Abstract 1882: Use of Speckle Tracking to Quantify Global LV Function: A Comparison with 2D and 3D Echo and Magnetic Resonance Imaging
Background: Ejection fraction (EF) plays a prominent role in clinical decision making but this calculation is time-consuming and dependent on load and geometry. A simple and quick technique for assessing global LV function would be useful. We sought to evaluate the robustness of global longitudinal strain (GLS) for assessment of LV function in comparison to Simpsons biplane ejection-fraction (2D-EF), 3D ejection fraction (3D-EF) and MRI ejection fraction (MRI-EF). We further investigated the automated measures of EF (auto-EF) from wall tracking.
Methods: 2D and 3D echo and MRI measurement of EF were performed in 53 pts with previous infarction. GLS was measured by offline speckle-tracking in the apical 4C and 2C views. Abnormal curves were excluded on the basis of visual assessment. Auto-EF was calculated using the method of discs, using the traced endocardial border to establish end-diastolic and end-systolic volumes.
Results: Average global TQ (tracking quality) was 1.14±0.22, permitting reliable derivation of strain from all segments. GLS showed a significant linear correlation with MRI-EF, similar to that between 3D-EF and MRI and better than that between 2D-EF and MRI and automated EF and MRI (Table⇓). Of 26 pts with a normal MRI-EF (≥50%), 85% had GLS within normal limits and 81% had normal 3D-EF, but significantly fewer were recognized as normal by 2D-EF (Table⇓). In pts with ≤5 abnormal segments, 3D-EF was the most accurate modality for assessing global LV function, while GLS was better than 2D-EF and auto-EF. In pts with >5 abnormal segments, GLS was the most accurate modality of quantifying global LV function against MRI-EF (r = −0.83, p <0.0001), comparatively better than 3D-EF against MRI-EF (r = 0.75, p <0.0001).
Conclusion: GLS is an effective method of quantifying global LV function. In pts with >5 abnormal segments, GLS offered the best correlation with MRI-EF, reflecting the benefit of a geometry independent and site-specific parameter.