Left ventricular global longitudinal strain in bicupsid aortic valve patients: head-to-head comparison between computed tomography, 4D flow cardiovascular magnetic resonance and speckle-tracking echocardiography

Abstract

Left ventricular global longitudinal strain (LVGLS) analysis is a sensitive measurement of myocardial deformation most often done using speckle-tracking transthoracic echocardiography (TTE). We propose a novel approach to measure LVGLS using feature-tracking software on the magnitude dataset of 4D flow cardiovascular magnetic resonance (CMR) and compare it to dynamic computed tomography (CT) and speckle tracking TTE derived measurements. In this prospective cohort study 59 consecutive adult patients with a bicuspid aortic valve (BAV) were included. The study protocol consisted of TTE, CT, and CMR on the same day. Image analysis was done using dedicated feature-tracking (4D flow CMR and CT) and speckle-tracking (TTE) software, on apical 2-, 3-, and 4-chamber long-axis multiplanar reconstructions (4D flow CMR and CT) or standard apical 2-, 3-, and 4-chamber acquisitions (TTE). CMR and CT GLS analysis was feasible in all patients. Good correlations were observed for GLS measured by CMR (− 21 ± 3%) and CT (− 20 ± 3%) versus TTE (− 20 ± 3%, Pearson’s r: 0.67 and 0.65, p < 0.001). CMR also correlated well with CT (Pearson’s r 0.62, p < 0.001). The inter-observer analysis showed moderate to good reproducibility of GLS measurement by CMR, CT and TTE (Pearsons’s r: 0.51, 0.77, 0.70 respectively; p < 0.05). Additionally, ejection fraction (EF), end-diastolic and end-systolic volume measurements (EDV and ESV) correlated well between all modalities (Pearson’s r > 0.61, p < 0.001). Feature-tracking GLS analysis is feasible using the magnitude images acquired with 4D flow CMR. GLS measurement by CMR correlates well with CT and speckle-tracking 2D TTE. GLS analysis on 4D flow CMR allows for an integrative approach, integrating flow and functional data in a single sequence. Not applicable, observational study. Electronic supplementary material The online version of this article (10.1007/s10554-020-01883-9) contains supplementary material, which is available to authorized users.

Early detection of reduced left ventricular systolic function by 2D speckle tracking echocardiography in patients with primary mitral regurgitation in a Vietnamese cohort

“…This finding is consistent with the findings of Ciro Santoro, Maurizio Galderisi, et al ( 2019) on subjects with MR and S. Yilmazer; R.G. Chelu, et al ( 2020), who discovered that EDV and ESV were well correlated with GLS (r > 0.61, p 0.01) 20,29 .…”

“…Research S. Yilmaze, R.G. Chelu, et al (2020) discovered that EF correlates well with GLS 29 . Lima MSM, Villarraga HR, et al (2017) also showed that the GLS of STE was strongly positively correlated with LVEF, particularly in LV systolic failure 30 .…”

Environmental Tobacco Smoke Exposure Estimated Using the SHSES Scale, and Feature Tracking Computed Tomography-Derived Left Ventricular Global Longitudinal Strain in Hypertensive Patients

“…However, the popularity of the CT-derived strain method is growing, and the methodology itself is standardized, as shown by recently published studies [ 33 ]. Studies from recent years indicate high repeatability of strain assessment in computed tomography, also high compliance with echocardiographic assessment or magnetic resonance imaging assessment [ 12 , 34 ]. In our study the reliability of the CT-derived strain evaluation was achieved by performing all tests on the same CT machine according to exactly the same image acquisition protocol, using a high-quality dedicated application for strain evaluation of a recognized company, evaluating the strain strictly according to the application instructions by an experienced researcher with practical skills certified by internationally recognized scientific societies, the use of manual correction of the initial automatic contour of endocardium and epicardium as well as an internal assessment of the repeatability of the assessment by determining the intra-observer and inter-observer variability.…”

Evaluation of left ventricular myocardial mechanics in patients with normally functioning bicuspid aortic valves: A systematic review and meta‐analysis

“…Several studies showed that there was a high correlation between CMRFT and 2D/3D STE for LV strain. [16][17][18] Data that reflected LV diastolic function included LAVI and E/e' (E/Em). LVMI reflected LV hypertrophy.…”