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Left ventricular longitudinal strain is a major determinant of CT-derived three-dimensional maximum principal strain: comparison with two-dimensional speckle tracking echocardiography

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Abstract

Computed tomography (CT)-derived three-dimensional maximum principal strain (MP-strain) can provide incremental value to coronary CT angiography for cardiac dysfunction assessment with high diagnostic performance in patients with myocardial infarction. Global longitudinal strain (GLS) measured using two-dimensional speckle tracking echocardiography (2D-STE) is more sensitive than left ventricular ejection fraction (LVEF) for detecting early myocardial dysfunction. We aimed to compare CT-derived MP-strain with each of 2D-STE-derived strains (i.e., longitudinal, circumferential, and radial strains), and identify the major determinants of CT-derived MP-strain among 2D-STE-derived strains. We studied 51 patients who underwent cardiac CT and echocardiography. CT images were reconstructed at every 5% (0–95%) of the RR interval. A dedicated workstation was used to analyze CT-derived MP-strain on the 16-segment model. We calculated CT-derived global MP-strain with all the 16 segments on a per patient basis. Pearson’s test was used to assess correlations between CT-derived MP-strain and STE-strain at global and segmental levels. The intra-class correlation coefficient for interobserver agreement for CT-derived global MP-strain was 0.98 (95% confidence interval 0.96–0.99). The low-CT-derived global MP-strain group (≤ 0.43) had more patients with LV dysfunction than the high-CT-derived global MP-strain group (> 0.43). CT-derived global MP-strain was associated with STE-GLS (r = 0.738, P < 0.001), global circumferential strain (r = 0.646, P < 0.001), and global radial strain (r = 0.432, P = 0.001). In multivariate analysis, STE-GLS had the strongest association to CT-derived global MP-strain among three directional STE-strains and LVEF by echocardiography (standardized coefficient =  − 0.527, P < 0.001). STE-GLS is a major determinant of CT-derived global MP-strain. CT-derived MP-strain may enhance the value of coronary CT angiography by adding functional information to CT-derived LVEF.

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Acknowledgements

We are grateful to Yamato Shimomiya (Ziosoft Inc., Tokyo, Japan) for valuable technical comments. The authors would like to thank Enago (http://www.enago.jp) for the English review.

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Authors and Affiliations

  1. Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan

    Masaki Kinoshita, Teruyoshi Uetani, Katsuji Inoue, Kazuhisa Nishimura, Shuntaro Ikeda & Osamu Yamaguchi

  2. Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan

    Yuki Tanabe, Kazuki Yoshida, Akira Kurata, Yusuke Kobayashi, Teruhito Mochizuki & Teruhito Kido

  3. Department of Radiology, I.M. Sechenov First Moscow State Medical University, 19c1, Bol’shaya Pirogovskaya Ulitsa, Moscow, 119146, Russia

    Teruhito Mochizuki

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  1. Masaki Kinoshita
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Correspondence to Masaki Kinoshita.

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The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. Yamato Shimomiya declares relationships with the following companies: Ziosoft Inc., Tokyo, Japan.

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Kinoshita, M., Tanabe, Y., Yoshida, K. et al. Left ventricular longitudinal strain is a major determinant of CT-derived three-dimensional maximum principal strain: comparison with two-dimensional speckle tracking echocardiography. Heart Vessels 37, 31–39 (2022). https://doi.org/10.1007/s00380-021-01901-3

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