Reference Ranges of Left Ventricular Global Longitudinal Strain by Contemporary Vendor‐Neutral Echocardiography Software in Healthy Subjects

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Auteurs principaux: Aro Daniela Arockiam, Tiffany Dong, Ankit Agrawal, Joseph El Dahdah, Elio Haroun, Muhammad Majid, Sharmeen Sorathia, Richard A. Grimm, Patrick Collier, Leonardo Rodriguez, Zoran B. Popovic, Brian P. Griffin, Tom Kai Ming Wang
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Publié: Wiley 2025
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author Aro Daniela Arockiam
Tiffany Dong
Ankit Agrawal
Joseph El Dahdah
Elio Haroun
Muhammad Majid
Sharmeen Sorathia
Richard A. Grimm
Patrick Collier
Leonardo Rodriguez
Zoran B. Popovic
Brian P. Griffin
Tom Kai Ming Wang
author_facet Aro Daniela Arockiam
Tiffany Dong
Ankit Agrawal
Joseph El Dahdah
Elio Haroun
Muhammad Majid
Sharmeen Sorathia
Richard A. Grimm
Patrick Collier
Leonardo Rodriguez
Zoran B. Popovic
Brian P. Griffin
Tom Kai Ming Wang
Aro Daniela Arockiam
Tiffany Dong
Ankit Agrawal
Joseph El Dahdah
Elio Haroun
Muhammad Majid
Sharmeen Sorathia
Richard A. Grimm
Patrick Collier
Leonardo Rodriguez
Zoran B. Popovic
Brian P. Griffin
Tom Kai Ming Wang
collection Wiley Open Access
contents Reference Ranges of Left Ventricular Global Longitudinal Strain by Contemporary Vendor‐Neutral Echocardiography Software in Healthy Subjects Aro Daniela Arockiam Tiffany Dong Ankit Agrawal Joseph El Dahdah Elio Haroun Muhammad Majid Sharmeen Sorathia Richard A. Grimm Patrick Collier Leonardo Rodriguez Zoran B. Popovic Brian P. Griffin Tom Kai Ming Wang Echocardiography ABSTRACT Background Left ventricular global longitudinal strain (LVGLS) by speckle‐tracking transthoracic echocardiography (TTE) is an established measure of left ventricular systolic function with many clinical applications. Strain software has evolved to achieve vendor‐neutrality in recent developments, although there is a notable absence of external validation studies. We assessed the normal ranges and associated factors of two‐dimensional LVGLS quantification by TomTec, EchoPAC, VVI, and Epsilon contemporary strain software in a healthy cross‐sectional cohort. Methods One hundred healthy subjects undergoing TTE during January–April 2023 at our institution were cross‐sectionally recruited, 20 per age‐group, 50% were female, and 50% had GE and 50% Philips scans. TomTec version 51.02 (Autostrain LV), EchoPAC version 206 (AFI‐LV), VVI version (V.2.00‐070730), and Epsilon (5.0.2.11295) were utilized to quantify two‐dimensional LVGLS in all patients for comparative and regression analyses. Results Means and lower limits of normal (95% confidence intervals) of LVGLS were −17.1% (−17.5%, −16.7%) and −14.7% (−15.4%, −14.0%) for TomTec; −17.8% (−18.4%, −17.2%) and −14.4% (−15.3%, −13.5%) for EchoPAC; −16.3% (−16.9%, −15.7%) and −13.0% (−13.9%, −12.1%) for VVI; and −17.0% (−17.6%, −16.4%) and −12.8% (−13.8%, −11.8%) for Epsilon. Factors significantly associated with LVGLS measurements in multivariable regression analyses with their beta‐coefficients (95% CI) were female −1.36 (−2.12, −0.59), heart rate (per 10 bpm) with a coefficient of 0.38 (0.10–0.66), left ventricular ejection fraction (per 10%) −1.03 (−1.72, −0.34), and EchoPAC (vs. TomTec) −0.62 (−1.2, 0.0), VVI (vs. TomTec) 0.82 (0.23, 1.41) and Epsilon (vs. TomTec) 0.13 (−0.45, 0.72). Conclusion LVGLS measurements were feasible across all four strain software on both GE and Philips scans in this study. Reference ranges to define normal, abnormal, and borderline LVGLS values along with associated factors in healthy patients are reported to enable clinical applications. 10.1111/echo.70102 http://creativecommons.org/licenses/by-nc/4.0/
doi_str_mv 10.1111/echo.70102
format Artículo Open Access
id wiley_oa_10_1111_echo_70102
institution Wiley Open Access
license_str_mv http://creativecommons.org/licenses/by-nc/4.0/
publishDate 2025
publisher Wiley
record_format wiley_oa
spellingShingle Reference Ranges of Left Ventricular Global Longitudinal Strain by Contemporary Vendor‐Neutral Echocardiography Software in Healthy Subjects
Aro Daniela Arockiam
Tiffany Dong
Ankit Agrawal
Joseph El Dahdah
Elio Haroun
Muhammad Majid
Sharmeen Sorathia
Richard A. Grimm
Patrick Collier
Leonardo Rodriguez
Zoran B. Popovic
Brian P. Griffin
Tom Kai Ming Wang
Echocardiography
Reference Ranges of Left Ventricular Global Longitudinal Strain by Contemporary Vendor‐Neutral Echocardiography Software in Healthy Subjects Aro Daniela Arockiam Tiffany Dong Ankit Agrawal Joseph El Dahdah Elio Haroun Muhammad Majid Sharmeen Sorathia Richard A. Grimm Patrick Collier Leonardo Rodriguez Zoran B. Popovic Brian P. Griffin Tom Kai Ming Wang Echocardiography ABSTRACT Background Left ventricular global longitudinal strain (LVGLS) by speckle‐tracking transthoracic echocardiography (TTE) is an established measure of left ventricular systolic function with many clinical applications. Strain software has evolved to achieve vendor‐neutrality in recent developments, although there is a notable absence of external validation studies. We assessed the normal ranges and associated factors of two‐dimensional LVGLS quantification by TomTec, EchoPAC, VVI, and Epsilon contemporary strain software in a healthy cross‐sectional cohort. Methods One hundred healthy subjects undergoing TTE during January–April 2023 at our institution were cross‐sectionally recruited, 20 per age‐group, 50% were female, and 50% had GE and 50% Philips scans. TomTec version 51.02 (Autostrain LV), EchoPAC version 206 (AFI‐LV), VVI version (V.2.00‐070730), and Epsilon (5.0.2.11295) were utilized to quantify two‐dimensional LVGLS in all patients for comparative and regression analyses. Results Means and lower limits of normal (95% confidence intervals) of LVGLS were −17.1% (−17.5%, −16.7%) and −14.7% (−15.4%, −14.0%) for TomTec; −17.8% (−18.4%, −17.2%) and −14.4% (−15.3%, −13.5%) for EchoPAC; −16.3% (−16.9%, −15.7%) and −13.0% (−13.9%, −12.1%) for VVI; and −17.0% (−17.6%, −16.4%) and −12.8% (−13.8%, −11.8%) for Epsilon. Factors significantly associated with LVGLS measurements in multivariable regression analyses with their beta‐coefficients (95% CI) were female −1.36 (−2.12, −0.59), heart rate (per 10 bpm) with a coefficient of 0.38 (0.10–0.66), left ventricular ejection fraction (per 10%) −1.03 (−1.72, −0.34), and EchoPAC (vs. TomTec) −0.62 (−1.2, 0.0), VVI (vs. TomTec) 0.82 (0.23, 1.41) and Epsilon (vs. TomTec) 0.13 (−0.45, 0.72). Conclusion LVGLS measurements were feasible across all four strain software on both GE and Philips scans in this study. Reference ranges to define normal, abnormal, and borderline LVGLS values along with associated factors in healthy patients are reported to enable clinical applications. 10.1111/echo.70102 http://creativecommons.org/licenses/by-nc/4.0/
title Reference Ranges of Left Ventricular Global Longitudinal Strain by Contemporary Vendor‐Neutral Echocardiography Software in Healthy Subjects
topic Echocardiography
url https://onlinelibrary.wiley.com/doi/10.1111/echo.70102