Feasibility, Reproducibility, and Clinical Implications of the Novel Fully Automated Assessment for Global Longitudinal Strain

被引:32
作者
Kawakami, Hiroshi [1 ]
Wright, Leah [1 ]
Nolan, Mark [1 ]
Potter, Elizabeth L. [1 ]
Yang, Hong [2 ]
Marwick, Thomas H. [1 ]
机构
[1] Monash Univ, Sch Publ Hlth & Preventat Med, Baker Heart & Diabet Inst, Melbourne, Vic, Australia
[2] Univ Tasmania, Menzies Inst Med Res, Hobart, Tas, Australia
基金
英国医学研究理事会;
关键词
Echocardiography; Strain imaging; Global longitudinal strain; Automated assessment; Screening; VENTRICULAR SYSTOLIC DYSFUNCTION; HEART-FAILURE; PROGNOSTIC VALUE; ECHOCARDIOGRAPHY; COMMUNITY; RECOMMENDATIONS; ASSOCIATION; MULTICENTER; POPULATION; EXPERIENCE;
D O I
10.1016/j.echo.2020.09.011
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Despite evidence of its usefulness, measurement of global longitudinal strain (GLS) has not been widely accepted as a clinical routine, because it requires proficiency and is time consuming. Automated assessment of GLS may be the solution for this situation. The aim of this study was to investigate the feasibility, reproducibility, and predictive value of automated strain analysis compared with semiautomated and manual assessment of GLS. Methods: In this validation study, different methods for the assessment of GLS were applied to echocardiograms from 561 asymptomatic subjects (mean age, 71 6 5 years) with heart failure risk factors, recruited from the community. All patients had both data on follow-up outcomes (new heart failure and cardiac death) and interpretable echocardiographic images for strain analysis. Measurement of GLS was repeated using the same apical images with three different measurement packages as follows: (1) fully automated GLS (AutoStrain), (2) semiautomated GLS (automated, corrected by a trained investigator), and (3) manual GLS (standard manual assessment by a trained investigator). Results: AutoStrain measurements were technically feasible in 99.5% of patients. Calculation times for automated (0.5 +/- 0.1 min/patient) and semiautomated assessment (2.7 +/- 0.6 min/patient) were significantly shorter than for manual assessment (4.5 +/- 1.6 min/patient; P < .001 for both). Approximately 40% of patients were thought to need manual correction after automatic calculation of GLS. Therefore, there was considerable discordance between automated and semiautomated and manual GLS. Over a median of 12 months of followup, cardiovascular events (new heart failure and cardiac death) occurred in 66 patients (11.8%). Automated GLS showed the potential to correctly detect normal and abnormal systolic function and predict cardiac events; the predictive value was inferior to that of semiautomated GLS. Conclusions: A novel fully automated assessment for GLS may provide a technically feasible, rapidly reproducible, and clinically applicable means of assessing left ventricular function, but a substantial number of automatic traces still need manual correction by experts. At the present stage, the semiautomated approach using this novel automated software seems to provide a better balance between feasibility and clinical relevance.
引用
收藏
页码:136 / U98
页数:12
相关论文
共 30 条
[1]   Use of an automatic application for wall motion classification based on longitudinal strain: is it affected by operator expertise in echocardiography? A multicentre study by the Israeli Echocardiography Research Group [J].
Blondheim, David S. ;
Friedman, Zvi ;
Lysyansky, Peter ;
Kuperstein, Rafael ;
Hay, Ilan ;
Feinberg, Micha S. ;
Beeri, Ronen ;
Vaturi, Mordehay ;
Sagie, Alik ;
Shimoni, Sarah ;
Fehske, Wolfgang ;
Deutsch, Lisa ;
Leitman, Marina ;
Gilon, Dan ;
Agmon, Yoram ;
Tsadok, Yossi ;
Rosenmann, David ;
Liel-Cohen, Noah .
EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING, 2012, 13 (03) :257-262
[2]   A novel two-dimensional echocardinarraphic image analysis system using artificial intelligence-learned pattern recognition for rapid automated ejection fraction [J].
Cannesson, Maxime ;
Tanabe, Masaki ;
Suffoletto, Matthew S. ;
McNamara, Dennis M. ;
Madan, Shobhit ;
Lacomis, Joan M. ;
Gorcsan, John, III .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2007, 49 (02) :217-226
[3]   The Development of Heart Failure in Patients With Diabetes Mellitus and Pre-Clinical Diastolic Dysfunction A Population-Based Study [J].
From, Aaron M. ;
Scott, Christopher G. ;
Chen, Horng H. .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2010, 55 (04) :300-305
[4]   New noninvasive method for assessment of left ventricular rotation - Speckle tracking echocardiography [J].
Helle-Valle, T ;
Crosby, J ;
Edvardsen, T ;
Lyseggen, E ;
Amundsen, BH ;
Smith, HJ ;
Rosen, BD ;
Lima, JAC ;
Torp, H ;
Ihlen, H ;
Smiseth, OA .
CIRCULATION, 2005, 112 (20) :3149-3156
[5]   THE EPIDEMIOLOGY OF HEART-FAILURE - THE FRAMINGHAM-STUDY [J].
HO, KKL ;
PINSKY, JL ;
KANNEL, WB ;
LEVY, D .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1993, 22 (04) :A6-A13
[6]   Prognostic implications of global LV dysfunction: a systematic review and meta-analysis of global longitudinal strain and ejection fraction [J].
Kalam, Kashif ;
Otahal, Petr ;
Marwick, Thomas H. .
HEART, 2014, 100 (21) :1673-1680
[7]   Left Atrial Mechanical Dispersion Assessed by Strain Echocardiography as an Independent Predictor of New-Onset Atrial Fibrillation: A Case-Control Study [J].
Kawakami, Hiroshi ;
Ramkumar, Satish ;
Nolan, Mark ;
Wright, Leah ;
Yang, Hong ;
Negishi, Kazuaki ;
Marwick, Thomas H. .
JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY, 2019, 32 (10) :1268-+
[8]   Fully Automated Versus Standard Tracking of Left Ventricular Ejection Fraction and Longitudinal Strain The FAST-EFs Multicenter Study [J].
Knackstedt, Christian ;
Bekkers, Sebastiaan C. A. M. ;
Schummers, Georg ;
Schreckenberg, Marcus ;
Muraru, Denisa ;
Badano, Luigi P. ;
Franke, Andreas ;
Bavishi, Chirag ;
Omar, Alaa Mabrouk Salem ;
Sengupta, Partho P. .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2015, 66 (13) :1456-1466
[9]   Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging [J].
Lang, Roberto M. ;
Badano, Luigi P. ;
Mor-Avi, Victor ;
Afilalo, Jonathan ;
Armstrong, Anderson ;
Ernande, Laura ;
Flachskampf, Frank A. ;
Foster, Elyse ;
Goldstein, Steven A. ;
Kuznetsova, Tatiana ;
Lancellotti, Patrizio ;
Muraru, Denisa ;
Picard, Michael H. ;
Rietzschel, Ernst R. ;
Rudski, Lawrence ;
Spencer, Kirk T. ;
Tsang, Wendy ;
Voigt, Jens-Uwe .
JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY, 2015, 28 (01) :1-U170
[10]   Role of strain values using automated function imaging on transthoracic echocardiography for the assessment of acute chest pain in emergency department [J].
Lee, Mirae ;
Chang, Sung-A ;
Cho, Eun Jeong ;
Park, Sung-Ji ;
Choi, Jin-Oh ;
Lee, Sang-Chol ;
Oh, Jae K. ;
Park, Seung Woo .
INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING, 2015, 31 (03) :547-556