J Cardiovasc Imaging.  2023 Jul;31(3):135-141. 10.4250/jcvi.2022.0130.

Echocardiography Core Laboratory Validation of a Novel VendorIndependent Web-Based Software for the Assessment of Left Ventricular Global Longitudinal Strain

• Spitzer E
• Camacho B
• Mrevlje B
• Brandendburg HJ
• Ren CB

• KMID: 2544965
• DOI: http://doi.org/10.4250/jcvi.2022.0130

Abstract

BACKGROUND
Global longitudinal strain (GLS) is an accurate and reproducible parameter of left ventricular (LV) systolic function which has shown meaningful prognostic value. Fast, user-friendly, and accurate tools are required for its widespread implementation. We aim to compare a novel web-based tool with two established algorithms for strain analysis and test its reproducibility.
METHODS
Thirty echocardiographic datasets with focused LV acquisitions were analyzed using three different semi-automated endocardial GLS algorithms by two readers. Analyses were repeated by one reader for the purpose of intra-observer variability. CAAS Qardia (Pie Medical Imaging) was compared with 2DCPA and AutoLV (TomTec).
RESULTS
Mean GLS values were −15.0 ± 3.5% from Qardia, −15.3 ± 4.0% from 2DCPA, and −15.2 ± 3.8% from AutoLV. Mean GLS between Qardia and 2DCPA were not statistically different (p = 0.359), with a bias of −0.3%, limits of agreement (LOA) of 3.7%, and an intraclass correlation coefficient (ICC) of 0.88. Mean GLS between Qardia and AutoLV were not statistically different (p = 0.637), with a bias of −0.2%, LOA of 3.4%, and an ICC of 0.89. The coefficient of variation (CV) for intra-observer variability was 4.4% for Qardia, 8.4% 2DCPA, and 7.7% AutoLV. The CV for inter-observer variability was 4.5%, 8.1%, and 8.0%, respectively.
CONCLUSIONS
In echocardiographic datasets of good image quality analyzed at an independent core laboratory using a standardized annotation method, a novel web-based tool for GLS analysis showed consistent results when compared with two algorithms of an established platform. Moreover, inter- and intra-observer reproducibility results were excellent.

Keyword

Left ventricular global longitudinal strain; Echocardiography; Core Lab; Validation; Reproducibility