Global longitudinal strain assessment by computed tomography in severe aortic stenosis patients - Feasibility using feature tracking analysis.
Aged
Aged, 80 and over
Aortic Valve
/ diagnostic imaging
Aortic Valve Stenosis
/ diagnostic imaging
Computed Tomography Angiography
Coronary Angiography
/ methods
Echocardiography, Doppler
Feasibility Studies
Female
Humans
Male
Myocardial Contraction
Predictive Value of Tests
Radiographic Image Interpretation, Computer-Assisted
Reproducibility of Results
Retrospective Studies
Severity of Illness Index
Stroke Volume
Ventricular Function, Left
Aortic stenosis
Computed tomography angiography
Global longitudinal strain
Left ventricular ejection fraction
Transcatheter aortic valve replacement
Transthoracic echocardiography
Journal
Journal of cardiovascular computed tomography
ISSN: 1876-861X
Titre abrégé: J Cardiovasc Comput Tomogr
Pays: United States
ID NLM: 101308347
Informations de publication
Date de publication:
Historique:
received:
02
07
2018
revised:
19
09
2018
accepted:
23
10
2018
pubmed:
7
11
2018
medline:
14
6
2019
entrez:
7
11
2018
Statut:
ppublish
Résumé
Global longitudinal strain (GLS) detects subclinical myocardial changes in patients with aortic stenosis (AS). Although GLS is typically measured by transthoracic echocardiography (TTE), assessment by multiphasic gated computed tomography angiography (CTA) has become recently available. We sought to evaluate the feasibility of CTA-derived GLS assessment and compare its agreement with TTE using the same post-processing software in severe AS patients undergoing transcatheter aortic valve replacement (TAVR) evaluation. We evaluated patients with severe AS, sinus rhythm and adequate image quality for GLS analysis by both CTA and TTE pre-TAVR using 2D CT-Cardiac Performance Analysis prototype software (TomTec). The 18-segment model was used for GLS analysis by averaging the three long-axis views in both CTA and TTE studies. Agreement was assessed using linear regression and Bland-Altman analysis. A total of 123 consecutive patients were included (mean age 84 ± 7 years, 45% female). The mean left ventricular ejection fraction (LVEF) by CTA and TTE were similar 53 ± 14% for both. On average, CTA-derived GLS was greater than by TTE (-20 ± 6.5% vs. -16 ± 4.9%, respectively, p < 0.001). There was a moderate correlation between GLS assessed by CTA vs. TTE (r = 0.62, p < 0.001), although variability between imaging methods existed. The correlation between GLS and LVEF was strong (r = -0.90, p < 0.001 for CTA, r = -0.88, p < 0.001 for TTE) using the same imaging modality. CTA-derived GLS assessment is feasible in selected patients with sinus rhythm and adequate image quality. The agreement of GLS between TTE and CTA is moderate but not interchangeable suggesting a potential modality-specific GLS threshold.
Sections du résumé
BACKGROUND
BACKGROUND
Global longitudinal strain (GLS) detects subclinical myocardial changes in patients with aortic stenosis (AS). Although GLS is typically measured by transthoracic echocardiography (TTE), assessment by multiphasic gated computed tomography angiography (CTA) has become recently available. We sought to evaluate the feasibility of CTA-derived GLS assessment and compare its agreement with TTE using the same post-processing software in severe AS patients undergoing transcatheter aortic valve replacement (TAVR) evaluation.
METHODS
METHODS
We evaluated patients with severe AS, sinus rhythm and adequate image quality for GLS analysis by both CTA and TTE pre-TAVR using 2D CT-Cardiac Performance Analysis prototype software (TomTec). The 18-segment model was used for GLS analysis by averaging the three long-axis views in both CTA and TTE studies. Agreement was assessed using linear regression and Bland-Altman analysis.
RESULTS
RESULTS
A total of 123 consecutive patients were included (mean age 84 ± 7 years, 45% female). The mean left ventricular ejection fraction (LVEF) by CTA and TTE were similar 53 ± 14% for both. On average, CTA-derived GLS was greater than by TTE (-20 ± 6.5% vs. -16 ± 4.9%, respectively, p < 0.001). There was a moderate correlation between GLS assessed by CTA vs. TTE (r = 0.62, p < 0.001), although variability between imaging methods existed. The correlation between GLS and LVEF was strong (r = -0.90, p < 0.001 for CTA, r = -0.88, p < 0.001 for TTE) using the same imaging modality.
CONCLUSION
CONCLUSIONS
CTA-derived GLS assessment is feasible in selected patients with sinus rhythm and adequate image quality. The agreement of GLS between TTE and CTA is moderate but not interchangeable suggesting a potential modality-specific GLS threshold.
Identifiants
pubmed: 30396864
pii: S1934-5925(18)30254-5
doi: 10.1016/j.jcct.2018.10.020
pii:
doi:
Types de publication
Comparative Study
Evaluation Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
157-162Informations de copyright
Copyright © 2018. Published by Elsevier Inc.