title: Efficiency of quantitative longitudinal peak systolic strain values using automated function imaging on transthoracic echocardiogram for evaluating left ventricular wall motion: new diagnostic criteria and agreement with naked eye evaluation by experienced cardiologist.
abstract: OBJECTIVE
  To evaluate the efficiency of automated function imaging (AFI) on transthoracic echocardiogram (TTE) for detecting left ventricular (LV) wall motion (LVWM) abnormalities, we compared longitudinal peak systolic strain (LPSS) measurements using AFI with naked eye TTE evaluations by experienced cardiologists and non-experienced residents.
  
  
  METHODS
  A total of 352 segments of LV myocardium from 22 consecutive subjects with LVWM abnormalities based on American Heart Association classifications (11 male, mean age 58 ± 14 years) on previous TTE (Vivid-7, GE) were evaluated. LPSS was measured using stored AFI data. Naked eye evaluation of LVWM was performed by 2 experienced cardiologists and 2 non-experienced residents.
  
  
  RESULTS
  AFI successfully tracked 342 (97%) of all segments (mean LPSS -14.8 ± 8.1%). A significant strong negative correlation was observed between LV ejection fraction using method of disks and global LPSS (R=-0.8974). Temporary AFI criteria of LPSS were normal <-12; hypokinesis -12-2; and akinesis >2. Of 342 segments, 239, 87, and 16 segments were diagnosed as normal, hypokinesis, and akinesis, respectively. Level of agreement and kappa coefficients between qualitative evaluation of LVWM by AFI temporary criteria and qualitative evaluation of LVWM by experienced cardiologist 2 (0.784 and 0.479, respectively) were inferior to those comparing experienced cardiologists (0.845 and 0.595) but superior comparing experienced cardiologist with non-experienced resident (0.696 and 0.323), and between the 2 non-experienced-residents (0.682 and 0.347).
  
  
  CONCLUSIONS
  Qualitative evaluation of LVWM using temporary AFI criteria had a 97% success rate and agreed well with findings of an experienced cardiologist. AFI can be a useful tool for training residents.
authors.affiliation: Department of Cardiovascular Science and Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan.
authors.forename: Maiko
authors.initials: M
authors.lastname: Takahashi
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Harada
authors.forename: Yuka
authors.initials: Y
authors.lastname: Isozaki
authors.forename: Kwangho
authors.initials: K
authors.lastname: Lee
authors.forename: Rei
authors.initials: R
authors.lastname: Yajima
authors.forename: Akihisa
authors.initials: A
authors.lastname: Kataoka
authors.forename: Mariko
authors.initials: M
authors.lastname: Saito
authors.forename: Akiyo
authors.initials: A
authors.lastname: Kanaeda
authors.forename: Chiharu
authors.initials: C
authors.lastname: Yamaguchi
authors.forename: Tomoko
authors.initials: T
authors.lastname: Kamata
authors.forename: Koya
authors.initials: K
authors.lastname: Ozawa
authors.forename: Akiko
authors.initials: A
authors.lastname: Tani
authors.forename: Sawako
authors.initials: S
authors.lastname: Horie
authors.forename: Tomoko
authors.initials: T
authors.lastname: Umazume
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Nobusada
authors.initials: N
authors.lastname: Funabashi
mesh_terms: D000328:Adult; D000368:Aged; D002309:Cardiology / Q000379:methods / Q000592:standards*; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002983:Clinical Competence / Q000592:standards*; D004452:Echocardiography / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000592:standards*; D013599:Systole / Q000502:physiology*; D016277:Ventricular Function, Left / Q000502:physiology*