Left atrial strain reproducibility using vendor-dependent and vendor-independent software

Area of Science:

• Cardiology
• Medical Imaging
• Echocardiography

Background:

• Two-dimensional speckle-tracking echocardiography (2D-STE) assesses left atrial (LA) deformation via myocardial strain analysis.
• Multiple speckle-tracking software packages exist for strain measurement, including vendor-specific and vendor-independent options.

Purpose of the Study:

• To compare the consistency of three commercially available software packages for measuring LA strain.
• Evaluate vendor-specific software for left ventricle strain (VSS_LV) and vendor-independent software for LV strain (VIS_LV) and LA strain (VIS_LA).

Main Methods:

• Sixty-four subjects underwent echocardiograms using a GE Vivid 9 system.
• Standard apical views of the left atrium were acquired at frame rates of 40-71 frames/s.
• LA strain (Sct, Scd, Sr) was analyzed by two observers using three different software packages.

Main Results:

• Significant differences in mean strain measurements and narrower limits of agreement were observed between VSS_LV and VIS (VIS_LV, VIS_LA).
• Vendor-independent software (VIS) demonstrated lower coefficients of variation (CV) compared to VSS_LV.
• Measurement reliability, assessed by intra-class correlation coefficients (ICCs), was weaker with VSS_LV (ICC < 0.6) than with VIS (ICC > 0.9).

Conclusions:

• Software measurement of LA strain yields considerable variability.
• It is recommended to avoid measuring LA strain across different vendor platforms due to inconsistencies.