TY - JOUR
T1 - Feasibility and reproducibility of systolic right ventricular strain measurement by speckle-tracking echocardiography in premature infants
AU - Levy, Philip Thaler
AU - Holland, Mark R.
AU - Sekarski, Timothy J.
AU - Hamvas, Aaron
AU - Singh, Gautam K.
N1 - Funding Information:
This study was supported by grants from the Premature and Respiratory Outcomes Program ( NIH 1U01 HL1014650 ), NIH R21 HL106417 , a Pediatric Physician Scientist Training Grant ( NIH 5 T32 HD043010-09 ), and the Postdoctoral Mentored Training Program in Clinical Investigation ( NIH UL1 TR000448 ).
PY - 2013/10
Y1 - 2013/10
N2 - Background Right ventricular (RV) systolic function is an important prognostic determinant of cardiopulmonary pathologies in premature infants. Measurements of dominant RV longitudinal deformation are likely to provide a sensitive measure of RV function. An approach for image acquisition and postacquisition processing is needed for reliable and reproducible measurements of myocardial deformation by two-dimensional (2D) speckle-tracking echocardiography. The aims of this study were to determine the feasibility and reproducibility of 2D speckle-tracking echocardiographic measurement of RV peak global longitudinal strain (pGLS) and peak global longitudinal strain rate in premature infants and to establish methods for acquiring and analyzing strain. Methods The study was designed in two phases: (1) a training phase to develop methods of image acquisition and postprocessing in a cohort of 30 premature infants (born at 28 ± 1 weeks) and (2) a study phase to prospectively test in a separate cohort of 50 premature infants (born at 2& ± 1 weeks) if the methods improved the feasibility and reproducibility of RV pGLS and peak global longitudinal strain rate measurements to a clinically significant level, assessed using Bland-Altman analysis (bias, limits of agreement, coefficient of variation, and intraclass correlation coefficient). Results Strain imaging was feasible from 84% of the acquisitions using the methods developed for optimal speckle brightness and frame rate for RV-focused image acquisition. There was high intraobserver (bias, 3%; 95% limits of agreement, -1.6 to +1.6; coefficient of variation, 2.7%; intraclass correlation coefficient, 0.97; P =.02) and interobserver (bias, 7%; 95% limits of agreement, -4.8 to +4.73; coefficient of variation, 3.9%; intraclass correlation coefficient, 0.93; P <.05) reproducibility, with excellent linear correlation between the two pGLS measurements (r = 0.9& [P <.01] and r = 0.93 [P <.05], respectively). Conclusions This study demonstrates high clinical feasibility and reproducibility of RV pGLS and RV peak global longitudinal strain rate measurements by 2D speckle-tracking echocardiography in premature infants and offers methods for image acquisition and data analysis for systolic strain imaging that can provide a reliable assessment of global RV function.
AB - Background Right ventricular (RV) systolic function is an important prognostic determinant of cardiopulmonary pathologies in premature infants. Measurements of dominant RV longitudinal deformation are likely to provide a sensitive measure of RV function. An approach for image acquisition and postacquisition processing is needed for reliable and reproducible measurements of myocardial deformation by two-dimensional (2D) speckle-tracking echocardiography. The aims of this study were to determine the feasibility and reproducibility of 2D speckle-tracking echocardiographic measurement of RV peak global longitudinal strain (pGLS) and peak global longitudinal strain rate in premature infants and to establish methods for acquiring and analyzing strain. Methods The study was designed in two phases: (1) a training phase to develop methods of image acquisition and postprocessing in a cohort of 30 premature infants (born at 28 ± 1 weeks) and (2) a study phase to prospectively test in a separate cohort of 50 premature infants (born at 2& ± 1 weeks) if the methods improved the feasibility and reproducibility of RV pGLS and peak global longitudinal strain rate measurements to a clinically significant level, assessed using Bland-Altman analysis (bias, limits of agreement, coefficient of variation, and intraclass correlation coefficient). Results Strain imaging was feasible from 84% of the acquisitions using the methods developed for optimal speckle brightness and frame rate for RV-focused image acquisition. There was high intraobserver (bias, 3%; 95% limits of agreement, -1.6 to +1.6; coefficient of variation, 2.7%; intraclass correlation coefficient, 0.97; P =.02) and interobserver (bias, 7%; 95% limits of agreement, -4.8 to +4.73; coefficient of variation, 3.9%; intraclass correlation coefficient, 0.93; P <.05) reproducibility, with excellent linear correlation between the two pGLS measurements (r = 0.9& [P <.01] and r = 0.93 [P <.05], respectively). Conclusions This study demonstrates high clinical feasibility and reproducibility of RV pGLS and RV peak global longitudinal strain rate measurements by 2D speckle-tracking echocardiography in premature infants and offers methods for image acquisition and data analysis for systolic strain imaging that can provide a reliable assessment of global RV function.
KW - Global longitudinal strain
KW - Premature infants
KW - Right ventricle
KW - Speckle-tracking echocardiography
KW - Systolic function
UR - http://www.scopus.com/inward/record.url?scp=84884533034&partnerID=8YFLogxK
U2 - 10.1016/j.echo.2013.06.005
DO - 10.1016/j.echo.2013.06.005
M3 - Article
C2 - 23880052
AN - SCOPUS:84884533034
SN - 0894-7317
VL - 26
SP - 1201
EP - 1213
JO - Journal of the American Society of Echocardiography
JF - Journal of the American Society of Echocardiography
IS - 10
ER -