Postoperative evaluation of left ventricular global strain using cardiac computed tomography in pediatric patients with congenital heart disease: A comparison with echocardiography

Eur J Radiol. 2021 Sep:142:109868. doi: 10.1016/j.ejrad.2021.109868. Epub 2021 Jul 21.

Abstract

Purpose: We explored the feasibility and reproducibility of cardiac computed tomography (CCT)-derived left ventricular (LV) global strain in postoperative children with congenital heart disease (CHD) and compared its correlation and agreement with transthoracic echocardiography (TTE).

Methods: Fifty-one patients (28 males, 23 females) were included who underwent clinically indicated retrospective electrocardiography-triggered CCT. and all patients underwent additional TTE on the same day. LV global longitudinal strain (GLS), global circumferential strain (GCS), and global radial strain (GRS) were measured. Correlations of global strains between CCT and TTE were assessed using Pearson's correlation coefficient. Intra-class correlation coefficients (ICC) were used to assess CCT intra-observer and inter-observer reproducibility.

Results: GLS and GCS were not significantly different between CCT and TTE (GLS: -23.54 ± 3.24 vs. -23.85 ± 3.72, respectively, p = 0.415; GCS: -28.21 ± 3.55 vs. -28.79 ± 3.69, respectively, p = 0.155). GRS was significantly different between CCT and TTE (60.79 ± 15.11 vs. 41.73 ± 4.27, respectively, p < 0.001). There was good correlation between CCT- and TTE-derived GLS (r = 0.70, p < 0.001) and GCS (r = 0.68, p < 0.001), but GRS showed no correlation between CCT and TTE (r = 0.09, p = 0.54). CCT-derived global strain showed good intra- and inter-observer reproducibility (ICC = 0.86-0.92), except the inter-observer reproducibility for GRS (ICC = 0.77).

Conclusions: CCT was feasible for postoperative evaluation of LV global strain in pediatric patients with CHD with sufficient reproducibility. CCT-derived global strain can provide additional information in selected CHD patients with poor acoustic windows and who are intolerant to or have contraindications for cardiac magnetic resonance.

Keywords: Cardiac computed tomography; Congenital heart disease; Global strain; Postoperative; Transthoracic echocardiography.

MeSH terms

  • Child
  • Echocardiography
  • Female
  • Heart Defects, Congenital* / diagnostic imaging
  • Heart Defects, Congenital* / surgery
  • Humans
  • Male
  • Reproducibility of Results
  • Retrospective Studies
  • Tomography
  • Ventricular Dysfunction, Left* / diagnostic imaging
  • Ventricular Function, Left