The Influence of the Region of Interest Width on Two‐Dimensional Speckle Tracking–Based Measurements of Strain and Strain Rate

Spriestersbach, Hendrik; Oh-Icí, Darach; Schmitt, Boris; Berger, Felix; Schmitz, L.

doi:10.1111/echo.12589

Cited by 15 publications

(25 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[26] As a relatively novel technique, there are still technical challenges for image acquisition. [27] In our study, averaging at least 3 LV segments seems adequate for STE parameters.…”

Section: Discussionmentioning

confidence: 72%

Quality Control and Reproducibility in M‐Mode, Two‐Dimensional, and Speckle Tracking Echocardiography Acquisition and Analysis: The CARDIA Study, Year 25 Examination Experience

et al. 2014

View full text Add to dashboard Cite

Introduction Few large studies describe quality control procedures and reproducibility findings in cardiovascular ultra-sound, particularly in novel techniques such as Speckle Tracking (STE). We evaluate the echocardiography assessment performance in the CARDIA study Y25 examination (2010-2011) and report findings from a quality control and reproducibility program conducted to assess Field Center image acquisition and Reading Center (RC) accuracy. Methods The CARDIA Y25 examination had 3,475 echocardiograms performed in 4 US Field Centers and analyzed in a Reading Center, assessing standard echocardiography (LA dimension, aortic root, LV mass, LV end-diastolic volume [LVEDV], ejection fraction [LVEF]), and STE (2- and 4-chamber longitudinal, circumferential, and radial strains). Reproducibility was assessed using intra-class correlation coefficients (ICC), coefficients of variation (CV), and Bland-Altman plots. Results For standard echocardiography reproducibility, LV mass and LVEDV consistently had CV above 10% and aortic root below 6%. Intra-sonographer aortic root and LV mass had the most robust values of ICC in standard echocardiography. For STE, the number of properly tracking segments was above 80% in short-axis and 4-chamber and 58% in 2-chamber. Longitudinal strain parameters were the most robust and radial strain showed the highest variation. Comparing Field Centers with Echo RC STE readings, mean differences ranged from 0.4% to 4.1% and ICC from 0.37 to 0.66, with robust results for longitudinal strains. Conclusion Echocardiography image acquisition and reading processes in the CARDIA study were highly reproducible, including robust results for STE analysis. Consistent quality control may increase the reliability of echocardiography measurements in large cohort studies.

show abstract

“…[26] As a relatively novel technique, there are still technical challenges for image acquisition. [27] In our study, averaging at least 3 LV segments seems adequate for STE parameters.…”

Section: Discussionmentioning

confidence: 72%

Quality Control and Reproducibility in M‐Mode, Two‐Dimensional, and Speckle Tracking Echocardiography Acquisition and Analysis: The CARDIA Study, Year 25 Examination Experience

et al. 2014

View full text Add to dashboard Cite

show abstract

“…The analysis of LV deformation including circumferential strain and rotation may improve the echocardiographic diagnostic approach in AM [ 24 , 27 , 28 ]. However, the use of myocardial deformation is not yet widely implemented in patients with AM [ 36 , 37 ]. Recently, the authors of the present study demonstrated the feasibility to define deformation patterns for radial and circumferential strain as well as rotation in a cohort of healthy volunteers and professional athletes [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…Recently, the authors of the present study demonstrated the feasibility to define deformation patterns for radial and circumferential strain as well as rotation in a cohort of healthy volunteers and professional athletes [ 19 ]. As also performed in the present study, several prerequisites have to be considered during image acquisition and post-processing analyses to exclude artifacts; for example, the acquisition of standardized short-axis views perpendicular to LV long axis, the documentation of apical rotation at the apical third of the left ventricle, the adjustment of the tracking area to exclude paracardial structures, as well as parts of the mitral valve [ 37 ]. Furthermore, the results of rotational deformation need to be counterchecked by multiple documentations to differentiate artifacts from deformation abnormalities as sequelae of SARS-CoV-2-induced myocardial involvement.…”

Section: Discussionmentioning

confidence: 99%

Echocardiographic characteristics of patients with SARS-CoV-2 infection

et al. 2020

View full text Add to dashboard Cite

Background Myocardial involvement induced by SARS-CoV-2 infection might be important for long-term prognosis. The aim of this observational study was to characterize the myocardial effects during SARS-CoV-2 infections by echocardiography. Results and methods An extended echocardiographic image acquisition protocol was performed in 18 patients with SARS-CoV-2 infection assessing LV longitudinal, radial, and circumferential deformation including rotation, twist, and untwisting. Furthermore, LV deformation was analyzed in an age-matched control group of healthy individuals ( n = 20). The most prevalent finding was a reduced longitudinal strain observed predominantly in more than one basal LV segment ( n = 10/14 patients, 71%). This pattern reminded of a “reverse tako-tsubo” morphology that is not typical for other viral myocarditis. Additional findings included a biphasic pattern with maximum post-systolic or negative regional radial strain predominantly basal ( n = 5/14 patients, 36%); the absence or dispersion of basal LV rotation ( n = 6/14 patients, 43%); a reduced or positive regional circumferential strain in more than one segment ( n = 7/14 patients, 50%); a net rotation showing late post-systolic twist or biphasic pattern ( n = 8/14 patients, 57%); a net rotation showing polyphasic pattern and/or higher maximum net values during diastole ( n = 8/14 patients, 57%). Conclusion Myocardial involvement due to SARS-CoV-2-infection was highly prevalent in the present cohort—even in patients with mild symptoms. It appears to be characterized by specific speckle tracking deformation abnormalities in the basal LV segments. These data set the stage to prospectively test whether these parameters are helpful for risk stratification and for the long-term follow-up of these patients.

show abstract

“…The authors emphasized that standard and reference values of deformation imaging should include detailed information about the position and width of the tracking area. Spriestersbach et al reported the influence of ROI width in 20 healthy subjects examined with a Vivid E 7 machine [15]. The Auto ROI applied was derived from a 4-chamber view only, and the endocardial border had been automatically traced based upon markers on the septal and lateral mitral ring and the apex.…”

Section: Discussionmentioning

confidence: 99%

The impact of semi-automatic versus manually adjusted assessment of global longitudinal strain in post-myocardial infarction patients

Otterstad

Norum

Ruddox

et al. 2020

Int J Cardiovasc Imaging

View full text Add to dashboard Cite

There are unresolved questions related to the proper use of editing the region of interest (ROI) for measurements of global longitudinal strain (GLS). The purpose of the present study was to compare the semi-automatic default GLS value by the vendor's software with manually adjusted GLS and test the impact on GLS measures with different ROI widths. We selected 25 patients post myocardial infarction treated with PCI who had excellent echocardiographic recordings after 2-5 days and 3 months. The different GLS values were assessed from these 50 analyses in three steps. The semi-automatically GLS by default ROIs was compared with manually adjusted ROIs widths selected by an expert and then with manual adjustments, but with fixed ROIs being narrow, medium and wide. Their mean age was 64 (± 12) years, 52% had ST elevation MI and mean LVEF was 52 (± 4)%. Mean default GLS was − 15.3 (± 2.5)% with the widest ROI level selected semi-automatically in 78% of all widths. The mean expert GLS with manually adjusted ROI was − 14.7 (± 2.4)%, and the medium ROI level was selected by the expert in 85% of all examinations. The mean adjusted GLS, but with fixed ROIs widths was − 15.0 (± 2.5%)% with narrow ROI, − 14.7 (± 2.6)% with medium and − 13.5 (± 2.3)% with wide ROI width (p < 0.001 vs. default GLS). The Intra Class Coefficient Correlation between default and manually adjusted expert GLS was 0.93 (p < 0.001). The difference between the default and the manually adjusted expert GLS was neglectable. These findings may represent a simplification of the assessment of GLS that might increase its use in clinical practice. The GLS measurements with a fixed wide ROIs were significantly different from the expert measurements and indicate that a wide ROI should be avoided.

show abstract

The Influence of the Region of Interest Width on Two‐Dimensional Speckle Tracking–Based Measurements of Strain and Strain Rate

Cited by 15 publications

References 30 publications

Quality Control and Reproducibility in M‐Mode, Two‐Dimensional, and Speckle Tracking Echocardiography Acquisition and Analysis: The CARDIA Study, Year 25 Examination Experience

Quality Control and Reproducibility in M‐Mode, Two‐Dimensional, and Speckle Tracking Echocardiography Acquisition and Analysis: The CARDIA Study, Year 25 Examination Experience

Echocardiographic characteristics of patients with SARS-CoV-2 infection

The impact of semi-automatic versus manually adjusted assessment of global longitudinal strain in post-myocardial infarction patients

Contact Info

Product

Resources

About