A new vendor-independent software tool allows for reliable measurement of left ventricular, right ventricular and left atrial global longitudinal strain
Authors: Braun C , Kasprzak J D , Wdowiak-Okrojwek K , Weijner-Mik P , Szymczyk E , Lipiec P 
Published: January 2025

Introduction

Speckle tracking echocardiography (STE) has become an essential clinical tool. However, its use in everyday practice remains cumbersome due to differences between vendor-specific measurement packages and a lack of compatibility. Vendor-independent software tools can overcome these limitations and allow for more widespread use of STE.

Aim

To assess the feasibility and accuracy of a new vendor-independent software (VIS) tool for measuring left and right ventricular, as well as left atrial global longitudinal strain using a well-established vendor-specific software (VSS) package as a reference.

Methods

110 patients (60 male, mean age 65 ±12,5 years) with various cardiovascular pathologies who underwent transthoracic echocardiography in the cardiology department were included in the study group. All acquired images were sent to an external workstation, where they were analyzed offline using a vendor-specific measurement package and a new vendor-independent software tool. Patients with suboptimal image quality of any myocardial segment were excluded from the study group. The analysis included measurements of left ventricular global longitudinal strain (LV GLS) based on three apical views, as well as right ventricular global longitudinal strain (RV GLS) and right ventricular free wall strain (RV FWS) based on apical four-chamber RV-focused view. Left atrial strain (LAS) measurements were based on a four – and two-chamber apical view and the three phases of the atrial function were analyzed.

Results

Due to suboptimal image quality, 31 and 36 patients were excluded from the LV and RV analysis groups, respectively. We observed strong correlations between measurement results obtained using VS and VI software tools for the LV (r=0,888, p&lt;0,0001) and RV global strain (r=0,807, p&lt;0,0001) and RV FWS (r=0,836, p&lt;0,0001). Mean LV GLS measured by VIS and VSS were -15,3±3,4% and -14,4±3,5%, respectively (p=NS). Mean RV GLS measured by VIS and VSS were -16,5±4,4% and -17,4±5%, respectively (p=0,NS). Mean RV FWS obtained with VIS and VSS were -18,7±5,5% and -21±6,7%, respectively (p=NS).

51 patients (32 male, mean age 63,5±12 years) had feasible image quality for calculating LAS. In this group, strong correlations between the measurement results using VS and VI software tools were observed for the reservoir (r=0,8956 p&lt;0,0001), conduit (r=0,8168, p&lt;0,0001), and contraction (r=0,8759 p&lt;0,0001) phases. The mean reservoir strain measured by VIS and VSS were 23,04±7,99% and 21,7±7,7%, respectively (p=NS). Mean conduit strain measured by VIS and VSS were 10,07±5,02% and 8,71±3,85%, respectively (p=NS). The mean contraction strains obtained with VIS and VSS were 13,01±5,42% and 13,99±5,49%, respectively (p=NS).

Conclusion

A new vendor-independent software tool, allows for reliable measurement of left and right ventricular global longitudinal strain, as well as left atrial strain.