Two-dimensional strain is more precise than conventional measures of left ventricular systolic function in pediatric patients
Version 2 2024-09-18, 23:28Version 2 2024-09-18, 23:28
Version 1 2023-05-20, 09:19Version 1 2023-05-20, 09:19
journal contribution
posted on 2024-09-18, 23:28authored byMD Patel, C Myers, K Negishi, GK Singh, S Anwar
Ejection fraction (EF) and fractional shortening (FS) are standard methods of quantifying left ventricular (LV) systolic function. 2D global longitudinal strain (2D GLS) is a well-established, but underutilized method for LV function quantification. The aim of this study was to assess precision of GLS compared to EF & FS in pediatrics. Echocardiograms were prospectively analyzed by 2 blinded observers. FS, EF, and GLS were calculated following standard methods. Bland-Altman was applied to assess agreement. Intraclass correlation coefficient (ICC) was used to measure reliability. Coefficient of variation was used to demonstrate relative variability between methods. 103 pediatric echos were evaluated for inter-observer reproducibility, and 15 patients for intra-observer reproducibility. GLS had higher inter-observer agreement and reliability (bias 7%, 95% LOA - 3.4 to + 3.5, ICC 0.86 CI 0.80-0.90) compared to EF (bias 27%, 95% LOA - 18.9 to + 19.5; ICC 0.25 CI 0.07-0.43) and FS (bias 12%, 95% LOA - 11.9 to + 12.2; ICC 0.53 CI 0.38-0.66). GLS also had higher intra-observer agreement (bias 4%, 95% LOA - 3.6 to + 3.7; ICC 0.87 CI 0.66-0.96) compared to EF (bias 11%, 95% LOA - 14.9 to + 15.1; ICC 0.26 CI - 0.28-0.67) and FS (bias 12%, 95% LOA - 12.2 to + 12.5; ICC 0.38 CI - 0.15-0.74). GLS is a more precise method for quantifying LV function in pediatrics, with lower variability compared to EF and FS. GLS provides a more reliable evaluation of LV systolic function and should be utilized more widely in pediatrics.
History
Publication title
Pediatric Cardiology
Volume
41
Issue
1
Pagination
186-193
ISSN
0172-0643
Department/School
Menzies Institute for Medical Research
Publisher
Springer-Verlag
Publication status
Published
Place of publication
175 Fifth Ave, New York, USA, Ny, 10010
Rights statement
Copyright 2019 Springer Science+Business Media, LLC, part of Springer Nature