title: Quantification of left ventricular longitudinal strain by two-dimensional speckle tracking: a comparison between expert and non-expert readers.
abstract: The study aimed to examine whether global and segmental longitudinal strain (LS) using speckle tracking echocardiography could improve the interpretation of wall motion (WM) asynergy for expert and non-expert readers compared to visual assessment by 2-dimensional echocardiography (2DE). Using the 17 left ventricular segments model, both segmental and global LS were assessed by automatic function imaging in 20 patients with ischemic heart disease (61.0 ± 9.9 years, 70 % are male) and 20 normal controls (57.7 ± 16.9 years, 75 % are male). Global and segmental WM score was calculated by 2DE visual analysis using the same model. Both modalities were analyzed by two expert and two non-expert readers. Inter- and intra-observer agreement was calculated between all readers. Complete WM analysis of 680 segments was performed in 94.1 and 81 % by expert and non-expert readers respectively. Analysis of LS was completed in 96.3 and 95 % by both readers respectively. WM score by expert readers was correlated well with global LS by both expert and non-expert readers (R = 0.81, P < 0.0001, R = 0.79, P < 0.0001) while by the non-expert readers it was correlated fairly (R = 0.58, P < 0.01, R = 0.57, P < 0.01 respectively). Inter and intra-observer agreements between the expert readings were excellent in both techniques while the non-expert readings showed better agreement for LS than WM score. The mean difference between expert and non-expert readers was higher for WM score than LS (2.4 ± 2.9, -1.5 ± 1.6). Assessment of LS using 2D speckle tracking echocardiography showed better inter and intra-observer agreement than the visual analysis of WM regardless of the experience level. This may help to improved the quantification of WM asynergy by non-expert readers.
authors.affiliation: Department of Cardiology, King Fahd Armed Forces Hospital, P.O. Box: 9862, Jeddah, 21159, Saudi Arabia, ashrafanwar2000@hotmail.com.
authors.forename: Ashraf
authors.initials: A
authors.lastname: Anwar
authors.forename: Youssef
authors.initials: Y
authors.lastname: Nosir
authors.forename: Mirvat
authors.initials: M
authors.lastname: Alasnag
authors.forename: Myline A
authors.initials: MA
authors.lastname: Llemit
authors.forename: Abdelfattah A
authors.initials: AA
authors.lastname: Elhagoly
authors.forename: Hassan
authors.initials: H
authors.lastname: Chamsi-Pasha
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D018618:Echocardiography, Doppler, Color; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000503:physiopathology; D015588:Observer Variation; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D013318:Stroke Volume; D016277:Ventricular Function, Left