Abstract 19229: DICOM-Based Regional Strain Shows Greater Variability with Base-Apex Gradient than Global Strain in a Heterogenous Population

Abstract

Introduction: Two-dimensional Strain (2D S) is a powerful technique to evaluate myocardial deformation. We compared S from images in raw Polar (P) format with the same images in DICOM (D) in adult & pediatric patients to test agreement.

Methods: 110 patients (55/110 pediatric, 80/110 normal LV function) had echocardiograms with a General Electric (GE) Vivid 7 or E9. 4,3 & 2-chamber LV apical views yielding 330 datasets were analyzed with EchoPAC (GE, v. 10.8.1) in P &Velocity Vector Imaging (VVI, Siemens, v. 3.5) in D by 3 blinded readers. Regional differences in longitudinal Strain (LS) were tested with Bland Altman analysis.

Results: Mean Global Longitudinal S (GLS) by EchoPAC (P) was -18.1 +/- 4.4 & VVI (D) -15.3 +/- 4.1. D yielded lower absolute GS by mean of 2.8 (± SD 2.7, p < 0.0001). In regional analysis, P also consistently produced higher values than D for corresponding segments. There was greater variability in RS with a consistent base to apex gradient. RS differences between P & D data were lowest at the base (Difference 1, p <0.00001) and highest at the apex (Difference 5.5, p <0.00001), Fig. 1&2.

Conclusion: In this large and heterogenous population, there is region-specific variability in RS from DICOM images compared to source Polar data. These differences average out in global S analysis. Further standardization among Strain platforms is necessary to minimize differences.