Author + information
- Kazuaki Negishi, MD, PhD∗,
- Tomoko Negishi, MD∗,
- Koji Kurosawa, MD, PhD†,
- Krasimira Hristova, MD‡,
- Bogdan A. Popescu, MD, PhD§,
- Dragos Vinereanu, MD, PhD§,
- Satoshi Yuda, MD, PhD‖ and
- Thomas H. Marwick, MBBS, PhD, MPH∗∗ ()
- ∗Menzies Research Institute Tasmania, Hobart, Tasmania, Australia
- †Gunma University, Gunma, Japan
- ‡National Heart Hospital, Sofia, Bulgaria
- §University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
- ‖Sapporo Medical University, Sapporo, Japan
- ↵∗Reprint requests and correspondence:
Dr. Thomas H. Marwick, Menzies Research Institute Tasmania, 17 Liverpool Street, Hobart, Tasmania 7000, Australia.
there has been increasing interest in the measurement of global myocardial strain because it is a sensitive and robust index to detect subclinical myocardial dysfunction, with a defined normal range (1). Numerous commercially-available versions of speckle tracking software are available for strain analysis, and measurement involves 6 steps that are common to different methods (Figure 1). Surprisingly, however, there are no standard instructions for measuring it adequately. This could be one of the causes of interobserver variation, especially in different echocardiography laboratories (2).
The authors developed a set of 9 cases as a step to establishing reader uniformity in an international multicenter trial of the incremental value of myocardial strain for the detection of cardiotoxicity (SUCCOUR [Strain sUrveillance during Chemotherapy for improving Cardiovascular Outcomes]; ACTRN12614000341628). The authors reviewed the tracings of collaborators and used this experience to develop an atlas of traps for the unwary, as well as lessons to avoid them. To emphasize the required image quality, the cases included a range of image quality.
The key points listed in Table 1 and shown in Figures 2 to 9⇓⇓⇓⇓⇓⇓⇓ and Online Figure 1 and in corresponding Online Videos 1 to 8Online Video 1A, Online Video 1B, Online Video 1C, Online Video 1D, Online Video 2A, Online Video 2B, Online Video 3A, Online Video 3B, Online Video 4A, Online Video 4B, Online Video 5A, Online Video 5B, Online Video 6A, Online Video 6B, Online Video 7A, Online Video 7B, Online Video 8A, Online Video 8B can be used to optimize strain measurement.
For an additional figure and supplemental videos and their legends, please see the online version of this article.
This work is supported in part by a grant from General Electric Medical Systems, Milwaukee, Wisconsin. Dr. Popescu has received research support and lecture honoraria from GE Healthcarehttp://dx.doi.org/10.13039/100006775. Dr. Marwick has received research support from General Electric Medical Systems. The other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Sherif Nagueh, MD, served as Guest Editor for this article.
- American College of Cardiology Foundation