Global longitudinal strain assessment by computed tomography in severe aortic stenosis patients - Feasibility using feature tracking analysis
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...
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| Vydáno v: | Journal of cardiovascular computed tomography Ročník 13; číslo 2; s. 157 - 162 |
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| Médium: | Journal Article |
| Jazyk: | angličtina |
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United States
Elsevier Inc
01.03.2019
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| ISSN: | 1934-5925, 1876-861X, 1876-861X |
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| Abstract | 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. |
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| AbstractList | 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. 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.BACKGROUNDGlobal 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.METHODSWe 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.RESULTSA 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.CONCLUSIONCTA-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. 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. |
| Author | Xu, Jeffrey Thoma, Floyd W. Cavalcante, João L. Althouse, Andrew D. Sharbaugh, Michael S. Abdelkarim, Islam Pedrizzetti, Gianni Fukui, Miho |
| Author_xml | – sequence: 1 givenname: Miho surname: Fukui fullname: Fukui, Miho organization: University of Pittsburgh, Department of Internal Medicine, Division of Cardiology, Pittsburgh, PA, USA – sequence: 2 givenname: Jeffrey surname: Xu fullname: Xu, Jeffrey organization: University of Pittsburgh, Department of Internal Medicine, Division of Cardiology, Pittsburgh, PA, USA – sequence: 3 givenname: Islam surname: Abdelkarim fullname: Abdelkarim, Islam organization: University of Pittsburgh, Department of Internal Medicine, Division of Cardiology, Pittsburgh, PA, USA – sequence: 4 givenname: Michael S. surname: Sharbaugh fullname: Sharbaugh, Michael S. organization: University of Pittsburgh, Department of Internal Medicine, Division of Cardiology, Pittsburgh, PA, USA – sequence: 5 givenname: Floyd W. surname: Thoma fullname: Thoma, Floyd W. organization: University of Pittsburgh, Department of Internal Medicine, Division of Cardiology, Pittsburgh, PA, USA – sequence: 6 givenname: Andrew D. surname: Althouse fullname: Althouse, Andrew D. organization: University of Pittsburgh, Department of Internal Medicine, Division of Cardiology, Pittsburgh, PA, USA – sequence: 7 givenname: Gianni orcidid: 0000-0003-2886-7653 surname: Pedrizzetti fullname: Pedrizzetti, Gianni organization: Department of Engineering and Architecture, University of Trieste, Trieste, Italy – sequence: 8 givenname: João L. surname: Cavalcante fullname: Cavalcante, João L. email: joao.cavalcante@allina.com organization: University of Pittsburgh, Department of Internal Medicine, Division of Cardiology, Pittsburgh, PA, USA |
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| Keywords | Computed tomography angiography Aortic stenosis Global longitudinal strain Transcatheter aortic valve replacement Left ventricular ejection fraction Transthoracic echocardiography |
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| Title | Global longitudinal strain assessment by computed tomography in severe aortic stenosis patients - Feasibility using feature tracking analysis |
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