Efficiency of quantitative longitudinal peak systolic strain values using automated function imaging on transthoracic echocardiogram for evaluating left ventricular wall motion: New diagnostic criteria and agreement with naked eye evaluation by experience

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• 作者：Maiko Takahashi ; Nobuhiro Harada ; Yuka Isozaki ; Kwangho Lee ; Rei Yajima ; Akihisa Kataoka ; Mariko Saito ; Akiyo Kanaeda ; Chiharu Yamaguchi ; Tomoko Kamata ; Koya Ozawa ; Akiko Tani ; Sawako Horie ; Tomoko Umazume ; Yoshio Kobayashi ; Nobusada Funabashi
• 关键词：Longitudinal peak systolic strain values ; Automated function imaging ; Transthoracic echocardiogram ; Left ventricular wall motion ; Naked eye evaluation ; Experienced cardiologist
• 刊名：International Journal of Cardiology
• 出版年：2013
• 出版时间：20 August, 2013
• 年：2013
• 卷：167
• 期：4
• 页码：1625-1631
• 全文大小：902 K

文摘

Purpose

To evaluate the efficiency of automated function imaging (AFI) on transthoracic echocardiogram (TTE) for detecting left ventricular (LV) wall motion (LVWM) abnormalities, we compared longitudinal peak systolic strain (LPSS) measurements using AFI with naked eye TTE evaluations by experienced cardiologists and non-experienced residents.

Materials and methods

A total of 352 segments of LV myocardium from 22 consecutive subjects with LVWM abnormalities based on American Heart Association classifications (11 male, mean age 58 ¡À 14 years) on previous TTE (Vivid-7, GE) were evaluated. LPSS was measured using stored AFI data. Naked eye evaluation of LVWM was performed by 2 experienced cardiologists and 2 non-experienced residents.

Results

AFI successfully tracked 342 (97 % ) of all segments (mean LPSS ? 14.8 ¡À 8.1 % ). A significant strong negative correlation was observed between LV ejection fraction using method of disks and global LPSS (R = ? 0.8974). Temporary AFI criteria of LPSS were normal <?12; hypokinesis ? 12-2; and akinesis > 2. Of 342 segments, 239, 87, and 16 segments were diagnosed as normal, hypokinesis, and akinesis, respectively. Level of agreement and kappa coefficients between qualitative evaluation of LVWM by AFI temporary criteria and qualitative evaluation of LVWM by experienced cardiologist 2 (0.784 and 0.479, respectively) were inferior to those comparing experienced cardiologists (0.845 and 0.595) but superior comparing experienced cardiologist with non-experienced resident (0.696 and 0.323), and between the 2 non-experienced-residents (0.682 and 0.347).

Conclusion

Qualitative evaluation of LVWM using temporary AFI criteria had a 97 % success rate and agreed well with findings of an experienced cardiologist. AFI can be a useful tool for training residents.