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Intervendor Agreement for Right Ventricular Global Longitudinal Strain in Children - 02/07/21

Doi : 10.1016/j.echo.2021.02.002 
Doaa Aly, MBBCH, MSc a, Sandhya Ramlogan, MD b, Rita France, RDCS, RDMS a, Stephanie Schmidt, RDCS a, Julie Hinzman, RDCS a, Ashley Sherman, MA c, Suma P. Goudar, MD d, Daniel Forsha, MD a,
a Ward Family Heart Center, Children's Mercy Hospital, Kansas City, Missouri 
b Children's Heart Center, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois 
c Division of Biostatistics, Children's Mercy Hospital, Kansas City, Missouri 
d Children's National Heart Institute, Washington, District of Columbia 

Reprint requests: Daniel Forsha, MD, Ward Family Heart Center, Division of Cardiology, Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO 64108.Ward Family Heart CenterDivision of CardiologyChildren's Mercy Hospital2401 Gillham RoadKansas CityMO64108

Abstract

Background

Right ventricular global longitudinal strain (RVGLS) has emerged as an important technique for clinical evaluation of (RV) function. The routine application of RVGLS in pediatrics remains limited by a lack of data on agreement between vendors. The aim of this study was to investigate intervendor agreement for RVGLS between the two commonly used analysis vendors in pediatrics, hypothesizing that RVGLS has good intervendor agreement, although it is likely lower than intravendor agreement (inter- and intraobserver reproducibility).

Methods

Seventy infants and children with normal cardiac anatomy and varying ventricular function were included after prospectively obtaining RV-focused four-chamber apical images on the GE Vivid E95. Images were analyzed for RVGLS at acquired frame rates in EchoPAC (GE) and TomTec (TT) and in the compressed Digital Imaging and Communications in Medicine format in TT. Intraclass correlation coefficients and Bland-Altman plots were used to test intervendor agreement and intravendor reproducibility.

Results

RVGLS measurements were equally feasible using TT and EchoPAC analysis (92%). There was good to excellent agreement for RVGLS between TT and EchoPAC analysis, with a relatively higher intraclass correlation coefficient between GE and TT at the acquired frame rate (0.85) than between GE and TT at the compressed frame rate (0.75) and significantly higher agreement in patients with abnormal RV function (0.7–0.9) than those with normal function (0.4–0.6). Intra- andinterobserver reproducibility for RVGLS was excellent (intraclass correlation coefficient = 0.74–0.96). Heart rate ≥ 100 beats/min and acquisition frame rate/heart rate ≤ 0.7 were associated with diminished agreement, especially when compressed data were involved.

Conclusions

RVGLS analyzed using EchoPAC and TT show good agreement, especially when analyzed at acquisition frame rates and in the setting of abnormal RV function. Otherwise, RVGLS should ideally be analyzed using the same vendor, and intervendor comparisons should be undertaken with caution, particularly if data are in a compressed format.

Le texte complet de cet article est disponible en PDF.

Highlights

Good to excellent RVGLS agreement between TomTec and EchoPAC in pediatrics.
Improved intervendor RVGLS agreement with diminished RV systolic function.
Worse intervendor RVGLS agreement with compressed data or acquisition FR/HR ≤ 0.7.
Excellent RVGLS intravendor reproducibility in pediatrics.

Le texte complet de cet article est disponible en PDF.

Keywords : Strain, Speckle-tracking echocardiography, Reproducibility, Pediatric, Global longitudinal, Intervendor, Right ventricle

Abbreviations : FR, GE, HR, ICC, LOA, LV, LVEF, LVGLS, ROI, RV, RVGLS, TAPSE, TT, TT30, TTacq


Plan


 Ms. Hinzman contributed to this project while working at Children's Mercy Hospital but has not contributed since becoming an employee of first Philips Healthcare and now Edwards Lifesciences.
 Drs. Aly and Ramlogan are joint primary authors.


© 2021  American Society of Echocardiography. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 34 - N° 7

P. 786-793 - juillet 2021 Retour au numéro
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