Accuracy and reliability of novel semi-automated two-dimensional layer specific speckle tracking software for quantifying left ventricular volumes and function

PLoS One. 2019 Aug 30;14(8):e0221204. doi: 10.1371/journal.pone.0221204. eCollection 2019.

Abstract

Purpose: To determine whether the semi-automated two-dimensional echocardiography (2DE) layer strain software, compared to cardiac magnetic resonance (CMR), is reliable for left ventricular (LV) volume quantification.

Methods and results: We retrospectively selected 84 patients who underwent CMR and 2DE on the same day. Novel 2DE layer strain software automatically provides LV contour in 3 myocardial layers and performs layer specific speckle tracking analysis, which calculates LV volumes, ejection fraction (LVEF), and global longitudinal strain (GLS) in each layer. These values were compared with reference values from CMR disk-area summation and feature tracking methods. Coverage probability (CP) was determined using predefined cut-off values and absolute differences in LV volumes of 30 mL, those in LVEF of 10%, and those in GLS of 4%. The software did not work in 3 patients (feasibility: 96%). Different layers resulted in different degrees of under- or over-estimation of LV volumes. Epicardial tracking significantly overestimated the LV volumes and significantly underestimated LVEF and GLS. Mid-myocardial tracking had less underestimation of LV volumes and equivalent CP values of LVEF (0.77 vs. 0.75 using the disk-area summation method and 0.90 vs. 0.94 using the feature tracking method) and GLS (0.95 vs. 0.92) compared with endocardial tracking. The new software showed excellent reproducibility, especially endocardial and mid-myocardial tracking.

Conclusions: Mid-myocardial tracking with the novel 2DE strain software provided less bias of LV volumes with high CP values of LVEF and GLS, which suggests that mid-myocardial layer speckle tracking analysis approximates CMR derived LV functional parameters.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Echocardiography / methods*
  • Elasticity Imaging Techniques
  • Female
  • Heart / diagnostic imaging*
  • Heart / physiopathology
  • Heart Ventricles / diagnostic imaging*
  • Heart Ventricles / physiopathology
  • Humans
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Reference Values
  • Software*
  • Ventricular Function, Left / physiology

Grants and funding

MT received an equipment grant from Canon Medical Systems. YA is an employee of Canon Medical Systems. The other authors declare that they have no conflict of interest. The funder provided support in the form of salary for Yasuhiko Abe, but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the ‘author contributions’ section.