Abstract 17029: Prospective Comparisons and Reference Ranges of Left Ventricular Global Longitudinal Strain by Contemporary Vendor-Neutral Echocardiography Software in Healthy Subjects

Abstract

Background: Left ventricular global longitudinal strain (LVGLS) by speckle-tracking is an established measure of left ventricular systolic function with many clinical applications. Most strain software traditionally can only analyze strain on scans of the same vendor, however recent advances have allowed them to analyze all scans, although external validation studies are lacking. We aimed to determine the normal ranges and compare two-dimensional LVGLS measurements by contemporary strain software in a healthy prospective cohort. Methods: One-hundred healthy subjects undergoing transthoracic echocardiography during January-April 2023 at our institution were prospectively recruited, 20 per age-group, 50% were female, and 50%GE and 50% Philips scans. TomTec version 51.02 (Autostrain LV), EchoPAC version 206 (AFI) and VVI software were utilized to quantify two-dimensional LVGLS in all patients for comparative and regression analyses. Results: Means (and lower limits of normal)±standard errors LVGLS were -17.1±0.2% (-13.2±0.3%) by TomTec, -17.8±0.3% (-12.7±0.4%) by EchoPAC and -16.3±0.3% (-11.0±0.5%) by VVI, with significant differences on all pairwise T-tests of means (P<0.001-0.017). Means±standard errors LVGLS by strain software for each subgroup are listed in the Table. In multivariable linear regression analyses, factors significantly associated with LVGLS measurements with their beta-coefficients (95%CI) were heart rate (per 1 bpm) 0.05 (0.01-0.07) for TomTec; male sex 1.19 (0.13-2.26) and diastolic blood pressure (per mmHg) 0.06 (0.00-0.12) for EchoPAC; and body mass index (per kg/m 2 ) 0.12 (0.01-0.22) with VVI. Conclusion: All three contemporary strain software demonstrated vendor-neutral properties to measure LVGLS on both GE and Philips scans, with means and lower limits of normal determined, and notably, factors affecting LVGLS values differed by software vendor.