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European Journal of Echocardiography Advance Access published online on November 3, 2009
European Journal of Echocardiography, doi:10.1093/ejechocard/jep161
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org

Reproducibility of myocardial velocity and deformation imaging in term and preterm infants

Suchita Joshi1, Julie M. Edwards2, Dirk G. Wilson3, Joon K. Wong3, Sailesh Kotecha1 and Alan G. Fraser2,*

1 Department of Child Health, Cardiff University, Cardiff, UK
2 Wales Heart Research Institute, Cardiff University, Cardiff CF14 4XN, UK
3 Department of Paediatric Cardiology, University Hospital of Wales, Cardiff, UK

Received 2 July 2009; accepted after revision 13 October 2009.

* Corresponding author. Tel: +44 29 2074 3489; fax: +44 29 2074 3500. E-mail address: fraserag{at}cardiff.ac.uk


  Abstract

Aims: Myocardial velocity imaging has been validated in adults for assessment of ventricular function and indirect indices of pulmonary arterial pressure. To establish whether it could also be used in infants, we investigated the reproducibility of myocardial velocities and deformation indices in term and preterm neonates.

Methods and results: Myocardial velocity loops acquired from 16 infants were analysed by four observers for inter-observer variability, and re-analysed after 6 months by one observer for intra-observer variability. For myocardial velocities, the coefficients of variation (CVs) for the left ventricle (LV) were 10–11 (intra-observer) and 14–20% (inter-observer) and for the right ventricle (RV) 15–19 and 18–24%, respectively. Reproducibility for annular displacements was <13% (intra-observer) and <18% (inter-observer). CVs for LV strain were 14–17 (intra-observer) and 36–43% (inter-observer) and for RV 19–24 and 25–37%. CVs for isovolumic acceleration were in general >40%. In comparison, the CVs for blood pool indices were 3–15%.

Conclusion: Intra-observer reproducibility for myocardial velocity and deformation indices in neonates is adequate for these parameters to be used in clinical research. Inter-observer reproducibility is sub-optimal suggesting that these measurements should be used in clinical practice with caution. Myocardial acceleration, a marker of contractile function, was poorly reproducible.

Keywords: Infants; Preterm; Tissue Doppler; Reproducibility; Myocardial velocity; Strain


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