4 Inter-modality agreement and test-retest reproducibility of CMR and Echocardiography for assessing myocardial deformation in type 2 diabetes mellitus. (1st November 2021)

• Record Type: Journal Article
• Authors: Alfuhied, Aseel; Gulsin, Gaurav S; Brady, Emer M; Yeo, Jian L; Parke, Kelly; Marsh, Anna-Marie; Arnold, Jayanth Ranjit; McCann, Gerry P; Singh, Anvesha
• Is Part Of: Heart. Volume 107(2021)Supplement 3
• Page Start: A2
• Page End: A3
• Publication Date: 2021-11-01
• Subjects: Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/heartjnl-2021-BSCMR.4
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Background: Inter-modality agreement allows interchangeable use of imaging modalities that is crucial for clinical decision-making, while the reproducibility of a technique is fundamental for monitoring disease progression or response to treatment. We aimed to investigate the test-retest reproducibility and inter-modality agreement of transthoracic echocardiography (TTE) and cardiac magnetic resonance (CMR) imaging in assessing left ventricular (LV) and left atrial (LA) myocardial deformation in people with type 2 diabetes mellitus (T2D). Methods: Participants with T2D and no cardiovascular disease underwent TTE and CMR on the same day and again 11± 4 days later. Images were analysed using TomTec-ARENA (v2.4, 2D-CPA) for TTE, where Medis Suite (v3.1, medical imaging system) was used for CMR images. LV global longitudinal strain (GLS) was calculated using an average of 2-, 3- and 4-chamber values and LV mid-circumferential strain (LV_MCS) was calculated from the mid short-axis cine at papillary muscles level. In addition, LA strain (LAS), corresponding to LA reservoir, conduit, and booster pump (contraction function), was calculated using the average of 4- and 2-chamber values. The exact same analysis technique was used for both imaging modalities, and blinded analysis was performed by the same observer. Results: 10 participants with T2D (mean age 65.6±7.3 years, 50% male) were studied. The LV_MCS and reservoir LAS were significantly lower on CMR compared to TTE, though there was no difference in GLS, with narrow limits of agreement between CMR and TTE values. Of all strain parameters, GLS had the best test-retest reproducibility, with almost identical bias and limits of agreement on Bland-Altman analysis and similar CoV (~15%). The test-retest reproducibility for LV_MCS and reservoir LAS were better on CMR than TTE ( table 1 & figure 1 ). TTE was more reproducible for conduit LAS (CoV 18.5%, ICC =0.80). Conclusion: Both CMR and TTE gave similar values for GLS, with good inter-modality agreement and equally good test-retest reproducibility, suggesting the potential use of both modalities for monitoring GLS in disease and in response to treatment. The test-retest reproducibility of LV_MCS and reservoir LAS was better on CMR, whilst TTE was better for assessing conduit LAS.