The Impact of the Width of the Tracking Area on Speckle Tracking Parameters—Methodological Aspects of Deformation Imaging

Stoebe, S.; Tarr, A.; Pfeiffer, Dietrich; Hagendorff, Andreas

doi:10.1111/echo.12440

Cited by 8 publications

(13 citation statements)

References 24 publications

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“…Although Mirea et al recently stated that different widths of ROI significantly impact strain measurements, the literature is remarkable sparse on this topic [13]. Stoebe et al found that GLS was significantly influenced by the ROI width in 30 healthy subjects and 15 patients with mild to moderate LV systolic dysfunction [14]. In the healthy group GLS was − 23.5% with narrow, − 20.0% with medium and − 14.6% with wide width.…”

Section: Discussionmentioning

confidence: 99%

The impact of semi-automatic versus manually adjusted assessment of global longitudinal strain in post-myocardial infarction patients

Otterstad

Norum

Ruddox

et al. 2020

Int J Cardiovasc Imaging

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There are unresolved questions related to the proper use of editing the region of interest (ROI) for measurements of global longitudinal strain (GLS). The purpose of the present study was to compare the semi-automatic default GLS value by the vendor's software with manually adjusted GLS and test the impact on GLS measures with different ROI widths. We selected 25 patients post myocardial infarction treated with PCI who had excellent echocardiographic recordings after 2-5 days and 3 months. The different GLS values were assessed from these 50 analyses in three steps. The semi-automatically GLS by default ROIs was compared with manually adjusted ROIs widths selected by an expert and then with manual adjustments, but with fixed ROIs being narrow, medium and wide. Their mean age was 64 (± 12) years, 52% had ST elevation MI and mean LVEF was 52 (± 4)%. Mean default GLS was − 15.3 (± 2.5)% with the widest ROI level selected semi-automatically in 78% of all widths. The mean expert GLS with manually adjusted ROI was − 14.7 (± 2.4)%, and the medium ROI level was selected by the expert in 85% of all examinations. The mean adjusted GLS, but with fixed ROIs widths was − 15.0 (± 2.5%)% with narrow ROI, − 14.7 (± 2.6)% with medium and − 13.5 (± 2.3)% with wide ROI width (p < 0.001 vs. default GLS). The Intra Class Coefficient Correlation between default and manually adjusted expert GLS was 0.93 (p < 0.001). The difference between the default and the manually adjusted expert GLS was neglectable. These findings may represent a simplification of the assessment of GLS that might increase its use in clinical practice. The GLS measurements with a fixed wide ROIs were significantly different from the expert measurements and indicate that a wide ROI should be avoided.

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Section: Discussionmentioning

confidence: 99%

The impact of semi-automatic versus manually adjusted assessment of global longitudinal strain in post-myocardial infarction patients

Otterstad

Norum

Ruddox

et al. 2020

Int J Cardiovasc Imaging

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“…It is import to note that although STE is less angle dependent than TDI measures of strain, the components of longitudinal and circumferential strains are opposite in polarity to radial strain therefore any deviation from the major axis will result in a progressive reduction in strain values in the relative axis (19). In view of this, it is essential to avoid apical foreshortening in the apical views and ensure circular LV chamber in the parasternal short axis (PSAX) views whilst avoiding the use of non-standardised views (20). Suboptimal image acquisition may result in poor speckle tracking.…”

Section: Optimal Image Acquisitionmentioning

confidence: 99%

“…In normal healthy individuals, the inner (subendocardial) layer contributes the most to longitudinal and circumferential strain, with a reduction in the mid-myocardium, and the lowest contribution from the outer (subepicardial) layer (27). Therefore, the width of the ROI has significant effects on the strain values reported (20, 28). If the tracking area width is too narrow, encompassing only the endocardial layer, higher strain values will be reported (28).…”

Section: Image Analysismentioning

confidence: 99%

Practical tips and tricks in measuring strain, strain rate and twist for the left and right ventricles

et al. 2019

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Strain imaging provides an accessible, feasible and non-invasive technique to assess cardiac mechanics. Speckle tracking echocardiography (STE) is the primary modality with the utility for detection of subclinical ventricular dysfunction. Investigation and adoption of this technique has increased significantly in both the research and clinical environment. It is therefore important to provide information to guide the sonographer on the production of valid and reproducible data. The focus of this review is to (1) describe cardiac physiology and mechanics relevant to strain imaging, (2) discuss the concepts of strain imaging and STE and (3) provide a practical guide for the investigation and interpretation of cardiac mechanics using STE.

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“…The ROI is the area in the image where speckle tracking occurs, and usually involves some form of delineation of the myocardium. Previous studies of adults have shown that the ROI width affects strain values and therefore is a source of variation for strain measurements [18][19][20]. The effect of ROI width is further nuanced when layer specific strain is taken into account, with ROI width having an increasing impact on strain as one moves from the endocardial to the epicardial layer.…”

Section: Introductionmentioning

confidence: 99%

The influence of region of interest width in fetal 2D-speckle tracking echocardiography late in pregnancy

Omdal

Khan

Ebbing

et al. 2021

Int J Cardiovasc Imaging

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Speckle tracking echocardiography is a promising method for assessment of myocardial function in fetal and neonatal hearts, but further studies are necessary to validate and optimize the settings for use in fetal cardiology. Previous studies have shown that the definition of the region of interest (ROI) affects strain values in adults. The aim of this study was to investigate how different widths of ROI influences measurements of four-chamber longitudinal systolic strain in fetuses late in pregnancy. Thirty-one singleton, healthy fetuses born to healthy mothers underwent an echocardiographic examination during gestational week 37. Speckle tracking was performed with two different settings for ROI width; the narrowest and second most narrow, provided both widths were assessed as suitable for the myocardial wall thickness of the fetus. We found an inverse correlation between the ROI width and the strain values. Four-chamber longitudinal strain changed from − 20.7 ± 3.6% to − 18.0 ± 4.4% (p < 0.001) with increasing ROI width. Further, strain decreased from the endocardium to the epicardium with multilayer measurements. Different widths of ROI influenced the strain measurements significantly in the fetal heart, comparable to what has been reported in adults. A standardization of the ROI setting could improve the interpretation, and reduce variability in fetal strain measurements.

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The Impact of the Width of the Tracking Area on Speckle Tracking Parameters—Methodological Aspects of Deformation Imaging

Cited by 8 publications

References 24 publications

The impact of semi-automatic versus manually adjusted assessment of global longitudinal strain in post-myocardial infarction patients

The impact of semi-automatic versus manually adjusted assessment of global longitudinal strain in post-myocardial infarction patients

Practical tips and tricks in measuring strain, strain rate and twist for the left and right ventricles

The influence of region of interest width in fetal 2D-speckle tracking echocardiography late in pregnancy

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