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Updated: Jun 19, 2026
Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
Reproducibility of myocardial velocity and deformation imaging in term and preterm infants
Suchita Joshi1, Julie M Edwards, Dirk G Wilson
1Department of Child Health, Cardiff University, Cardiff, UK.
Insights
Myocardial velocity imaging shows adequate intra-observer reproducibility for neonatal clinical research but sub-optimal inter-observer reproducibility. Myocardial acceleration was poorly reproducible in infants.
Area of Science:
- Pediatric Cardiology
- Neonatal Physiology
- Echocardiography
Background:
- Myocardial velocity imaging is established for adult ventricular function assessment.
- Its utility in neonates for assessing ventricular function and pulmonary arterial pressure requires investigation.
Purpose of the Study:
- To evaluate the reproducibility of myocardial velocities and deformation indices in term and preterm neonates.
- To determine if myocardial velocity imaging is suitable for infant cardiac research.
Main Methods:
- Analysis of myocardial velocity loops from 16 infants.
- Assessment of intra-observer variability by re-analysis after 6 months.
- Assessment of inter-observer variability by analysis from four independent observers.
Main Results:
- Adequate intra-observer reproducibility (CVs 10-17%) for myocardial velocities and annular displacements.
- Sub-optimal inter-observer reproducibility (CVs 14-43%) for most myocardial deformation indices.
- Poor reproducibility (CVs >40%) for isovolumic acceleration, contrasting with blood pool indices (CVs 3-15%).
Conclusions:
- Myocardial velocity and deformation indices demonstrate adequate intra-observer reproducibility for neonatal clinical research.
- Inter-observer reproducibility is suboptimal, necessitating caution in clinical practice.
- Myocardial acceleration is not reliably reproducible in neonates.
Aims:
Myocardial velocity imaging has been validated in adults for assessment of ventricular function and indirect indices of pulmonary arterial pressure. To establish whether it could also be used in infants, we investigated the reproducibility of myocardial velocities and deformation indices in term and preterm neonates.
Methods And Results:
Myocardial velocity loops acquired from 16 infants were analysed by four observers for inter-observer variability, and re-analysed after 6 months by one observer for intra-observer variability. For myocardial velocities, the coefficients of variation (CVs) for the left ventricle (LV) were 10-11 (intra-observer) and 14-20% (inter-observer) and for the right ventricle (RV) 15-19 and 18-24%, respectively. Reproducibility for annular displacements was <13% (intra-observer) and <18% (inter-observer). CVs for LV strain were 14-17 (intra-observer) and 36-43% (inter-observer) and for RV 19-24 and 25-37%. CVs for isovolumic acceleration were in general >40%. In comparison, the CVs for blood pool indices were 3-15%.
Conclusion:
Intra-observer reproducibility for myocardial velocity and deformation indices in neonates is adequate for these parameters to be used in clinical research. Inter-observer reproducibility is sub-optimal suggesting that these measurements should be used in clinical practice with caution. Myocardial acceleration, a marker of contractile function, was poorly reproducible.
