strain index provide comparable diagnostic accuracy and greater rapidity than manual assessment for identifying ATTR-CM?
Semi-automatic assessment of longitudinal strain is a rapid and accurate alternative to manual measurement for the echocardiographic diagnosis of ATTR-CM.
Answers are grounded in this paper and cite their sources.
Semi-automatic RapLSI offers comparable accuracy with faster processing for ATTR-CM; hypothesis-generating, requiring prospective validation before adoption.
Background: Left ventricular (LV) apical sparing by transthoracic echocardiography (TTE) has not been widely accepted to diagnose transthyretin amyloid cardiomyopathy (ATTR-CM), because it is time consuming and requires a level of expertise. We hypothesized that automatic assessment may be the solution for these problems. Methods-and-Results: Tc-PYP) scintigraphy on suspicion of ATTR-CM and performed TTE by EPIQ7G, and had enough information for two-dimensional speckle tracking echocardiography at Kumamoto University Hospital from January 2016 to December 2019. LV apical sparing was described as a high relative apical longitudinal strain (LS) index (RapLSI). Measurement of LS was repeated using the same apical images with three different measurement packages as follows: (1) full-automatic assessment, (2) semi-automatic assessment, and (3) manual assessment. The calculation time for full-automatic assessment (14.7 ± 1.4 sec/patient) and semi-automatic assessment (66.7 ± 14.4 sec/patient) were significantly shorter than that for manual assessment (171.2 ± 59.7 sec/patient) (p < 0.01 for both). Receiver operating characteristic curve analysis showed that the area under curve of the RapLSI evaluated by full-automatic assessment for predicting ATTR-CM was 0.70 (best cut-off point; 1.14 [sensitivity 63%, specificity 81%]), by semi-automatic assessment was 0.85 (best cut-off point; 1.00 [sensitivity, 66%; specificity, 100%]) and by manual assessment was 0.83 (best cut-off point; 0.97 [sensitivity, 72%; specificity, 97%]). Conclusion: There was no significant difference between the diagnostic accuracy of RapLSI estimated by semi-automatic assessment and that estimated by manual assessment. Semi-automatically assessed RapLSI is useful to diagnose ATTR-CM in terms of rapidity and diagnostic accuracy.
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Usuku et al. (2023) conducted an observational in Transthyretin amyloid cardiomyopathy (ATTR-CM) (n=63). Semi-automatic assessment of relative apical longitudinal strain index (RapLSI) vs. Manual assessment of RapLSI was evaluated on Diagnostic accuracy (Area Under the Curve) for predicting ATTR-CM (p=0.69). Semi-automatic assessment of relative apical longitudinal strain index (RapLSI) demonstrated comparable diagnostic accuracy to manual assessment for predicting ATTR-CM (AUC 0.85 vs 0.83, p=0.69).
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