Reproducibility and Intervendor Agreement of Left Ventricular Global Systolic Strain in Children Using a Layer-Specific Analysis

Ramlogan, Sandhya R.; Aly, Doaa; France, Rita; Schmidt, Stephanie; Hinzman, Julie; Sherman, Ashley; Goudar, Suma; Forsha, Daniel

doi:10.1016/j.echo.2019.08.004

Cited by 23 publications

(21 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Low frame rates have also been hypothesized to decrease the agreement of strain and synchrony measurements with other vendors that analyze the images at high frame rates. TomTec also imports images with lower fidelity compared to the raw image files used by the vendor dependent platforms, potentially influencing spatial resolution and decreasing the tracking reliability of the speckle patterns [16]. In our study, we demonstrated that LV longitudinal and circumferential strain showed excellent agreement when using TomTec at high and low frame rates in children with normal cardiac anatomy and ventricular paced rhythm, similar to recent reports in children [15,16], and adults [17].…”

Section: Discussionsupporting

confidence: 84%

“…The findings in this study imply that the technical characteristics of the tested software packages coupled with the patient population likely have a combined impact on the measurement results. Few studies have addressed the inter-vendor variability of longitudinal and circumferential strain measurements in children [12,15,16,18,19]. The EACVI/ASE developed a Task Force to standardize deformation imaging and initially concluded from head-to-head comparison of nine different vendors in adults only (including Tom-Tec Image Arena 2D CPA 1.2 and QLAB version 10.0) that global LV longitudinal strain was feasible and comparable, and in many cases superior to conventional echocardiographic parameters such as volumes and ejection fraction [13].…”

Section: Discussionmentioning

confidence: 99%

“…Prior to the Task Force establishment, Koopman et al showed that longitudinal strain, measured using a vendor-independent software (TomTec version 1.0) and a vendor-specific software (EchoPAC version 7.0 and QLAB version 7.0) had reasonable agreement, while for circumferential strain wide variability existed between the software packages [15]. Ramlogan et al recently assessed the measured variability of overall longitudinal strain agreement slightly stronger than circumferential [16]. de Waal et al also reported robust longitudinal strain agreement in term and preterm infants between QLAB 10.8 and TomTec CPA 1.3, but poor correlation with circumferential strain [18].…”

Section: Discussionmentioning

confidence: 99%

“…TomTec also imports images with lower fidelity compared to the raw image files used by the vendor dependent platforms, potentially influencing spatial resolution and decreasing the tracking reliability of the speckle patterns [16]. In our study, we demonstrated that LV longitudinal and circumferential strain showed excellent agreement when using TomTec at high and low frame rates in children with normal cardiac anatomy and ventricular paced rhythm, similar to recent reports in children [15,16], and adults [17]. For children with abnormal septal contour, however, differences in mean longitudinal and circumferential strain between the high and low frame rate analysis were larger.…”

Section: Discussionmentioning

confidence: 99%

“…Strain and synchrony can be calculated with the use of a variety of analysis packages, some of which are vendor-specific, while others are vendorindependent [13]. Recent studies in adults [14] and children [15,16], as well as an international task force for deformation imaging, have investigated the variations in reported values of strain from different packages [10,13]. A paucity of evidence on inter-vendor synchrony differences currently exists, with only a single study published in adults, and none in children [4].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Speckle tracking echocardiographically-based analysis of ventricular strain in children: an intervendor comparison

Ferraro¹,

Adar²,

Ghelani³

et al. 2020

Cardiovasc Ultrasound

View full text Add to dashboard Cite

Background: Strain and synchrony can be calculated from a variety of software packages, but there is a paucity of data with inter-vendor comparisons in children. To test the hypothesis that different packages may affect results, independent of acquisition, we compared values obtained using two commercially available analysis tool (QLAB and TomTec), with several different settings. Methods: The study population included 108 children; patients were divided into three groups: (1) normal cardiac structure and conduction; (2) ventricular paced rhythm; and (3) flattened ventricular septum (reflecting right ventricular pressure or volume load lesions). We analyzed the same image acquired from the apical 4-chamber (AP4) and short-axis at the mid-papillary level (SAXM) views in both QLAB (versions 10.5 and 10.8) and TomTec (version 1.2). In QLAB version 10.8, low, medium, and high quantification smoothness settings were employed. In TomTec, images were analyzed with both low and high frame rates. Tracking quality for each package was graded. AP4 and SAXM strain and synchrony values were recorded. A mixed-effects linear regression model was used, with main effect considered significant if the p-value was < 0.05. Results: Tracking scores were high for all packages except QLAB 10.5 in the SAXM view. AP4 and SAXM strain values varied significantly between QLAB 10.5 and the other packages. Synchrony values varied widely for all strain values (p < 0.001 for both) in all packages. Quantification smoothness changes in QLAB 10.8 did not impact strain significantly in any patient group; temporal resolution changes in TomTec resulted in strain differences in children with flat ventricular septums, but not those with normal or ventricular paced hearts. Conclusion: Synchrony values varied substantially among all packages in children. Strain values varied widely between QLAB 10.5 and all other software packages, recommending avoidance of QLAB 10.5 for future studies. Quantification smoothness settings in QLAB 10.8 resulted in minimal strain differences. In TomTec, low and high frame rate strain values differed only in a subset of patients (flattened septum). These data suggest that reliable comparisons between strain values derived from QLAB and TomTec is possible in certain cases, but that caution should be used especially in different hemodynamics conditions.

show abstract