Key result
Multilayer strain analysis did not evaluate myocardial viability with more accuracy than standard segmental longitudinal strain, yielding an AUC of 0.817 for mid-segmental strain.
Why the study?
Does multilayer strain analysis provide additional value over standard segmental longitudinal strain for detecting myocardial viability assessed by SPECT imaging in patients referred for viability evaluation?
Observational (n=47)
Does multilayer strain analysis provide additional value over standard segmental longitudinal strain for detecting myocardial viability assessed by SPECT imaging in patients referred for viability evaluation?
Multilayer strain analysis by echocardiography does not provide greater accuracy than standard segmental longitudinal strain for assessing myocardial viability compared to SPECT.
Multilayer strain adds no accuracy over standard segmental strain for viability; leaves open incremental value versus SPECT in observational data.
BACKGROUND: The aim of this study was to evaluate the value of multilayer strain analysis to the assessment of myocardial viability (MV) through the comparison of both speckle tracking echocardiography and single-photon emission computed tomography (SPECT) imaging. We also intended to determine which segmental longitudinal strain (LS) cutoff value would be optimal to discriminate viable myocardium. METHODS: We included 47 patients (average age: 61 ± 11 years) referred to our cardiac imaging center for MV evaluation. All patients underwent transthoracic echocardiography with measures of LS, SPECT, and coronary angiography. RESULTS: In all, 799 segments were analyzed. We correlated myocardial tracer uptake by SPECT with sub-endocardial, sub-epicardial, and mid-segmental LS values with r = .514 P < .0001, r = .501 P < .0001, and r = .520 P < .0001, respectively. The measurements of each layer strain (sub-endocardial, sub-epicardial, and mid) had the same performance to predict MV viability as defined by SPECT with areas under curve of 0.819 [0.778-0.861, P < .0001], 0.809 [0.764-0.854, P < .0001], and 0.817 [0.773-0.860, P < .0001], respectively. The receiver-operating characteristic analysis yielded a cutoff value of -6.5% for mid-segmental LS with a sensitivity of 76% and specificity of 76% to predict segmental MV as defined by SPECT. CONCLUSIONS: Multilayer strain analysis does not evaluate MV with more accuracy than standard segmental LS analysis.
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Orloff et al. (2018) conducted an observational in Myocardial viability (n=47). Multilayer strain analysis vs. Standard segmental longitudinal strain analysis was evaluated on Prediction of myocardial viability as defined by SPECT (AUC 0.817, 95% CI 0.773-0.860, p=<.0001). Multilayer strain analysis did not evaluate myocardial viability with more accuracy than standard segmental longitudinal strain, yielding an AUC of 0.817 for mid-segmental strain.
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