How Does Regional Hypertrophy Affect Strain Measurements With Different Speckle-Tracking Methods? - 31/10/19

Abstract |
Background |
In this study, we evaluate the impact of abnormal myocardial shapes, such as regional hypertrophy, on longitudinal strain measurements with different tracking approaches.
Methods |
We selected 40 patients with normal ejection fraction and prominent septal bulge. We assessed longitudinal strain with full wall (FW) tracking, (GE EchoPAC) as well as endo-, mid-, and epicardial (EME) tracking (Tomtec ImageArena), on the same image acquired with a GE machine (using raw data and full frame rate DICOM data, respectively). We used a region of interest (ROI) which follows precisely the endo- and epicardial contours (true contour ROI) and one where the bulging region was excluded (straight ROI).
Results |
In segments with bulge, absolute segmental longitudinal strain values were in all myocardial layers significantly higher with a straight ROI compared to a true contour ROI, both with FW tracking and EME tracking. The highest difference was found in the endocardial layer (3.4 ± 2.5% and 7.7 ± 7.1%, respectively, both P < 0.001). In the bulged segments, the effect of ROI shape was more pronounced in EME tracking software compared to FW tracking software. Bulged segments also influenced global longitudinal strain measurements, mostly in the endocardial layer (P < 0.001). Global longitudinal strain values obtained with the straight ROI correlated better with longitudinal fractional shortening of the LV.
Conclusions |
Regional bulging has a significant effect on both global and segmental strain measurements. Endocardial strain values obtained with EME tracking and a true contour ROI were most sensitive to bulging. Midwall strain values derived from FW tracking using a straight ROI were most robust.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Regional bulging can have a dramatic effect on strain measurements. |
• | Endocardial layer strain was most influenced by the inclusion or exclusion of bulging. |
• | Layer-specific tracking is more sensitive to bulging than full wall tracking. |
Graphical abstract |
Keywords : Speckle-tracking, Echocardiography, Regional hypertrophy, Layer strain, Full wall tracking, Endocardial tracking
Abbreviations : 2DST, ASE, EACVI, EME tracking, FW tracking, GLS, LFS, LV, ROI, SB, SLS
Plan
| The research for this article was performed at the University of Leuven, Leuven, Belgium. |
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| The first two authors should be considered similar in author order. |
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| In cooperation with the European Association of Cardiovascular Imaging/American Society of Echocardiography Industry Task Force on Strain Standardization. |
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| Chairs: Luigi P. Badano, Padua, Italy, and James D. Thomas, Chicago, Illinois. |
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| S.Ü. received a research grant of the European Association of Cardiovascular Imaging. A.P. received a research grant of the German Society of Cardiology. A.S.B. received a grant of the Egyptian ministry of high education. J-U.V. holds a personal research mandate and received a project grant of the Flemish Research Council. |
Vol 32 - N° 11
P. 1444-1450 - novembre 2019 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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