Global longitudinal strain is a more reproducible measure of left ventricular function than ejection fraction regardless of echocardiographic training

• Published in: Cardiovascular ultrasound Vol. 17; no. 1; p. 18
• Main Authors: Karlsen, Sigve, Dahlslett, Thomas, Grenne, Bjørnar, Sjøli, Benthe, Smiseth, Otto, Edvardsen, Thor, Brunvand, Harald
• Format: Journal Article
• Language: English
• Published: England BioMed Central 02.09.2019; BMC
• Subjects: Acute Coronary Syndrome - diagnosis; Acute Coronary Syndrome - physiopathology; Acute coronary syndromes; Aged; Aged, 80 and over; Algorithms; Cardiology - education; Cardiovascular disease; Clinical Competence; Correlation coefficient; Correlation coefficients; Echocardiographic training; Echocardiography; Echocardiography, Three-Dimensional - methods; Education, Medical, Graduate - methods; Ejection fraction; Evaluation; Female; Follow-Up Studies; Global longitudinal strain; Heart; Hospitals; Humans; Image analysis; Image processing; Left ventricular ejection fraction; Longitude; Male; Middle Aged; Prospective Studies; Reproducibility; Reproducibility of Results; ROC Curve; Stroke Volume - physiology; Studies; Systole; Time Factors; Tracking; Training; Ultrasonic imaging; Ventricle; Ventricular Function, Left - physiology; Norway; Echocardiographic training; Left ventricular ejection fraction; Global longitudinal strain
• ISSN: 1476-7120; 1476-7120
• DOI: 10.1186/s12947-019-0168-9

Left 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. Forty-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. The 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. GLS is a more reproducible method for evaluation of LV function than LVEF regardless of echocardiographic training.