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The International Journal of Cardiovascular Imaging
Published in: The International Journal of Cardiovascular Imaging 3/2016

01-03-2016 | Original Paper

Comparison of left ventricular manual versus automated derived longitudinal strain: implications for clinical practice and research

Authors: Yukari Kobayashi, Miyuki Ariyama, Yuhei Kobayashi, Genevieve Giraldeau, Dominik Fleischman, Mirta Kozelj, Bojan Vrtovec, Euan Ashley, Tatiana Kuznetsova, Ingela Schnittger, David Liang, Francois Haddad

Published in: The International Journal of Cardiovascular Imaging | Issue 3/2016

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Abstract

Systolic global longitudinal strain (GLS) is emerging as a useful metric of ventricular function in heart failure and usually assessed using post-processing software. The purpose of this study was to investigate whether longitudinal strain (LS) derived using manual-tracings of ventricular lengths (manual-LS) can be reliable and time efficient when compared to LS obtained by post-processing software (software-LS). Apical 4-chamber view images were retrospectively examined in 50 healthy controls, 100 patients with dilated cardiomyopathy (DCM), and 100 with hypertrophic cardiomyopathy (HCM). We measured endocardial and mid-wall manual-LS and software-LS, using peak of average regional curve [software-LS(a)] and global ventricular lengths [software-LS(l)] according to definition of Lagragian strain. We compared manual-LS and software-LS by using Bland–Altman plot and coefficient of variation (COV). In addition, test–retest was also performed for further assessment of variability in measurements. While manual-LS was obtained in all subjects, software-LS could be obtained in 238 subjects (95 %). The time spent for obtaining manual-LS was significantly shorter than for the software-LS (94 ± 39 s vs. 141 ± 79 s, P < 0.001). Overall, manual-LS had an excellent correlation with both software-LS (a) (R2 = 0.93, P < 0.001) and software-LS(l) (R2 = 0.84, P < 0.001). The bias (95 %CI) between endocardial manual-LS and software-LS(a) was 0.4 % [−2.8, 3.6 %] in absolute and 3.5 % [−17.0, 24.0 %] in relative difference while it was 0.4 % [−2.5, 3.3 %] and 3.4 % [−16.2, 23.1 %], respectively with software-LS(l). Mid-wall manual-LS and mid-wall software-LS(a) also had good agreement [a bias (95 % CI) for absolute value of 0.1 % [−2.1, 2.5 %] in HCM, and 0.2 % [−2.2, 2.6 %] in controls]. The COV for manual and software derived LS were below 6 %. Test–retest showed good variability for both methods (COVs were 5.8 and 4.7 for endocardial and mid-wall manual-LS, and 4.6 and 4.9 for endocardial and mid-wall software-LS(a), respectively. Manual-LS appears to be as reproducible as software-LS; this may be of value especially when global strain is the metric of interest.
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Metadata
Title
Comparison of left ventricular manual versus automated derived longitudinal strain: implications for clinical practice and research
Authors
Yukari Kobayashi
Miyuki Ariyama
Yuhei Kobayashi
Genevieve Giraldeau
Dominik Fleischman
Mirta Kozelj
Bojan Vrtovec
Euan Ashley
Tatiana Kuznetsova
Ingela Schnittger
David Liang
Francois Haddad
Publication date
01-03-2016
Publisher
Springer Netherlands
Published in
The International Journal of Cardiovascular Imaging / Issue 3/2016
Print ISSN: 1569-5794
Electronic ISSN: 1875-8312
DOI
https://doi.org/10.1007/s10554-015-0804-x

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