TY - JOUR
T1 - Archeological Echocardiography
T2 - Digitization and Speckle Tracking Analysis of Archival Echocardiograms in the HyperGEN Study
AU - Aguilar, Frank G.
AU - Selvaraj, Senthil
AU - Martinez, Eva E.
AU - Katz, Daniel H.
AU - Beussink, Lauren
AU - Kim, Kwang Youn A.
AU - Ping, Jie
AU - Rasmussen-Torvik, Laura
AU - Goyal, Amita
AU - Sha, Jin
AU - Irvin, Marguerite R.
AU - Arnett, Donna K.
AU - Shah, Sanjiv J.
N1 - Funding Information:
The HyperGEN cardiac mechanics ancillary study was funded by the National Institutes of Health (R01 HL 107577 to S.J.S.). The HyperGEN parent study was funded by cooperative agreements (U10) with the National Heart, Lung, and Blood Institute: HL54471, HL54472, HL54473, HL54495, HL54496, HL54497, HL54509, HL54515.
Publisher Copyright:
© 2015, Wiley Periodicals, Inc.
PY - 2016/3/1
Y1 - 2016/3/1
N2 - Background: Several large epidemiologic studies and clinical trials have included echocardiography, but images were stored in analog format and these studies predated tissue Doppler imaging (TDI) and speckle tracking echocardiography (STE). We hypothesized that digitization of analog echocardiograms, with subsequent quantification of cardiac mechanics using STE, is feasible, reproducible, accurate, and produces clinically valid results. Methods: In the NHLBI HyperGEN study (N = 2234), archived analog echocardiograms were digitized and subsequently analyzed using STE to obtain tissue velocities/strain. Echocardiograms were assigned quality scores and inter-/intra-observer agreement was calculated. Accuracy was evaluated in: (1) a separate second study (N = 50) comparing prospective digital strain versus post hoc analog-to-digital strain, and (2) in a third study (N = 95) comparing prospectively obtained TDI e' velocities with post hoc STE e' velocities. Finally, we replicated previously known associations between tissue velocities/strain, conventional echocardiographic measurements, and clinical data. Results: Of the 2234 HyperGEN echocardiograms, 2150 (96.2%) underwent successful digitization and STE analysis. Inter/intra-observer agreement was high for all STE parameters, especially longitudinal strain (LS). In accuracy studies, LS performed best when comparing post hoc STE to prospective digital STE for strain analysis. STE-derived e' velocities correlated with, but systematically underestimated, TDI e' velocity. Several known associations between clinical variables and cardiac mechanics were replicated in HyperGEN. We also found a novel independent inverse association between fasting glucose and LS (adjusted β = -2.4 [95% CI -3.6, -1.2]% per 1-SD increase in fasting glucose; P < 0.001). Conclusions: Archeological echocardiography, the digitization and speckle tracking analysis of archival echocardiograms, is feasible and generates indices of cardiac mechanics similar to contemporary studies.
AB - Background: Several large epidemiologic studies and clinical trials have included echocardiography, but images were stored in analog format and these studies predated tissue Doppler imaging (TDI) and speckle tracking echocardiography (STE). We hypothesized that digitization of analog echocardiograms, with subsequent quantification of cardiac mechanics using STE, is feasible, reproducible, accurate, and produces clinically valid results. Methods: In the NHLBI HyperGEN study (N = 2234), archived analog echocardiograms were digitized and subsequently analyzed using STE to obtain tissue velocities/strain. Echocardiograms were assigned quality scores and inter-/intra-observer agreement was calculated. Accuracy was evaluated in: (1) a separate second study (N = 50) comparing prospective digital strain versus post hoc analog-to-digital strain, and (2) in a third study (N = 95) comparing prospectively obtained TDI e' velocities with post hoc STE e' velocities. Finally, we replicated previously known associations between tissue velocities/strain, conventional echocardiographic measurements, and clinical data. Results: Of the 2234 HyperGEN echocardiograms, 2150 (96.2%) underwent successful digitization and STE analysis. Inter/intra-observer agreement was high for all STE parameters, especially longitudinal strain (LS). In accuracy studies, LS performed best when comparing post hoc STE to prospective digital STE for strain analysis. STE-derived e' velocities correlated with, but systematically underestimated, TDI e' velocity. Several known associations between clinical variables and cardiac mechanics were replicated in HyperGEN. We also found a novel independent inverse association between fasting glucose and LS (adjusted β = -2.4 [95% CI -3.6, -1.2]% per 1-SD increase in fasting glucose; P < 0.001). Conclusions: Archeological echocardiography, the digitization and speckle tracking analysis of archival echocardiograms, is feasible and generates indices of cardiac mechanics similar to contemporary studies.
KW - epidemiology
KW - speckle tracking echocardiography
KW - strain
KW - ventricular mechanics
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U2 - 10.1111/echo.13095
DO - 10.1111/echo.13095
M3 - Article
C2 - 26525308
AN - SCOPUS:84959460737
SN - 0742-2822
VL - 33
SP - 386
EP - 397
JO - Echocardiography
JF - Echocardiography
IS - 3
ER -