J Cardiovasc Ultrasound.  2017 Sep;25(3):91-97. 10.4250/jcu.2017.25.3.91.

Current Awareness and Use of the Strain Echocardiography in Routine Clinical Practices: Result of a Nationwide Survey in Korea

Affiliations
  • 1Division of Cardiology, Department of Internal Medicine, Chungbuk National University School of Medicine, Cheongju, Korea.
  • 2Division of Cardiology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea. jaehpark@cnu.ac.kr
  • 3Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 4Cardiovascular Center, Department of Internal Medicine, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Korea.
  • 5Department of Cardiology, Kyung Hee University School of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea.
  • 6Division of Cardiology, Eulji University School of Medicine, Daejeon, Korea.
  • 7Division of Cardiology, Department of Internal Medicine, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea.
  • 8Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 9Department of Cardiology, Chonbuk National University Hospital, Chonbuk National University, Jeonju, Korea.
  • 10Division of Cardiology, Department of Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea.
  • 11Division of Cardiology, Department of Internal Medicine, Gil Hospital, Gachon University of Medicine and Science, Incheon, Korea.
  • 12Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • 13Department of Internal Medicine, Wonkwang University Hospital, Institute of Wonkwang Medical Science, Iksan, Korea.
  • 14Heart Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • 15Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea.
  • 16Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea.
  • 17Department of Cardiology, Ajou University Medical Centre, Suwon, Korea.
  • 18Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 19Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea.
  • 20Division of Cardiology, Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
  • 21Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Seoul National University College of Medicine, Seoul, Korea.
  • 22Division of Cardiology, Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea.
  • 23Division of Cardiology, Heart Center, College of Medicine, Konyang University, Daejeon, Korea.
  • 24Division of Cardiology, Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
  • 25Division of Cardiology, Department of Internal Medicine, Seoul National University and Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea.

Abstract

BACKGROUND
Because conventional echocardiographic parameters have several limitations, strain echocardiography has often been introduced in clinical practice. However, there are also obstacles in using it in clinical practice. Therefore, we wanted to find the current status of awareness on using strain echocardiography in Korea.
METHODS
We conducted a nationwide survey to evaluate current use and awareness of strain echocardiography from the members of the Korean Society of Echocardiography.
RESULTS
We gathered total 321 questionnaires from 25 cardiology centers in Korea. All participants were able to perform or interpret echocardiographic examinations. All participating institutions performed strain echocardiography. Most of our study participants (97%) were aware of speckle tracking echocardiography and 185 (58%) performed it for clinical and research purposes. Two-dimensional strain echocardiography was the most commonly used modality and left ventricle (LV) was the most commonly used cardiac chamber (99%) for clinical purposes. Most of the participants (89%) did not think LV strain can replace LV ejection fraction (LVEF) in their clinical practice. The common reasons for not performing routine use of strain echocardiography was diversity of strain measurements and lack of normal reference value. Many participants had a favorable view of the future of strain echocardiography.
CONCLUSION
Most of our study participants were aware of strain echocardiography, and all institutions performed strain echocardiography for clinical and research purposes. However, they did not think the LV strain values could replace LVEF. The diversity of strain measurements and lack of normal reference values were common reasons for not using strain echocardiography in clinical practice.

Keyword

Awareness; Strain echocardiography; Survey

MeSH Terms

Cardiology
Echocardiography*
Heart Ventricles
Korea*
Reference Values

Figure

  • Fig. 1 Result of questionnaire about clinical usefulness of strain echocardiography in the future. The responders were asked on a scale from 1 to 10, and the higher score means the more favorable response to the question. IHD: ischemic heart disease, HFrEF: heart failure with reduced ejection fraction, CRT: cardiac resynchronization therapy, HFpEF: heart failure with preserved ejection fraction, CMP: cardiomyopathy, OP: operation, VHD: valvular heart disease.


Cited by  1 articles

Two-dimensional Echocardiographic Assessment of Myocardial Strain: Important Echocardiographic Parameter Readily Useful in Clinical Field
Jae-Hyeong Park
Korean Circ J. 2019;49(10):908-931.    doi: 10.4070/kcj.2019.0200.


Reference

1. Joyce E, Hoogslag GE, Leong DP, Debonnaire P, Katsanos S, Boden H, Schalij MJ, Marsan NA, Bax JJ, Delgado V. Association between left ventricular global longitudinal strain and adverse left ventricular dilatation after ST-segment-elevation myocardial infarction. Circ Cardiovasc Imaging. 2014; 7:74–81.
2. Choi SW, Park JH, Sun BJ, Park Y, Kim YJ, Lee IS, Kim MS, Kim JH, Lee JH, Jeong JO, Kwon IS, Seong IW. Impaired two-dimensional global longitudinal strain of left ventricle predicts adverse long-term clinical outcomes in patients with acute myocardial infarction. Int J Cardiol. 2015; 196:165–167.
3. Park SJ, Park JH, Lee HS, Kim MS, Park YK, Park Y, Kim YJ, Lee JH, Choi SW, Jeong JO, Kwon IS, Seong IW. Impaired RV global longitudinal strain is associated with poor long-term clinical outcomes in patients with acute inferior STEMI. JACC Cardiovasc Imaging. 2015; 8:161–169.
4. SAVE Investigators. Zornoff LA, Skali H, Pfeffer MA, St John, Rouleau JL, Lamas GA, Plappert T, Rouleau JR, Moyé LA, Lewis SJ, Braunwald E, Solomon SD. Right ventricular dysfunction and risk of heart failure and mortality after myocardial infarction. J Am Coll Cardiol. 2002; 39:1450–1455.
5. Park JH, Park MM, Farha S, Sharp J, Lundgrin E, Comhair S, Tang WH, Erzurum SC, Thomas JD. Impaired global right ventricular longitudinal strain predicts long-term adverse outcomes in patients with pulmonary arterial hypertension. J Cardiovasc Ultrasound. 2015; 23:91–99.
6. White HD, Norris RM, Brown MA, Brandt PW, Whitlock RM, Wild CJ. Left ventricular end-systolic volume as the major determinant of survival after recovery from myocardial infarction. Circulation. 1987; 76:44–51.
7. White HD, Norris RM, Brown MA, Takayama M, Maslowski A, Bass NM, Ormiston JA, Whitlock T. Effect of intravenous streptokinase on left ventricular function and early survival after acute myocardial infarction. N Engl J Med. 1987; 317:850–855.
8. Hoit BD. Strain and strain rate echocardiography and coronary artery disease. Circ Cardiovasc Imaging. 2011; 4:179–190.
9. Haddad F, Hunt SA, Rosenthal DN, Murphy DJ. Right ventricular function in cardiovascular disease, part I: anatomy, physiology, aging, and functional assessment of the right ventricle. Circulation. 2008; 117:1436–1448.
10. Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, Flachskampf FA, Foster E, Goldstein SA, Kuznetsova T, Lancellotti P, Muraru D, Picard MH, Rietzschel ER, Rudski L, Spencer KT, Tsang W, Voigt JU. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015; 28:1–39.e14.
11. Pirat B, McCulloch ML, Zoghbi WA. Evaluation of global and regional right ventricular systolic function in patients with pulmonary hypertension using a novel speckle tracking method. Am J Cardiol. 2006; 98:699–704.
12. Sarvari SI, Haugaa KH, Anfinsen OG, Leren TP, Smiseth OA, Kongsgaard E, Amlie JP, Edvardsen T. Right ventricular mechanical dispersion is related to malignant arrhythmias: a study of patients with arrhythmogenic right ventricular cardiomyopathy and subclinical right ventricular dysfunction. Eur Heart J. 2011; 32:1089–1096.
13. Thomas JD, Popović ZB. Assessment of left ventricular function by cardiac ultrasound. J Am Coll Cardiol. 2006; 48:2012–2025.
14. Geyer H, Caracciolo G, Abe H, Wilansky S, Carerj S, Gentile F, Nesser HJ, Khandheria B, Narula J, Sengupta PP. Assessment of myocardial mechanics using speckle tracking echocardiography: fundamentals and clinical applications. J Am Soc Echocardiogr. 2010; 23:351–369.
15. Nahum J, Bensaid A, Dussault C, Macron L, Clémence D, Bouhemad B, Monin JL, Rande JL, Gueret P, Lim P. Impact of longitudinal myocardial deformation on the prognosis of chronic heart failure patients. Circ Cardiovasc Imaging. 2010; 3:249–256.
16. Cho GY, Park WJ, Han SW, Han SJ, Choi SH, Choi YJ, Doo YC, Han KR, Lee NH, Oh DJ, Ryu KH, Rhim CY, Lee Y. Quantification of regional wall motion abnormality using myocardial strain in acute myocardial infarction. Korean Circ J. 2003; 33:583–589.
17. Mollema SA, Delgado V, Bertini M, Antoni ML, Boersma E, Holman ER, Stokkel MP, van der Wall EE, Schalij MJ, Bax JJ. Viability assessment with global left ventricular longitudinal strain predicts recovery of left ventricular function after acute myocardial infarction. Circ Cardiovasc Imaging. 2010; 3:15–23.
18. Markley RR, Ali A, Potfay J, Paulsen W, Jovin IS. Echocardiographic evaluation of the right heart. J Cardiovasc Ultrasound. 2016; 24:183–190.
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