Reproducibility of 4D cardiac computed tomography feature tracking myocardial strain and comparison against speckle-tracking echocardiography in patients with severe aortic stenosis.

Abstract

BACKGROUND:

Myocardial strain is an established parameter for the assessment of cardiac function and routinely derived from speckle tracking echocardiography (STE). Novel post-processing tools allow deformation imaging also by 4D cardiac computed tomography angiography (CCT). This retrospective study aims to analyze the reproducibility of CCT strain and compare it to that of STE.

METHODS:

Left (LV) and right ventricular (RV), and left atrial (LA) ejection fraction (EF), dimensions, global longitudinal (GLS), circumferential (GCS) and radial strain (GRS) were determined by STE and CCT feature tracking in consecutive patients with severe aortic stenosis evaluated for transcatheter aortic valve implantation.

RESULTS:

106 patients (mean age 79.9 ​± ​7.8, 44.3% females) underwent CCT at a median of 3 days (IQR 0-28 days) after STE. In CCT, strain measures showed good to excellent reproducibility (intra- and inter-reader intraclass correlation coefficient ≥0.75) consistently in the LV, RV and LA. In STE, only LV GLS and LA GLS yielded good reproducibility, whereas LV GCS and LV GRS showed moderate, and RV GLS and free wall longitudinal strain (FWLS) poor reproducibility. Agreement between CCT and STE was strong for LV GLS only, while other strain features displayed moderate (LV GCS, LA GLS) or weak (LV GRS, RV GLS and FWLS) inter-modality correlation.

CONCLUSION:

LV, RV and LA CCT strain assessments were highly reproducible. While a strong agreement to STE was found for LV GLS, inter-modality correlation was moderate or weak for LV GCS, LV GRS, and RV and LA longitudinal strain, possibly related to poor reproducibility of STE measurements.

• Authors: Benedikt Bernhard, Hanna Grogg, Jan Zurkirchen, Caglayan Demirel, Daniel Hagemeyer, Taishi Okuno, Nicolas Brugger, Stefano De Marchi, Adrian T Huber, Martina Boscolo Berto, Giancarlo Spano, Stefan Stortecky, Stephan Windecker, Thomas Pilgrim, Christoph Gräni
• Journal: Journal of cardiovascular computed tomography (J Cardiovasc Comput Tomogr) 2022 Jul-Aug Vol. 16 Issue 4 Pg. 309-318 ISSN: 1876-861X [Electronic] United States
• PMID: 35148996 (Publication Type: Journal Article)
• Copyright: Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.

Topics

• Aortic Valve Stenosis (diagnostic imaging, surgery)
• Computed Tomography Angiography
• Echocardiography (methods)
• Female
• Humans
• Male
• Predictive Value of Tests
• Reproducibility of Results
• Retrospective Studies
• Ventricular Function, Left