Use of an automatic application for wall motion classification based on longitudinal strain: Is it affected by operator expertise in echocardiography? A multicentre study by the Israeli Echocardiography Research Group

David S. Blondheim*, Zvi Friedman, Peter Lysyansky, Rafael Kuperstein, Ilan Hay, Micha S. Feinberg, Ronen Beeri, Mordehay Vaturi, Alik Sagie, Sarah Shimoni, Wolfgang Fehske, Lisa Deutsch, Marina Leitman, Dan Gilon, Yoram Agmon, Yossi Tsadok, David Rosenmann, Noah Liel-Cohen

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Aims: Assessing the quality ofwallmotion(WM) on echocardiograms remains a challenge. Previously,we validated an automated application used by experienced echocardiographers for WM classification based on longitudinal two-dimensional (2D) strain. The aim of this studywas to showthat the use of this automatic applicationwas independent of the user's experience. Methods and results: We compared the WM classifications obtained by the application when used by 12 highly experienced readers (Exp-R) vs. 11 inexperienced readers (InExp-R). Both classifications were compared with expert consensus classifications using the standard visual method. Digitized clips of cardiac cycles from three apical views in 105 patients were used for these analyses. Reproducibility of both groups was high (overall intra-class correlation coefficient: InExp-R = 0.89, Exp-R = 0.83); the lowest was noted for hypokinetic segments (InExp-R = 0.79, Exp-R = 0.72). InExp-R scores were concordant with Exp-R mode scores in 88.8% of segments; they were overestimated in 5.8% and underestimated in 3.2%. The sensitivity, specificity, and accuracy of InExp-R vs. Exp-R for classifying segments as normal/abnormal were identical (87, 85, and 86%, respectively). Conclusion: Classification of WM from apical views with an automatic application based on longitudinal 2D strain by InExp-R vs. Exp-R was similar to visual classification by Exp-R. This application may be useful for inexperienced echocardiographers/ technicians and may serve as an automated 'second opinion' for experienced echocardiographers. Published on behalf of the European Society of Cardiology. All rights reserved.

Original languageEnglish
Pages (from-to)257-262
Number of pages6
JournalEuropean Heart Journal Cardiovascular Imaging
Volume13
Issue number3
DOIs
StatePublished - Mar 2012
Externally publishedYes

Keywords

  • Automated scoring
  • Echocardiography
  • Segmental strain
  • Speckle tracking
  • Wall motion analysis

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