Cardiovascular magnetic resonance-derived global circumferential strain was significantly associated with the presence of late gadolinium enhancement (OR 1.41), whereas echocardiography strain was not.
Observational (n=50)
Blinded readers
No
How do CMR-derived and STE-derived myocardial strain measurements compare in agreement, reproducibility, and association with late gadolinium enhancement?
CMR and STE strain measurements show good agreement and reproducibility, but CMR-derived circumferential strain is better associated with the presence of late gadolinium enhancement than longitudinal strain.
Effect estimate: OR 1.41 (95% CI 1.14-1.74)
p-value: p=0.002
OBJECTIVES: We sought to: (1) determine the agreement in cardiovascular magnetic resonance (CMR) and speckle tracking echocardiography (STE) derived strain measurements, (2) compare their reproducibility, (3) determine which approach is best related to CMR late gadolinium enhancement (LGE). BACKGROUND: While STE-derived strain is routinely used to assess left ventricular (LV) function, CMR strain measurements are not yet standardized. Strain can be measured using dedicated pulse sequences (strain-encoding, SENC), or post-processing of cine images (feature tracking, FT). It is unclear whether these measurements are interchangeable, and whether strain can be used as an alternative to LGE. METHODS: Fifty patients underwent 2D echocardiography and 1.5 T CMR. Global longitudinal strain (GLS) was measured by STE (Epsilon), FT (NeoSoft) and SENC (Myocardial Solutions) and circumferential strain (GCS) by FT and SENC. RESULTS: GLS showed good inter-modality agreement (r-values: 0.71-0.75), small biases (< 1%) but considerable limits of agreement (- 7 to 8%). The agreement between the CMR techniques was better for GLS than GCS (r = 0.81 vs 0.67; smaller bias). Repeated measurements showed low intra- and inter-observer variability for both GLS and GCS (intraclass correlations 0.86-0.99; coefficients of variation 3-13%). LGE was present in 22 (44%) of patients. Both SENC- and FT-derived GLS and GCS were associated with LGE, while STE-GLS was not. Irrespective of CMR technique, this association was stronger for GCS (AUC 0.77-0.78) than GLS (AUC 0.67-0.72) and STE-GLS (AUC = 0.58). CONCLUSION: There is good inter-technique agreement in strain measurements, which were highly reproducible, irrespective of modality or analysis technique. GCS may better reflect the presence of underlying LGE than GLS.
Erley et al. (Tue,) conducted a observational in Ischemic and non-ischemic heart disease (n=50). Cardiovascular magnetic resonance (CMR) strain (Feature Tracking and Strain-Encoding) vs. Speckle tracking echocardiography (STE) strain was evaluated on Association of SENC-derived global circumferential strain (GCS) with the presence of late gadolinium enhancement (LGE) (OR 1.41, 95% CI 1.14-1.74, p=0.002). Cardiovascular magnetic resonance-derived global circumferential strain was significantly associated with the presence of late gadolinium enhancement (OR 1.41), whereas echocardiography strain was not.