Skip to main content

Two-dimensional global and segmental longitudinal strain: are the results from software in different high-end ultrasound systems comparable?

Abstract

To compare the peak global longitudinal myocardial strain (PGLS) and peak segmental longitudinal myocardial strain (PSLS) values by speckle-tracking echocardiography (STE) obtained using two different echocardiography devices. STE is an emerging quantitative ultrasound technique that allows an accurate evaluation of global and segmental myocardial function. However, there is a lack of standardization of the acquired data among different manufacturers. Sixty-three subjects, mean age 56.2±10.4 years, underwent complete echocardiographic studies with two different devices (Philips IE33 and General Electric VIVID E9) performed by the same operator. Thirty-one of them had known cardiac disease, with estimated left ventricular ejection fraction <50%, while 32 were free of any cardiovascular disease (control subjects). All images were digitally stored and analyzed using off-line post processing with QLAB 9 and EchoPAC 11 Software packages. PSLS and PGLS were calculated. A strong relationship between QLAB and EchoPAC was found for PGLS (r=0.91, P<0.001), PSLS-4 chamber (CH; r=0.79, P<0.001), PSLS-2CH (r=0.73, P<0.001), and PSLS-3CH (r=0.78, P<0.001) QLAB. Bland–Altman analysis showed absolute differences vs average of −0.16, −0.37, −0.21, and −0.16 for PGLS, PSLS-4CH, PSLS-2CH, and PSLS-apical long-axis views respectively. Segmental analysis showed a good agreement between the apical segments, whereas poor correlations were found for the basal segments. Receiver operating characteristic curve analysis showed that cutoff values for PGLS of −17.5 and −17.75% with Philips or GE systems gave a sensitivity and specificity of 93.5 and 87.5%, and 90 and 87.5%, respectively, in the discrimination of the patients from the controls. Both Philips and GE echo stations were found to give comparable results for PGLS, with approximately the same cutoff values, suggesting that their PGLS results may be interchangeable.

References

  1. Mor-Avi V, Lang RM, Badano LP, Belohlavek M, Cardim NM, Derumeaux G, Galderisi M, Marwick T, Nagueh SF, Sengupta PP et al. 2011 Current and evolving echocardiographic techniques for the quantitative evaluation of cardiac mechanics: ASE/EAE consensus statement on methodology and indications endorsed by the Japanese Society of Echocardiography. European Journal of Echocardiography 12 167–205. (doi:10.1093/ejechocard/jer021)

    Article  Google Scholar 

  2. Geyer H, Caracciolo G, Abe H, Wilansky S, Carerj S, Gentile F, Nesser HJ, Khandheria B, Narula J, Sengupta PP 2010 Assessment of myocardial mechanics using speckle tracking echocardiography: fundamentals and clinical applications. Journal of the American Society of Echocardiography 23 351–369. (quiz 453–455) (doi:10.1016/j.echo.2010.02.015)

    Article  Google Scholar 

  3. Biswas M, Sudhakar S, Nanda NC, Buckberg G, Pradhan M, Roomi AU, Gorissen W, Houle H 2013 Two- and three-dimensional speckle tracking echocardiography: clinical applications and future directions. Echocardiography 30 88–105. (doi:10.1111/echo.12079)

    Article  Google Scholar 

  4. Cho GY, Marwick TH, Kim HS, Kim MK, Hong KS, Oh DJ 2009 Global 2-dimensional strain as a new prognosticator in patients with heart failure. Journal of the American College of Cardiology 54 618–624. (doi:10.1016/j.jacc.2009.04.061)

    Article  Google Scholar 

  5. Nahum J, Bensaid A, Dussault C, Macron L, Clémence D, Bouhemad B, Monin JL, Rande JL, Gueret P, Lim P 2010 Impact of longitudinal myocardial deformation on the prognosis of chronic heart failure patients. Circulation. Cardiovascular Imaging 3 249–256. (doi:10.1161/CIRCIMAGING.109.910893)

    Article  Google Scholar 

  6. Fontana A, Zambon A, Cesana F, Giannattasio C, Trocino G 2012 Tissue Doppler, triplane echocardiography, and speckle tracking echocardiography: different ways of measuring longitudinal myocardial velocity and deformation parameters. A comparative clinical study. Echocardiography 29 428–437. (doi:10.1111/j.1540-8175.2011.01618.x)

    Article  Google Scholar 

  7. Amundsen BH, Crosby J, Steen PA, Torp H, Slørdahl SA, Støylen A 2009 Regional myocardial long-axis strain and strain rate measured by different tissue Doppler and speckle tracking echocardiography methods: a comparison with tagged magnetic resonance imaging. European Journal of Echocardiography 10 229–237. (doi:10.1093/ejechocard/jen201)

    PubMed  Google Scholar 

  8. Sjøli B, Ørn S, Grenne B, Vartdal T, Smiseth OA, Edvardsen T, Brunvand H 2009 Comparison of left ventricular ejection fraction and left ventricular global strain as determinants of infarct size in patients with acute myocardial infarction. Journal of the American Society of Echocardiography 22 1232–1238. (doi:10.1016/j.echo.2009.07.027)

    Article  Google Scholar 

  9. Bland JM, Altman DG 1999 Measuring agreement in method comparison studies. Statistical Methods in Medical Research 8 135–160. (doi:10.1191/096228099673819272)

    CAS  Article  Google Scholar 

  10. Sun JP, Lee AP, Wu C, Lam YY, Hung MJ, Chen L, Hu Z, Fang F, Yang XS, Merlino JD et al. 2013 Quantification of left ventricular regional myocardial function using two-dimensional speckle tracking echocardiography in healthy volunteers–a multi-center study. International Journal of Cardiology 167 495–501. (doi:10.1016/j.ijcard.2012.01.071)

    Article  Google Scholar 

  11. Takigiku K, Takeuchi M, Izumi C, Yuda S, Sakata K, Ohte N, Tanabe K, Nakatani S, JUSTICE investigators 2012 Normal range of left ventricular 2-dimensional strain: Japanese Ultrasound Speckle Tracking of the Left Ventricle (JUSTICE) study. Circulation Journal 76 2623–2632. (doi:10.1253/circj.CJ-12-0264)

    Article  Google Scholar 

  12. Malm S, Frigstad S, Sagberg E, Larsson H, Skjaerpe T 2004 Accurate and reproducible measurement of left ventricular volume and ejection fraction by contrast echocardiography: a comparison with magnetic resonance imaging. Journal of the American College of Cardiology 44 1030–1035. (doi:10.1016/j.jacc.2004.05.068)

    Article  Google Scholar 

  13. Thomson HL, Basmadjian AJ, Rainbird AJ, Razavi M, Avierinos JF, Pellikka PA, Bailey KR, Breen JF, Enriquez-Sarano M 2001 Contrast echocardiography improves the accuracy and reproducibility of left ventricular remodeling measurements: a prospective, randomly assigned, blinded study. Journal of the American College of Cardiology 38 867–875. (doi:10.1016/S0735-1097(01)01416-4)

    CAS  Article  Google Scholar 

  14. Marwick TH, Leano RL, Brown J, Sun JP, Hoffmann R, Lysyansky P, Becker M, Thomas JD 2009 Myocardial strain measurement with 2-dimensional speckle-tracking echocardiography: definition of normal range. JACC. Cardiovascular Imaging 2 80–84. (doi:10.1016/j.jcmg.2007.12.007)

    Article  Google Scholar 

  15. Yingchoncharoen T, Agarwal S, Popović ZB, Marwick TH 2013 Normal ranges of left ventricular strain: a meta-analysis. Journal of the American Society of Echocardiography 26 185–191. (doi:10.1016/j.echo.2012.10.008)

    Article  Google Scholar 

  16. Dalen H, Thorstensen A, Aase SA, Ingul CB, Torp H, Vatten LJ, Stoylen A 2010 Segmental and global longitudinal strain and strain rate based on echocardiography of 1266 healthy individuals: the HUNT study in Norway. European Journal of Echocardiography 11 176–183. (doi:10.1093/ejechocard/jep194)

    Article  Google Scholar 

  17. Reckefuss N, Butz T, Horstkotte D, Faber L 2011 Evaluation of longitudinal and radial left ventricular function by two-dimensional speckle-tracking echocardiography in a large cohort of normal probands. International Journal of Cardiovascular Imaging 27 515–526. (doi:10.1007/s10554-010-9716-y)

    Article  Google Scholar 

  18. Carstensen S, Ali SM, Stensgaard-Hansen FV, Toft J, Haunsø S, Kelbaek H, Saunamäki K 1995 Dobutamine–atropine stress echocardiography in asymptomatic healthy individuals. The relativity of stress-induced hyperkinesia. Circulation 92 3453–3463. (doi:10.1161/01.CIR.92.12.3453)

    CAS  Article  Google Scholar 

  19. Bach DS, Muller DW, Gros BJ, Armstrong WF 1994 False positive dobutamine stress echocardiograms characterization of clinical, echocardiographic and angiographic findings. Journal of the American College of Cardiology 24 928–933. (doi:10.1016/0735-1097(94)90851-6)

    CAS  Article  Google Scholar 

  20. Castel AL, Szymanski C, Delelis F, Levy F, Menet A, Mailliet A, Marotte N, Graux P, Tribouilloy C, Maréchaux S 2014 Prospective comparison of speckle tracking longitudinal bidimensional strain between two vendors. Archives of Cardiovascular Diseases 107 96–104. (doi:10.1016/j.acvd.2014.01.007)

    Article  Google Scholar 

  21. Manovel A, Dawson D, Smith B, Nihoyannopoulos P 2010 Assessment of left ventricular function by different speckle-tracking software. European Journal of Echocardiography 11 417–421. (doi:10.1093/ejechocard/jep226)

    Article  Google Scholar 

Download references

Funding

This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Alexandros P. Patrianakos MD.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the articles Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the articles Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Patrianakos, A.P., Zacharaki, A.A., Kalogerakis, A. et al. Two-dimensional global and segmental longitudinal strain: are the results from software in different high-end ultrasound systems comparable?. Echo Res Pract 2, 29–39 (2015). https://doi.org/10.1530/ERP-14-0070

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1530/ERP-14-0070

Key Words

  • echocardiography
  • speckle-tracking echocardiography
  • peak global longitudinal myocardial systolic strain
  • segmental longitudinal myocardial systolic strain