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Two-dimensional strain is more precise than conventional measures of left ventricular systolic function in pediatric patients

Version 2 2024-09-18, 23:28
Version 1 2023-05-20, 09:19
journal contribution
posted on 2024-09-18, 23:28 authored by MD 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

Socio-economic Objectives

200199 Clinical health not elsewhere classified