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Background Two-dimensional speckle-tracking echocardiography (2D-STE) enables objective assessment of left atrial (LA) deformation through the analysis of myocardial strain, which can be measured by different speckle-tracking software. The aim of this study was to compare the consistency of 3 different commercially available software, which include vendor-specific software for measuring left ventricle (VSS LV ), vendor-independent software packages for measuring LV strain (VIS LV ) and vendor-independent software packages for measuring LA strain (VIS LA ). Methods Sixty-four subjects (mean age: 44 ± 16 years, 50% males) underwent conventional echocardiograms using a GE Vivid 9 (GE Ultrasound, Horten, Norway) cardiac ultrasound system. Standard apical 4 and 2 chamber views of the left atrium were obtained in each subject with a frame-rate range of 40–71 frames/s. LA strain during the contraction phase (Sct), conduit phase (Scd), reservoir phase (Sr = Sct + Scd) were analyzed by 2 independent observers and 3 different software. Results Sct, Scd, Sr were, respectively, − 11.26 ± 2.45%, − 16.77 ± 7.06%, and 28.03 ± 7.58% with VSS LV , − 14.77 ± 3.59%, − 23.17 ± 10.33%, and 38.23 ± 10.99% with VIS LV , and − 14.80 ± 3.88%, − 23.94 ± 10.48%, and 38.73 ± 11.56% when VIS LA was used. A comparison of strain measurements between VSS LV and VIS (VIS LV and VIS LA ) showed VIS had significantly smaller mean differences and narrower limits of agreement. Similar results were observed in the coefficient of variation (CV) for measurements between VSS LV and VIS (VIS LV and VIS LA ). Comparison of the intra-class correlation coefficients (ICCs) indicated that measurement reliability was weaker with VSS LV (ICC < 0.6) than with VIS (VIS LV and VIS LA ) (ICC > 0.9). For intra-observer ICCs, VIS LA > VSS LV = VIS LV . For inter-observer ICCs, VSS LV > VIS LA > VIS LV . Conclusions Software measurement results of LA strain vary considerably. We recommended not measuring LA strain across vendor platforms. Electronic supplementary material The online version of this article (10.1186/s12947-019-0158-y) contains supplementary material, which is available to authorized users.

We aimed to investigate whether left ventricular (LV) twist analysis can detect the extent of myocardial fibrosis in patients with hypertrophic cardiomyopathy (HCM). This prospective case–control study recruited 81 consecutive patients with HCM examined between January 2012 and April 2013. Data of 76 patients were analyzed after excluding 5 patients whose echocardiographic images were of poor quality. Healthy volunteers (n = 46) served as controls. Both groups underwent comprehensive echocardiographic examination (i.e., Bas-Rotation, AP-Rotation, LVEF, LADs, IVST, LAVi, E/Em, LVMI, advanced LV-twist analysis by speckle tracking echocardiography) and magnetic resonance imaging. Between-group differences were analyzed by independent t test; logistic regression analysis was performed to identify effect factors. No significant differences were found between baseline characteristics of HCM and control groups (all p > 0.05). HCM patients had significantly higher Bas-Rotation, AP-Rotation, LV Twist, LVEF, LADs, IVST, LAVi, E/Em and LVMI than controls (all p < 0.0001) and significantly lower LVDd and E/A (both p < 0.001). Bas-Rotation, AP-Rotation, LV-Twist, LADs, IVST, LAVi, E/Em and LVMI were significantly higher in HCM patients with fibrosis than in those without fibrosis (p < 0.001), but no significant differences in other echocardiographic parameters were found between those with and without fibrosis. Age, Bas-Rotation, AP-Rotation, LV twist, LADs, IVST, LAVi, E/A, E/Em, and LVMI were significant effect factors for fibrosis. AUROC analysis showed that LV twist had high discriminatory power to detect extent of myocardial fibrosis (AUC 0.996, 95 % CI 0.989–1.004, p < 0.001). Left ventricular twist mechanics are associated with the extent of myocardial fibrosis. LV-twist assessment by STE may be clinically useful.Electronic supplementary materialThe online version of this article (doi:10.1007/s10554-014-0509-6) contains supplementary material, which is available to authorized users.