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In-vivo validation of a new clinical tool to quantify three-dimensional myocardial strain using ultrasound

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Abstract
Three-dimensional (3D) strain analysis based on real-time 3-D echocardiography (RT3DE) has emerged as a novel technique to quantify regional myocardial function. The goal of this study was to evaluate accuracy of a novel model-based 3D tracking tool (eSie Volume Mechanics, Siemens Ultrasound, Mountain View, CA, USA) using sonomicrometry as an independent measure of cardiac deformation. Thirteen sheep were instrumented with microcrystals sutured to the epi- and endocardium of the inferolateral left ventricular wall to trace myocardial deformation along its three directional axes of motion. Paired acquisitions of RT3DE and sonomicrometry were made at baseline, during inotropic modulation and during myocardial ischemia. Accuracy of 3D strain measurements was quantified and expressed as level of agreement with sonomicrometry using linear regression and Bland-Altman analysis. Correlations between 3D strain analysis and sonomicrometry were good for longitudinal and circumferential strain components (r = 0.78 and r = 0.71) but poor for radial strain (r = 0.30). Accordingly, agreement (bias +/- 2SD) was -5 +/- 6 % for longitudinal, -5 +/- 7 % for circumferential, and 15 +/- 19 % for radial strain. Intra-observer variability was low for all components (intra-class correlation coefficients (ICC) of respectively 0.89, 0.88 and 0.95) while inter-observer variability was higher, in particular for radial strain (ICC = 0.41). The present study shows that 3D strain analysis provided good estimates of circumferential and longitudinal strain, while estimates of radial strain were less accurate between observers.
Keywords
Cardiology, Ultrasound imaging, Ventricular mechanics, In-vivo validation, Sonomicrometry, Strain, SPECKLE-TRACKING ECHOCARDIOGRAPHY, LEFT-VENTRICULAR FUNCTION, SYSTOLIC FUNCTION, DEFORMATION, REPRODUCIBILITY, REGISTRATION, IMAGES, HEART

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MLA
Bouchez, Stefaan et al. “In-vivo Validation of a New Clinical Tool to Quantify Three-dimensional Myocardial Strain Using Ultrasound.” INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 32.12 (2016): 1707–1714. Print.
APA
Bouchez, S., Heyde, B., Barbosa, D., Vandenheuvel, M., Houle, H., Wang, Y., D’hooge, J., et al. (2016). In-vivo validation of a new clinical tool to quantify three-dimensional myocardial strain using ultrasound. INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING, 32(12), 1707–1714.
Chicago author-date
Bouchez, Stefaan, B Heyde, D Barbosa, Michaël Vandenheuvel, H Houle, Y Wang, J D’hooge, and Patrick Wouters. 2016. “In-vivo Validation of a New Clinical Tool to Quantify Three-dimensional Myocardial Strain Using Ultrasound.” International Journal of Cardiovascular Imaging 32 (12): 1707–1714.
Chicago author-date (all authors)
Bouchez, Stefaan, B Heyde, D Barbosa, Michaël Vandenheuvel, H Houle, Y Wang, J D’hooge, and Patrick Wouters. 2016. “In-vivo Validation of a New Clinical Tool to Quantify Three-dimensional Myocardial Strain Using Ultrasound.” International Journal of Cardiovascular Imaging 32 (12): 1707–1714.
Vancouver
1.
Bouchez S, Heyde B, Barbosa D, Vandenheuvel M, Houle H, Wang Y, et al. In-vivo validation of a new clinical tool to quantify three-dimensional myocardial strain using ultrasound. INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING. 2016;32(12):1707–14.
IEEE
[1]
S. Bouchez et al., “In-vivo validation of a new clinical tool to quantify three-dimensional myocardial strain using ultrasound,” INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING, vol. 32, no. 12, pp. 1707–1714, 2016.
@article{8500090,
  abstract     = {Three-dimensional (3D) strain analysis based on real-time 3-D echocardiography (RT3DE) has emerged as a novel technique to quantify regional myocardial function. The goal of this study was to evaluate accuracy of a novel model-based 3D tracking tool (eSie Volume Mechanics, Siemens Ultrasound, Mountain View, CA, USA) using sonomicrometry as an independent measure of cardiac deformation. Thirteen sheep were instrumented with microcrystals sutured to the epi- and endocardium of the inferolateral left ventricular wall to trace myocardial deformation along its three directional axes of motion. Paired acquisitions of RT3DE and sonomicrometry were made at baseline, during inotropic modulation and during myocardial ischemia. Accuracy of 3D strain measurements was quantified and expressed as level of agreement with sonomicrometry using linear regression and Bland-Altman analysis. Correlations between 3D strain analysis and sonomicrometry were good for longitudinal and circumferential strain components (r = 0.78 and r = 0.71) but poor for radial strain (r = 0.30). Accordingly, agreement (bias +/- 2SD) was -5 +/- 6 % for longitudinal, -5 +/- 7 % for circumferential, and 15 +/- 19 % for radial strain. Intra-observer variability was low for all components (intra-class correlation coefficients (ICC) of respectively 0.89, 0.88 and 0.95) while inter-observer variability was higher, in particular for radial strain (ICC = 0.41). The present study shows that 3D strain analysis provided good estimates of circumferential and longitudinal strain, while estimates of radial strain were less accurate between observers.},
  author       = {Bouchez, Stefaan and Heyde, B and Barbosa, D and Vandenheuvel, Michaël and Houle, H and Wang, Y and D'hooge, J and Wouters, Patrick},
  issn         = {1569-5794},
  journal      = {INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING},
  keywords     = {Cardiology,Ultrasound imaging,Ventricular mechanics,In-vivo validation,Sonomicrometry,Strain,SPECKLE-TRACKING ECHOCARDIOGRAPHY,LEFT-VENTRICULAR FUNCTION,SYSTOLIC FUNCTION,DEFORMATION,REPRODUCIBILITY,REGISTRATION,IMAGES,HEART},
  language     = {eng},
  number       = {12},
  pages        = {1707--1714},
  title        = {In-vivo validation of a new clinical tool to quantify three-dimensional myocardial strain using ultrasound},
  url          = {http://dx.doi.org/10.1007/s10554-016-0962-5},
  volume       = {32},
  year         = {2016},
}

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