The nice thing about standards…is that you have so many to choose from.
The development of any new technology inevitably involves a different perspective from different engineers and inventors. In the case of strain, all mainstream ultrasound equipment manufacturers as well as makers of independent measurement and reporting software have developed software for the measurement of myocardial deformation from speckle-tracking. Unfortunately, subtle differences in these iterations of software, both between and within manufacturers, have led to variability in measurements between studies that are the result of differences in the technical implementation of speckle-tracking analysis rather than reflecting changes in physiology ( Table 1 ). The implication is that comparative studies of patients across time require the use of the same equipment and possibly the same version of software. Clearly, in most laboratories, this is close to being unmanageable. The introduction of global longitudinal strain (GLS) measurement to diagnostic and management guidelines for cardiotoxicity has increased the urgency of finding a solution, because a 10% to 15% change in strain is used as a criterion for subclinical left ventricular (LV) impairment to predict a subsequent fall in ejection fraction (EF) and guide the institution of cardioprotective therapy.
| Study | Year | n , clinical setting | Acquisition | Analysis | Reference | Mean difference (95% CI) between different methods for measuring GLS | |
|---|---|---|---|---|---|---|---|
| Observed at time of original publication | Expected differences based on present study | ||||||
| Bansal et al . | 2008 | 30 IHD | GE Vivid 7 | EchoPAC vs VVI | CMR strain | 0.80 (−10.6 to 12.2) | 1.0 (−3.1 to 5.2) |
| Manovel et al . | 2010 | 28 normal | GE Vivid 7 Toshiba Artida 4D | EchoPAC vs WM tracking | None | 0.7 (−2.3 to 3.7) | 2.4 (−1.7 to 6.5) |
| Koopman et al . | 2011 | 34 normal and abnormal (children) | GE Vivid 7 Philips iE33 | EchoPAC vs TomTec | None | 1.2 (−5 to 7) | −0.7 (−4.0 to 2.7) |
| Koopman et al . | 2011 | 34 normal and abnormal (children) | GE Vivid 7 Philips iE33 | QLAB vs TomTec | None | −0.3 (−8 to 7) | −2.7 (−7.0 to 0.6) |
| Biaggi et al . | 2011 | 47 normal | GE Vivid 7 | EchoPAC vs VVI | None | 1.0 (−6.2 to 8.2) | 1.0 (−3.1 to 5.2) |
| Risum et al . | 2012 | 30 normal and abnormal (adults) | GE Vivid e9 Philips iE33 | EchoPC vs TomTec | None | 0 (−3.6 to 3.6) | −0.7 (−4.0 to 2.7) |
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
