Reliability of left ventricular global longitudinal strain across acquisition and analysis techniques: a prospective...

Area of Science:

• Cardiovascular Imaging
• Echocardiography
• Cardiac Mechanics

Background:

• Left ventricular global longitudinal strain (GLS) is a sensitive indicator of subclinical systolic dysfunction.
• Variability in echocardiographic acquisition and analysis can impact the clinical utility of GLS measurements.
• Standardization is needed to ensure reliable GLS assessment.

Purpose of the Study:

• To evaluate the accuracy, variability, and correlation of LV GLS using different 2D and 3D echocardiographic methods.
• To compare GLS measurements obtained from vendor-specific and vendor-neutral software platforms.
• To assess the interchangeability of 2D and 3D GLS measurements.

Main Methods:

• Prospective analysis of 254 consecutive patients undergoing echocardiography.
• GLS measurement using multiple 2D (three-beat, single-beat) and 3D acquisition methods.
• Analysis performed using EchoPac and TomTec-Arena software; statistical analysis included Pearson correlation, ICC, and Bland-Altman analysis.

Main Results:

• High consistency of GLS values across acquisition methods and software platforms.
• Low intra- and interobserver variability for 2D GLS (ICC >0.9), indicating excellent reproducibility.
• 3D GLS values were significantly lower than 2D GLS (mean difference -4.3%) with moderate correlation (r=0.66), indicating they are not interchangeable.

Conclusions:

• LV GLS is a reliable method for assessing LV function with strong reproducibility.
• 3D GLS measurements are consistently lower than 2D GLS and should not be used interchangeably.
• Ongoing standardization and caution are necessary when comparing GLS values across 2D and 3D methods.