Abstract 13708: Right Ventricular Strain Comparison Between Quantification Software in Pediatric Normal and Pulmonary Hypertension Patients

Abstract

Background: Right ventricular (RV) free wall longitudinal strain (FWLS) is a functional assessment in pediatric pulmonary hypertension (PH). RV FWLS analysis requires study transfer to an offline software which can hinder clinical use. Autostrain RV (AS-RV) uses an automatic recognition and speckle tracking that allows for an efficient tool in routine clinical use. We evaluated the feasibility and reproducibility of AS-RV FWLS in controls and PH patients, and compared the timing of AS-RV to the offline analysis. Methods: Two and 3-dimensional echocardiography 4-chamber RV images were obtained in 32 PH patients and 33 controls. RV FWLS was analyzed by AS-RV software on the EPIQ machines and offline by TomTec 4D RV strain software. AS-RV timing with and without RVFW adjustments were compared to TomTec. Adjusted AS-RV and TomTec RVFWLS were compared between controls and PH patients using paired T-tests, Intraclass correlation (ICC), and Bland-Altman. Results: Controls and PH patients were not statistically different in age, body surface area, or heart rate. PH patients had decreased RV FWLS than controls (-24.1 ± 5.2 vs -28.3 ± 3.6; p<0.001). AS-RV was feasible in all controls and 31/32 PH patients. However, 72% of controls and 75% of PH patients required contour adjustments for accurate tracking. There were significant differences in timing between AS-RV, adjusted AS-RV, and TomTec in controls (4.3 ± 1.0 seconds, 26.5 ± 25.7 seconds, 50.4 ± 6.9 seconds; p<0.0001 respectively) and PH patients (4.4 ± 1.3 seconds, 42.4 ± 29.7 seconds, 52.7 ± 5.5; p<0.0001). ICC of adjusted AS-RV and TomTec showed strong correlation in controls and PH patients (0.70 and 0.78 respectively). Bland-Altman analysis shown in Figure 1. Conclusion: RV FWLS evaluation is feasible and reproducible using AS-RV, but frequent adjustments need to be made for data accuracy. Adjusted AS-RV can be incorporated into clinical use with less time, making quantification of RV easier in clinical practice.