Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
Normal Range of Left Ventricular 2-Dimensional Strain
– Japanese Ultrasound Speckle Tracking of the Left Ventricle (JUSTICE) Study –
Kiyohiro TakigikuMasaaki TakeuchiChisato IzumiSatoshi YudaKonomi SakataNobuyuki OhteKazuaki TanabeSatoshi Nakatanion behalf of the JUSTICE investigators
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2012 Volume 76 Issue 11 Pages 2623-2632


Background: To determine the normal range of left ventricular (LV) 2- dimensional (2-D) strain and vendor-specific differences, a multicenter prospective 2-D strain study endorsed by the Japanese Society of Echocardiography was conducted. Methods and Results: 2-D speckle tracking analysis was performed on 817 healthy subjects (age range, 0–88 years); the images included 3 LV short axis and 3 apical views using an ultrasound system from 1 of the 3 different vendors (V1, n=333; V2, n=330; V3, n=337). With the 2-D speckle tracking software from each vendor, radial, circumferential and longitudinal strain were measured using an 18-segment model. Inter-vendor variability was also assessed in a subset of subjects. The feasibility for 2-D strain measurements was different among the 3 vendors (V1, 83%; V2, 70%; V3, 88%, P<0.01). The global radial (V1, 54.6±12.6%; V2, 36.3±8.2%; V3, 51.4±8.0%), circumferential (V1, –22.8±2.9%; V2, –22.2±3.2%; V3, –30.5±3.8%), and longitudinal (V1, –21.3±2.1%; V2, –18.9±2.5%; V3, –19.9±2.4%) strain measurements were significantly different for each of the vendors. Segmental strain was also different between the 3 vendors. On inter-vendor analysis, vendor agreement ranged from mild to moderate. Conclusions: Reference values are provided for normal 2-D strain for 3 different ultrasound vendors. Due to a low inter-vendor agreement, 2-D strain data are not interchangeable when conducting a longitudinal follow-up or a cross-sectional assessment of LV function.  (Circ J 2012; 76: 2623–2632)

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