Variability in the assessment of myocardial strain patterns: implications for adequate interpretation

Nicolas Duchateau; Filip Loncaric; Maja Cikes; Adelina Doltra; Marta Sitges; Bijnens, Bart

doi:http://dx.doi.org/10.1016/j.ultrasmedbio.2019.10.013

Variability in the assessment of myocardial strain patterns: implications for adequate interpretation

Citation

Duchateau N, Loncaric F, Cikes M, Doltra A, Sitges M, Bijnens B. Variability in the assessment of myocardial strain patterns: implications for adequate interpretation. Ultrasound Med Biol. 2020 Feb;46(2):244-54. DOI: 10.1016/j.ultrasmedbio.2019.10.013

Abstract

Variability in global and regional peak strain has been thoroughly studied, but variability in spatiotemporal myocardial strain patterns has not been studied as well. This study reports on such variability and its implications for adequate disease interpretation. Forty in-training operators, distributed on 20 workstations, analyzed six cases with representative deformation patterns with commercial speckle tracking. Interoperator differences were quantified through the variability in myocardial delineations, spatiotemporal longitudinal strain patterns and peak longitudinal strain. Intraoperator differences were assessed similarly using 10 repeated measurements from a single clinician expert. Delineations varied mainly along the lateral wall and at the valve level. Peak longitudinal strain variability was low to moderate. The spatiotemporal strain patterns were consistent despite high variability at the apex and near the valve. The results indicate that relevant pattern assessment is possible despite heterogeneous experience with speckle tracking and that careful interpretation of pattern abnormalities should be recommended before a more systematic quantitative analysis.