Author + information
- Theodore John Kolias,
- Peter Hagan,
- Stanley Chetcuti,
- Diane Eberhart,
- Nicole Kline,
- Sean Lucas and
- James Hamilton
Current conventional techniques for speckle tracking have limitations that have impeded their widespread use; these include variability between ultrasound systems, limited interoperability between vendors, and the inability of most software to use standard DICOM images obtained from any ultrasound system. To address these limitations, we have developed new universal strain software (USS) which can be used to perform speckle tracking of any DICOM image, regardless of the ultrasound system used to obtain it. In this study, we assessed the ability of this new USS to evaluate LV systolic and diastolic function.
50 patients prospectively underwent echocardiography immediately prior to cardiac catheterization using a latest generation system (Vivid E9, GE Healthcare). Biplane peak global longitudinal strain (GLS), peak systolic longitudinal strain rate (SSR), peak early diastolic longitudinal strain rate (DSR), and peak early diastolic circumferential strain rate (DCSR) were determined using conventional strain software (CSS) that uses raw data (EchoPac, GE Healthcare), and using the new USS applied to DICOM images (EchoInsight, Epsilon Imaging). Diastolic function was graded based on the mitral inflow pattern and catheter-derived measurement of LV end-diastolic pressure, and LVEF was also assessed.
USS correlated with CSS for GLS (r = 0.78, p < 0.001), SSR (r = 0.78, p < 0.001), DSR (r = 0.54, p < 0.001) and DCSR (r = 0.43, p = 0.019). GLS and SSR using USS correlated with LVEF (r = −0.67 and −0.71, respectively) as well as using CSS (r = −0.66 and −0.71, p < 0.001 for all 4 correlations). Patients with diastolic dysfunction had significantly lower DSR (0.61 vs 0.87 sec-1, p = 0.02) and DCSR (0.89 vs 1.23 sec-1, p = 0.03), and less negative GLS (−10.8 vs −16.1%, p = 0.002) using USS in all patients, as well as among those with LVEF > 50% (n = 31, p < 0.05 for each). ROC analysis for detection of diastolic dysfunction revealed a sensitivity and specificity of 82% and 83% for DCSR < 1.09 sec-1 (AUC = 0.80, p = 0.025) and 85% and 83% for GLS > −13.7% (AUC = 0.84, p = 0.009) using USS.
USS can be used to accurately assess LV systolic and diastolic function using speckle tracking echocardiography.
Moderated Poster Contributions
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Imaging: Clinical Applications of Myocardial Mechanics
Abstract Category: 18. Imaging: Echo
Presentation Number: 1268M-338
- 2013 American College of Cardiology Foundation