Challenges associated with retrospective analysis of left ventricular function using clinical echocardiograms from a...

Area of Science:

• Cardiology
• Pediatric Oncology
• Medical Imaging

Background:

• Retrospective multicenter studies using archived echocardiograms face quality challenges.
• Assessing cardiac function in childhood cancer survivors requires high-quality echocardiographic data.

Purpose of the Study:

• To evaluate imaging and patient factors affecting echocardiogram quality in childhood cancer survivors.
• To identify limitations in assessing cardiac function from archived echocardiograms.

Main Methods:

• A single blinded reviewer assessed echocardiogram quality from five centers.
• Key cardiac function measures including fractional shortening (FS), ejection fraction (EF), myocardial performance index (MPI), and global longitudinal strain (GLS) were evaluated.
• Image quality and technical issues were systematically graded.

Main Results:

• Only 7% of studies allowed assessment of all cardiac function measures.
• Fractional shortening (FS) and myocardial performance index (MPI) were measurable in most studies (>80%).
• Technical issues were common (33%), and earlier echocardiogram era and performing center were significant risk factors for quality issues.

Conclusions:

• Pooled multicenter archived echocardiograms significantly limit cardiac function assessment.
• Standardizing echocardiographic protocols, including specific views and tissue Doppler imaging (TDI), is essential for accurate quantitative left ventricular (LV) function analysis.