Abstract
BackgroundLeft ventricular ejection fraction (LVEF) is an established method for evaluation of left ventricular (LV) systolic function. Global longitudinal strain (GLS) by speckle tracking echocardiography seems to be an important additive method for evaluation of LV function with improved reproducibility compared with LVEF. Our aim was to compare reproducibility of GLS and LVEF between an expert and trainee both as echocardiographic examiner and analyst.MethodsForty-seven patients with recent Acute Coronary Syndrome (ACS) underwent echocardiographic examination by both an expert echocardiographer and a trainee. Both echocardiographers, blinded for clinical data and each other’s findings, performed image analysis for evaluation of intra- and inter- observer variability. GLS was measured using speckle tracking echocardiography. LVEF was calculated by Simpson’s biplane method.ResultsThe trainee measured a GLS of − 19.4% (±3.5%) and expert − 18.7% (±3.2%) with an Intra class correlation coefficient (ICC) of 0.89 (0.74–0.95). LVEF by trainee was 50.3% (±8.2%) and by expert 53.6% (±8.6%), ICC coefficient was 0.63 (0.32–0.80). For GLS the systematic difference was 0.21% (− 4.58–2.64) vs. 4.08% (− 20.78–12.62) for LVEF.ConclusionGLS is a more reproducible method for evaluation of LV function than LVEF regardless of echocardiographic training.
Highlights
Left ventricular ejection fraction (LVEF) is the established method for evaluation of left ventricular (LV) systolic function and can be measured by a number of imaging modalities
It is a vital measurement when determining whether patients benefit from an implantable cardioverter-defibrillator (ICD) or cardiac resynchronization therapy (CRT) [1]
Since several studies have shown advantages of Global longitudinal strain (GLS) compared to LVEF in the evaluation of LV function especially for mild systolic dysfunction [11], GLS is increasingly used in clinical practice
Summary
Left ventricular ejection fraction (LVEF) is the established method for evaluation of LV systolic function and can be measured by a number of imaging modalities. LVEF by echocardiography has been regarded as a cornerstone in the prediction of outcome and is the most widely available method for evaluation of LV function. It is a vital measurement when determining whether patients benefit from an implantable cardioverter-defibrillator (ICD) or cardiac resynchronization therapy (CRT) [1]. GLS is recommended used in early detection of cardiotoxicity during chemotherapy [13] It is not well studied how the level of echocardiographic training impact performance of GLS compared to LVEF. Global longitudinal strain (GLS) by speckle tracking echocardiography seems to be an important additive method for evaluation of LV function with improved reproducibility compared with LVEF. Our aim was to compare reproducibility of GLS and LVEF between an expert and trainee both as echocardiographic examiner and analyst
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