title: Reproducibility of echocardiographic assessment of 2D-derived longitudinal strain parameters in a population-based study (the STANISLAS Cohort study).
abstract: Global peak systolic longitudinal strain (PLS) derived from speckle tracking echocardiography (STE) is a widely used left ventricular deformation parameter. Modern ultrasound systems with improved temporal resolution and new software now allow automated multilayer analysis; however, there is limited evidence regarding its reproducibility. We performed intra- and inter-observer analyses within a population-based cohort study using conventional quantitative strain analysis (GE Healthcare). Fifty patients (49 ± 14 years) were randomly selected among the fourth visit of the STANISLAS Cohort. Multilayer PLS (transmural, subendocardial, and subepicardial), and strain rate (peak systolic, early and late diastolic) were evaluated. Peak systolic shortening (PSS) and early positive systolic strain (EPS) were calculated, as well as post-systolic index (PSI) and pre-stretch index (PST), two additional strain-derived parameters. Intra-observer intraclass correlation coefficients (ICC) were >0.75 for all analyzed parameters. The mean relative intra-observer differences were <5% for all considered parameters, and their 1.96 SDs were <15% for multilayer PLS, strain rate and PSS, but not for EPS, PSI and PST. Inter-observer ICCs were >0.70 (the majority being >0.80). The mean relative inter-observer differences were <7.5% for all considered parameters, with 1.96 SDs of relative differences being <21% for multilayer PLS, strain rate and PSS, but not for EPS, PSI and PST. In this population-based study, in subjects without or with a limited number of cardiovascular risk factors and no previous cardiovascular events, deformation parameters were found to be highly reproducible, except for EPS, PSI and PST, which showed moderately higher variability. Quantitative strain analysis appears to be an effective clinical and research tool, providing insights regarding longitudinal deformation using a simple three-step post-processing procedure.
authors.affiliation: INSERM CHU de Nancy, Institut Lorrain du cœur et des vaisseaux, 4 Rue du Morvan, 54500, Vandoeuvre lès Nancy, France.|Division of Cardiology, Ospedale S. Maria della Misericordia, University of Perugia, Perugia, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Coiro
authors.affiliation: INSERM CHU de Nancy, Institut Lorrain du cœur et des vaisseaux, 4 Rue du Morvan, 54500, Vandoeuvre lès Nancy, France.|Service de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux, Centre Hospitalier Universitaire de Nancy, Vandoeuvre lès Nancy, Francia.
authors.forename: Olivier
authors.initials: O
authors.lastname: Huttin
authors.affiliation: INSERM CHU de Nancy, Institut Lorrain du cœur et des vaisseaux, 4 Rue du Morvan, 54500, Vandoeuvre lès Nancy, France.
authors.forename: Erwan
authors.initials: E
authors.lastname: Bozec
authors.affiliation: Service de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux, Centre Hospitalier Universitaire de Nancy, Vandoeuvre lès Nancy, Francia.
authors.forename: Christine
authors.initials: C
authors.lastname: Selton-Suty
authors.affiliation: INSERM CHU de Nancy, Institut Lorrain du cœur et des vaisseaux, 4 Rue du Morvan, 54500, Vandoeuvre lès Nancy, France.
authors.forename: Zohra
authors.initials: Z
authors.lastname: Lamiral
authors.affiliation: Division of Cardiology, Ospedale S. Maria della Misericordia, University of Perugia, Perugia, Italy.
authors.forename: Erberto
authors.initials: E
authors.lastname: Carluccio
authors.affiliation: Department of Cardiology, Nouvel Civil Hospital, University Hospital of Strasbourg, Strasbourg, France.
authors.forename: Annie
authors.initials: A
authors.lastname: Trinh
authors.affiliation: Wales Heart Research Institute, Cardiff University, Cardiff, UK.
authors.forename: Alan G
authors.initials: AG
authors.lastname: Fraser
authors.affiliation: Division of Cardiology, Ospedale S. Maria della Misericordia, University of Perugia, Perugia, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ambrosio
authors.affiliation: INSERM CHU de Nancy, Institut Lorrain du cœur et des vaisseaux, 4 Rue du Morvan, 54500, Vandoeuvre lès Nancy, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Rossignol
authors.affiliation: INSERM CHU de Nancy, Institut Lorrain du cœur et des vaisseaux, 4 Rue du Morvan, 54500, Vandoeuvre lès Nancy, France.
authors.forename: Faiez
authors.initials: F
authors.lastname: Zannad
authors.affiliation: INSERM CHU de Nancy, Institut Lorrain du cœur et des vaisseaux, 4 Rue du Morvan, 54500, Vandoeuvre lès Nancy, France. nicolas_girerd@yahoo.com.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Girerd
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena; D004452:Echocardiography / Q000379:methods*; D005260:Female; D005602:France; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D015588:Observer Variation; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D013314:Stress, Mechanical; D016277:Ventricular Function, Left
keywords: Deformation; Longitudinal strain; Multilayer analysis; Reproducibility; Speckle tracking echocardiography