Abstract 10596: Reproducibility and Inter-vendor Variability of Left Ventricular Strains Determined by 3D-speckle Tracking Systems

Abstract

Background: Inter-vendor discordance of left ventricular (LV) strains assessed by two-dimensional speckle tracking is well known. However, inter-vendordiscordance and the inter-observer/intra-observer variability in LV strains determined by three-dimensional speckle tracking (3DS) remains unclear.

Objective: We aimed to compare the inter-observer, intra-observer and inter-vendor, variabilities of 3D LV strains between two commercial 3DS systems.

Methods: Echocardiographic examinations with 3DS were performed in 41 healthy subjects (age 31+/-12 years, 63% men) using a Vivid E9 system (V1) with 4V probe (GE Health Care) and also Artida (V2) with PST-25SX probe (Toshiba Medical Systems) on the same day. Peak global longitudinal, circumferential, radial and area strains were measured by vendor-specific softwares, 4D strain EchoPac BT11 (for V1) and 3D WMT (for V2), respectively. Reproducibility was assessed by Bland-Altman analysis and an intraclass correlation coefficient (ICC).

Results: Twenty-seven subjects (66%) and 34 subjects (83%, p=NS) showed adequate waveforms for measurements of 3D LV strains by V1 and by V2, respectively. The mean time required for 3DS analysis was 5.5+/-1.1 min for V1, which was 16% less than that for V2 (6.5+/-1.6 min, p<0.01). Reproducibilities of all LV strains, except for intra- and inter-observer variabilities of radial strain (ICC for V1 0.82 and 0.82 and ICC for V2 0.44 and 0.40, respectively), were comparable between V1 (ICC 0.50 to 0.82) and V2 (ICC 0.51 to 0.76). LV strains in all directions and area strain were significantly different and poorly correlated between V1 and V2 (Table).

Conclusion: Global longitudinal, circumferential and area LV strains are reproducible in both Vivid E9 and Artida. However, values of 3D LV strains are highly vendor-dependent and the venders are not interchangeable in a longitudinal follow-up study of LV function.