Feasibility of CT-derived myocardial strain measurement in patients with advanced cardiac valve disease

• Published in: Scientific reports Vol. 11; no. 1; p. 8793
• Main Authors: Vach, Marius, Vogelhuber, Johanna, Weber, Marcel, Sprinkart, Alois M., Pieper, Claus C., Block, Wolfgang, Kuetting, Daniel, Attenberger, Ulrike I., Luetkens, Julian A.
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 22.04.2021; Nature Publishing Group; Nature Portfolio
• Subjects: 692/308; 692/4019; Algorithms; Body mass index; Coronary artery disease; Correlation coefficient; Echocardiography; Ejection fraction; Electrocardiography; Heart; Heart diseases; Humanities and Social Sciences; Magnetic resonance imaging; multidisciplinary; Science; Science (multidisciplinary); Strain measurement; Ultrasonic imaging; Ventricle
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-021-88294-5

To explore the feasibility of CT-derived myocardial strain measurement in patients with advanced cardiac valve disease and to compare it to strain measurements derived from transthoracic echocardiography (TTE). 43 consecutive patients with advanced cardiac valve disease and clinically indicated retrospectively gated cardiac CTs were retrospectively analyzed. The longitudinal, circumferential as well as radial systolic strain were determined in all patients utilizing a commercially available CT strain software. In 36/43 (84%) patients, CT-derived longitudinal strain was compared to speckle-tracking TTE. Pearson’s correlation coefficients as well as Bland–Altman analysis were used to compare the CT-derived strain measurements to TTE. The intra- and inter-reader-reliability of the CT-derived strain measurements were assessed by intra-class correlation coefficients (ICCs). Strain measurements were feasible in all patients. CT-derived global longitudinal strain (GLS) correlated moderately with TTE-derived GLS ( r  = 0.6, p  < 0.001). A moderate correlation between CT-derived GLS and CT-derived left ventricular ejection fraction was found (LVEF, r  = − 0.66, p  = 0.036). Bland–Altman analysis showed a systematic underestimation of myocardial strain by cardiac CT compared to TTE (mean difference: − 5.8%, 95% limit of agreement between − 13.3 and 1.8%). Strain measurements showed an excellent intra- and inter-reader-reliability with an intra-reader ICC of 1.0 and an inter-reader ICC of 0.99 for GLS measurements. CT-derived myocardial strain measurements are feasible in patients with advanced cardiac valve disease. They are highly reproducible and correlate with established parameters of strain measurements. Our results encourage the implementation of CT-derived strain measurement into clinical routine.