Reproducibility of speckle-tracking-based strain measures of left ventricular function in a community-based study

Abstract

Background: The reproducibility of echocardiographic measurements of myocardial strain, performed in a community-based setting, has not been reported previously.

Methods: The reproducibility of left ventricular strain measurements was examined in two samples of 20 participants each from the Offspring Cohort of the Framingham Heart Study (mean age, 63 ± 9 years; 59% women). Two-dimensional speckle-tracking-based measurements of global peak left ventricular strain in systole were performed in the apical four-chamber, apical two-chamber, and midventricular parasternal short-axis views.

Results: Interobserver intraclass correlation coefficients were ≥0.84 for all global strain measurements, with average coefficients of variation of ≤4% for global longitudinal and circumferential strain and <8% for global transverse and radial strain. For left ventricular strain measurements performed in each of the three views, intraobserver intraclass correlation coefficients were ≥0.91 among time points spanning a total 8-month period. The average coefficients of variation were <6% for global longitudinal and circumferential strain and <9% for global transverse and radial strain. Interobserver and intraobserver reproducibility findings were similar in analyses adjusting for frame rate.

Conclusions: Excellent reproducibility of global longitudinal and circumferential strain measurements and very good reproducibility of global transverse and radial strain measurements were observed. Taken together, these findings demonstrate the reproducibility of performing echocardiographic strain measurements in a large, epidemiologic community-based setting.

Keywords: A2C; A4C; Apical four-chamber; Apical two-chamber; Epidemiology; ICC; Intraclass correlation coefficient; LV; Left ventricular; Myocardial deformation; SAX; Short-axis; Speckle-tracking; Strain.