Why the study?
Clinical applicability of myocardial strain is hindered by uncertain repeatability, particularly for segmental values across imaging methods.
Does multimodal cardiac imaging (1.5T/3T CMR with feature tracking, tagging, DENSE, and 2D/3D echocardiography) provide repeatable global and segmental myocardial strain measurements in healthy volunteers?
Does multimodal cardiac imaging (1.5T/3T CMR with feature tracking, tagging, DENSE, and 2D/3D echocardiography) provide repeatable global and segmental myocardial strain measurements in healthy volunteers?
Both CMR and echocardiography demonstrate fair-to-excellent scan-rescan repeatability for global myocardial strain parameters (such as a 5.5% threshold for true GLS change on 2D Echo and 11.2% on 1.5T CMR feature tracking), but segmental longitudinal and radial strain values are currently too unreliable for serial clinical monitoring.
Global strain shows fair repeatability across methods; leaves open reliable segmental use pending larger validation studies.
Aims: Myocardial strain is a powerful, non-invasive diagnostic and prognostic marker in patients with heart disease. However, its applicability is hindered by uncertain repeatability, particularly for segmental values. This study measures the repeatability of myocardial strain across eight imaging methods. Methods and results: 8, 14 men) were recruited and scanned twice with eight strain imaging protocols: cardiac magnetic resonance (CMR) at 1.5T and 3T with cine, tagging, and displacement encoding with stimulated echoes (DENSE) sequences, and 2D and 3D echocardiography (Echo). Global and segmental strains were quantified from each scan. Inter-scan repeatability was assessed with the coefficient of variation (CoV), intraclass correlation coefficient, and Bland-Altman analysis. Results: Inter-scan repeatability of global strains ranged from excellent to fair (CoV ≤ 20%) depending on protocol. Using CMR feature tracking at 1.5T, relative global longitudinal strain (GLS) changes exceeding 11.2% are unlikely to be caused by measurement variability alone; this figure is 5.5% for 2D echocardiography. Segmental strain values frequently had poor repeatability (CoV > 20%), particularly for longitudinal and radial strains. Conclusion: Imaging protocols including CMR and Echo can measure global strain parameters with fair repeatability, but segmental strain values are unreliable. Future work should aim to improve the repeatability of segmental strain values, particularly longitudinal strain.
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Bell et al. (2025) studied this question.
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