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February 19, 2021BMC Cardiovascular DisordersOpen Access

Direct comparison of multilayer left ventricular global longitudinal strain using CMR feature tracking and speckle tracking echocardiography

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Key result

Cardiac magnetic resonance feature tracking demonstrated good inter-modality agreement and correlation with speckle tracking echocardiography for whole-layer global longitudinal strain (r = 0.687, p < 0.001).

Why the study?

Multilayer strain measurement provides novel layer-specific insight into cardiac contractility, but CMR-FT required validation through direct comparison with STE for multilayer GLS.

Does CMR-FT provide comparable multilayer global longitudinal strain measurements to STE in patients with acute myocardial infarction?

Population

100 AMI patients undergoing CMR and echocardiography

Comparison

Multilayer GLS measured by CMR-FT vs STE

Follow-up

48 ± 13 days

Authors

SASaikrishna AnanthapadmanabhanVGVo Van GiauTNT. Nguyen

Discussion

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Overview

CMR-FT may support GLS assessment when STE unavailable in AMI; leaves open interchangeability given wide limits of agreement.

Key Points

  • To validate CMR feature tracking (CMR-FT) as an accurate tool for multilayer strain analysis by directly comparing multilayer global longitudinal strain (GLS) values against speckle tracking echocardiography (STE).
  • Assessed 100 patients with acute myocardial infarction (AMI) who underwent CMR imaging and echocardiography at baseline and follow-up (48 ± 13 days).
  • Quantified single- and multi-layer GLS values (endocardial, epicardial, and whole-layer) for both CMR-FT and STE using dedicated tissue tracking software.
  • Correlation coefficients between CMR-FT and STE were 0.685 for endocardial, 0.687 for epicardial, and 0.660 for whole-layer GLS (all p < 0.001).
  • Bland-Altman analysis demonstrated minimal absolute bias (1.79 for endocardial, 0.80 for whole-layer, and 0.98 for epicardial GLS) with limits of agreement of 6.4, 5.9, and 5.5, respectively.
  • Intraclass correlation coefficient (ICC) indicated moderate agreement between modalities across all layers (0.626 for endocardial, 0.671 for whole-layer, and 0.632 for epicardial GLS; all p < 0.001).

Study Design

Type

Observational (n=100)

Blinding

Blinded assessors

Multicenter

No

Structured PICO

Does CMR-FT provide comparable multilayer global longitudinal strain measurements to STE in patients with acute myocardial infarction?

P
Population
100 patients aged 19 to 84 years with acute myocardial infarction who underwent both CMR imaging and echocardiography at baseline and follow-up at 35-49 days.
E
Exposure
Cardiac magnetic resonance feature tracking (CMR-FT) for multilayer global longitudinal strain analysis
C
Comparator
Speckle tracking echocardiography (STE) for multilayer global longitudinal strain analysis
O
Outcome
Inter-modality agreement and correlation between CMR-FT and STE for whole-layer, endocardial, and epicardial global longitudinal strain (GLS)surrogate

Main Result

Effect estimate: r = 0.687

p-value: p=<0.001

CMR-FT shows good inter-modality agreement with STE for multilayer global longitudinal strain in AMI patients, though the values are not interchangeable due to wide limits of agreement and underestimation by CMR-FT.

Limitations

  • CMR-FT measurements were limited to two myocardial layers compared to three in STE, requiring a weighted average for comparison.
  • Strain analysis was performed using only a single software, limiting the assessment of inter-vendor reproducibility.
  • The study focused solely on global longitudinal strain and did not assess global circumferential strain.
  • The cohort consisted entirely of AMI patients and lacked healthy volunteers for broader generalizability.
  • CMR-FT multilayer strain data was not validated against gold standard modalities such as sonomicrometry or CMR tagging.
  • Wide limits of agreement
  • Underestimation of GLS by CMR-FT compared to STE, meaning measurements are not interchangeable

Cite This Study

Ananthapadmanabhan et al. (2021) conducted an observational in Acute myocardial infarction (n=100). Cardiac magnetic resonance feature tracking (CMR-FT) vs. Speckle tracking echocardiography (STE) was evaluated on Inter-modality correlation for whole-layer global longitudinal strain (r = 0.687, p=<0.001). Cardiac magnetic resonance feature tracking demonstrated good inter-modality agreement and correlation with speckle tracking echocardiography for whole-layer global longitudinal strain (r = 0.687, p < 0.001).

synapsesocial.com/papers/6a7f0cd321eb47f0c49b28c3https://doi.org/10.1186/s12872-021-01916-8
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Intra- and inter-observer reproducibility of multilayer cardiac magnetic resonance feature tracking derived longitudinal and circumferential strain2020 · 7 citations
  2. 2Cardiac magnetic resonance longitudinal strain analysis in acute ST-segment elevation myocardial infarction: A comparison with speckle-tracking echocardiography2020 · 15 citations
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  4. 4Left ventricular strain measured by feature-tracking cardiac magnetic resonance imaging and 2D speckle-tracking echocardiography in chronic ischemic heart disease: an intermodality agreement study2026 · 2 citations
  5. 5Direct comparison of cardiac magnetic resonance feature tracking and 2D/3D echocardiography speckle tracking for evaluation of global left ventricular strain2015 · 153 citations