Abstract 2919: Feasibility, Validation and Diagnostic Accuracy of Semi-Automated Regional Strain Maps: Comparison with Coronary Angiography and Magnetic Resonance
Background: Regional strain analysis by echocardiography has several potential clinical uses but is limited by the need for extensive operator input and variability. We determined the feasibility, reproducibility, validation and clinical value of a novel, automated, regional strain analysis program.
Methods and Results: We performed regional strain analysis using a novel program (AFI) in 35 subjects, 20 males, mean age 51 ± 14 years, mean ejection fraction 52 ± 11%. Strain by magnetic resonance (MR) was available in 15 and coronary angiography data were available in 20 subjects. AFI generates bulls-eye maps of regional strain with minimum operator input. Mean time to generate maps was 5 ± 2 min. Acceptable images were available in all subjects. The sensitivity and specificity of AFI for prediction of > 70% luminal coronary stenosis was 0.79 and 0.56, respectively, (using −15% strain as cutoff value), and was 0.75 and 0.65, respectively, by visual wall motion analysis. AFI maps (Figure⇓) clearly differentiated normal (A) from an infero-posterior infarct (B) and dilated cardiomyopathy(C). Intra-and inter-observer correlation for regional strain values was 0.91, p = 0.001 and 0.82, p = 0.01, respectively. Mean intra- and inter-observer difference was −1 ± 3% and 1 ± 3%, respectively. AFI strain values correlated with MR (r = 0.39, p = 0.002) with good agreement (mean AFI-MR strain difference 1 ± 5% (D).
Conclusions: AFI strain maps are highly feasible, time-efficient, and demonstrate low variability. Regional strain values correlate well with MR and have high diagnostic accuracy for significant coronary disease. AFI maps may facilitate wider clinical application of strain analysis.