P1504 Inter-vendor comparison of left atrial 2-dimensional strain using multilayer analysis

Abstract

Abstract BACKGROUND Left atrial strain (LAS) is increasingly being accepted as a marker of left atrial function. Different vendors utilise different techniques of measuring LAS in echocardiography. AIMS To determine the difference between multilayer endocardial and mid-myocardial measurements of LA strain on General Electric (GE) Echopac compared to the TOMTEC system which tracks endocardial strain. METHODS Peak reservoir left atrial strain (LAS) was measured on 50 healthy controls using the two different echocardiographic software packages. GE Echopac (v201) 2D-speckle tracking echocardiography technique (LV package) was used to measuremid-myocardial (GE-mid) and endocardial (GE-endo) LAS. This was compared to LAS measurement using TOMTEC (v4.6) which uses an endocardial tracking technique. LAS was measured in 4ch and 2ch views and average biplane strain measurement was obtained. RESULTS The mean of GE-mid LAS was 36.3 ± 6.3%, GE-endo LAS was higher with a mean of 44.1 ± 8.0%, while TOMTEC LAS was 42.1 ± 6.3 %. GE-mid and GE-endo LAS correlated well with TOMTEC LAS (r = 0.9, p < 0.001 for both). On Bland-Altman Analysis, GE-mid LAS measurements were systematically lower than TOMTEC LAS (mean difference -5.77), whereas GE-endo LAS had no systematic bias (mean difference 1.99). CONCLUSIONS Mid-myocardial peak reservoir left atrial strain, which is routinely measured using GE Echopac software, systematically underestimates LAS as compared to TOMTEC LAS or GE endocardial LAS. This suggests that serial follow up of LAS measurements for patients should be performed on the same software.