Single systemic right ventricle longitudinal strain: Intravendor reproducibility and intervendor agreement in children. Issue 3 (1st February 2021)

• Record Type: Journal Article
• Authors: Colquitt, John L.; Wilkinson, J. Chris; Liu, Asela M.; Pignatelli, Ricardo H.; Loar, Robert W.
• Is Part Of: Echocardiography. Volume 38:Issue 3(2021)
• Page Start: 402
• Page End: 409
• Publication Date: 2021-02-01
• Subjects: congenital heart disease -- pediatrics -- reproducibility -- single ventricle -- strain imaging; Echocardiography -- Periodicals; Echocardiography -- Periodicals; 616.1207543
• DOI: 10.1111/echo.14985
• Languages: English
• ISSNs: 0742-2822

Abstract

Abstract: Purpose: Strain derived from speckle‐tracking echocardiography is emerging as a useful tool in the assessment of single ventricle function. The purpose of this study is to compare layer‐specific longitudinal strain values in children with single, systemic right ventricles (sRV) using two commercially available software platforms (GE EchoPAC (EP) and TomTec (TT)). Methods: Two readers analyzed two‐dimensional longitudinal strain on EP (v 202) and TT (v 2.21.25) in 40 pediatric sRV patients. Intravendor reproducibility and intervendor agreement between layer‐specific measurements were assessed by intraclass correlation coefficient and Bland–Altman analysis. Absolute difference (AbΔ) and relative mean errors (RME) were calculated. Subgroup comparisons (stratified by age, heart rate (HR), and frames per second (FPS): HR ratio) were made. Results: Median age was 4.4 years. 32 (80%) patients had hypoplastic left heart syndrome; 19 (48%) were post‐Fontan. Intravendor reproducibility was excellent with high ICC (0.86‐0.97). AbΔ between readers was small (1.2%‐1.5%) with interobserver RME slightly higher for TT (11%‐12% vs 8%‐9% for EP). Layer‐specific intervendor agreement was poor (ICC 0.45‐0.62). Default layer comparisons (EP mid vs TT endo) showed good agreement (ICC 0.72‐0.77) and less variability (AbΔ 2%, RME 15%) than layer‐to‐layer. There were no differences in ICC for groups dichotomized by age, HR, or FPS:HR ratio. sRV strain values are more negative when using EP. Conclusion: Intravendor reproducibility for sRV peak longitudinal strain in children is excellent with acceptable variability between experienced users. Intervendor, layer‐specific strain agreement is poor. Vendor default layer strain values show better agreement but are not interchangeable.