Inter-vendor comparison of left atrial strain using layer specific strain analysis.

Area of Science:

• Cardiology
• Medical Imaging
• Echocardiography

Background:

• Left atrial strain (LAS) assessed via transthoracic echocardiogram (TTE) is crucial for cardiovascular disease evaluation.
• Variability in LAS measurements between different software vendors hinders widespread clinical adoption.

Purpose of the Study:

• To compare LAS measurements between General Electric (GE) Echopac (mid-myocardial and endocardial) and TomTec software.
• To evaluate the impact of vendor-specific algorithms on LAS assessment in healthy individuals and paroxysmal atrial fibrillation (PAF) patients.

Main Methods:

• LAS (reservoir, contractile, conduit strain) was measured using GE Echopac (mid-myocardial and endocardial) and TomTec software in 88 healthy subjects and 40 PAF patients.
• Bland-Altman analysis was employed to assess agreement and systematic differences between vendor measurements.

Main Results:

• Both GE mid-myocardial and endocardial LAS correlated well with TomTec.
• GE mid-myocardial LAS systematically underestimated strain compared to TomTec.
• GE endocardial LAS showed no systematic bias but wider limits of agreement; reservoir strain demonstrated the best reproducibility.

Conclusions:

• Routine GE Echopac mid-myocardial LAS underestimates values obtained with TomTec.
• GE endocardial LAS mitigates bias but increases measurement variability.
• Consistent use of the same vendor system is recommended for serial LAS measurements to ensure reliability.