Reproducibility of global left atrial strain and strain rate between novice and expert using multi-vendor analysis software
- 143 Downloads
Left atrial (LA) strain is an emerging technique with potential applications including arrhythmia prediction in atrial fibrillation and early identification of atrial dysfunction. The aim of this study was to evaluate reproducibility of LA strain and strain rate (SR) using multi-vendor analysis software between novice and expert. For LA strain to be a reliable tool, the technique must be reproducible by observers with variable experience. Use of multi-vendor analysis software allows serial strain assessment when echocardiographic images are acquired using different vendors. Fifty subjects underwent 2D-Speckle tracking echocardiographic (STE) derived LA strain and SR analysis measured from apical four and two-chamber views. Three strain parameters of LA function were assessed: reservoir (S-LAs, SR-LAs), contractile (S-LAa, SR-LAa) and conduit (S-LAs–S-LAa, SR-LAe). Strain analyses were performed by 2 independent, blinded novice and expert observers using multi-vendor analysis software. Intraobserver and interobserver analyses were performed using intra class correlation coefficients (ICC) and Bland–Altman analysis. LA strain and SR measured by novice observer demonstrated excellent intraobserver reproducibility (ICC for all strain and SR values > 0.88). There was good interobserver agreement of LA strain values between novice and expert (S-LAs:ICC 0.81, S-LAe:ICC 0.82, S-LAa:ICC 0.74). SR values also demonstrated good interobserver agreement (SR-LAs:ICC 0.83, SR-LAe:ICC 0.79, SR-LAa:ICC 0.86). Of all parameters, SR-LAa had the best interobserver and intraobserver agreement (ICC 0.86, 0.96). Global LA strain and SR values were highly reproducible by novice strain reader using multi-vendor analysis software. Interobserver reproducibility between novice and experts were good and acceptable within limits of agreement.
KeywordsLeft atrial strain Atrial function Atrial deformation Left atrium Strain Reproducibility
This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.
Compliance with ethical standards
Conflict of interest
The authors declared that they have no conflict of interest.
- 7.Yamada A, Luis SA, Sathianathan D, Khandheria BK, Cafaro J, Hamilton-Craig C, Platts D, Haeseler L, Bursotw D (2014) Reproducibility of regional and global longitudinal strains derived from two-dimensional speckle-tracking and Doppler tissue imaging between expert and novice readers during quantitative dobutamine stress echocardiography. J Am Soc Echocardiogr 27:880–887CrossRefGoogle Scholar
- 8.Chan J, Shiino K, Nchafatso OG, Hana J, Chamberlain R, Small A, Scalia I, Scalia W, Yamada A, Hamilton-Craig C, Scalia GM, Zamorano J (2017) Left ventricular global strain analysis by two-dimensional speckle-tracking echocardiography: the learning curve. J Am Soc Echocardiogr 11:1081–1090CrossRefGoogle Scholar
- 9.Badano LP, Kolias TJ, Muraru D, Abraham TP, Aurigemma G, Edvardsen T et al (2018) Standardization of left atrial, right ventricular and right atrial deformation imaging using two-dimensional speckle tracking echocardiography: a consensus document of the EACVI/ASE/Industry Task Force to standardize deformation imaging. Eur Heart J Cardiovasc Imaging 0:1–10Google Scholar
- 14.Yasuda R, Murata M, Roberts R, Toluda H, Minakata Y, Suzuki K, Tsuruta H, Kimura T, Nishiyama N, Fukumoto K, Aizawa Y, Tanimoto K, Takatsuki S, Abe T, Fukuda K (2015) Left atrial strain is a powerful predictor of atrial fibrillation recurrence after catheter ablation: study of a heterogeneous population with sinus rhythm or atrial fibrillation. Eur Heart J Cardiovasc Imaging 16:1008–1014Google Scholar
- 16.Nochioka K, Quarta C, Claggett B, Roca GQ, Rapezzi C, Falk R, Solomon S (2017) Left atrial structure and function in cardiac amyloidosis. Eur Heart J Cardiovasc Imaging 0:1–10Google Scholar
- 20.Habibi M, Chahal H, Opdahl A et al (2015) Association of CMR-measured LA function with heart failure development: results from the MESA study. JACC Cardiovasc Imaging 6:570–579Google Scholar
- 25.Shiino K, Yamada A, Ischenko M, Khandheria B, Hudaverdi M, Speranza V, Harten M, Benjamin A, Hamilton-Craig C, Platts D, Burstow D, Scalia M, Chan J (2017) Intervendor consistency and reproducibility of left ventricular 2D global and regional strain with two different high-end ultrasound systems. Eur Heart J 18:707–716Google Scholar