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. 2021 Apr;42(4):743-752.
doi: 10.1007/s00246-020-02536-3. Epub 2021 Jan 25.

Effect of Temporal and Spatial Smoothing on Speckle-Tracking-Derived Strain in Neonates

Umael Khan  1 , Tom R Omdal  2   3 , Gottfried Greve  2   3 , Ketil Grong  4 , Knut Matre  4
Affiliations

Effect of Temporal and Spatial Smoothing on Speckle-Tracking-Derived Strain in Neonates

Umael Khan et al. Pediatr Cardiol. 2021 Apr.

Abstract

Clinical application of strain in neonates requires an understanding of which image acquisition and processing parameters affect strain values. Previous studies have examined frame rate, transmitting frequency, and vendor heterogeneity. However, there is a lack of human studies on how user-regulated spatial and temporal smoothing affect strain values in 36 neonates. This study examined nine different combinations of spatial and temporal smoothing on peak systolic left ventricular longitudinal strain in 36 healthy neonates. Strain values were acquired from four-chamber echocardiographic images in the software-defined epicardial, midwall, and endocardial layers in the six standard segments and average four-chamber stain. Strain values were compared using repeated measure ANOVAs. Overall, spatial smoothing had a larger impact than temporal smoothing, and segmental strain values were more sensitive to smoothing settings than average four-chamber strain. Apicoseptal strain decreased by approximately 4% with increasing spatial smoothing, corresponding to a 13-19% proportional change (depending on wall layer). Therefore, we recommend clinicians be mindful of smoothing settings when assessing segmental strain values.

Keywords: Deformation; Myocardial; Neonatal; Smoothing; Speckle; Strain.

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Conflict of interest statement

None of the authors have any declarations of interest.

Figures

Fig. 1
Fig. 1
An example of a speckle-tracking echocardiography analysis. a The ultrasound image. b Six different curves with different colors, each corresponding to strain in a specific segment over time, in addition to the curve presenting average 4-chamber strain (broken curve). c Temporal changes in strain for each strain value, with high strain values represented as a darker red color
Fig. 2
Fig. 2
Average 4-chamber (4ch) strain. Each dot represents strain for a different setting of spatial and temporal smoothing. The error bars represent standard error of mean. For each graph, the significances (expressed as p values) of spatial smoothing (pi) and temporal smoothing (pt) were calculated, and in case of significance (p < 0.05), the p values are presented above the graphs. In addition, p values for interaction between spatial and temporal smoothing (ps) are presented if significant (p < 0.05). a Endocardial values, b Midwall values and c Epicardial values
Fig. 3
Fig. 3
Endocardial segmental strain derived from 4-chamber view. Each dot represents strain for different settings of spatial and temporal smoothing. The error bars represent standard error of mean. For each graph, the significances (expressed as p values) of spatial smoothing (ps) and temporal smoothing (pt) were calculated, and in case of significance (p < 0.05), the p values are presented above the graphs. In addition, p values for interaction between spatial and temporal smoothing (pi) are presented if significance (p < 0.05). a Basoseptal segment, b Basolateral segment, c Midseptal segment, d Midlateral segment, e Apicoseptal segment, f Apicolateral segment
Fig. 4
Fig. 4
Midwall segmental strain derived from 4-chamber view. Each dot represents strain at a different setting for spatial and temporal smoothing. The error bars represent standard error of mean. For each graph, the significance (expressed as p values) of spatial smoothing (ps) and temporal smoothing (pt) were calculated, and in case of significance (p < 0.05), the p values are presented above the graphs. In addition, p values for interaction between spatial and temporal smoothing (pi) are presented if significance (p < 0.05). a Basoseptal segment, b Basolateral segment, c Midseptal segment, d Midlateral segment, e Apicoseptal segment, f Apicolateral segment
Fig. 5
Fig. 5
Epicardial segmental strain derived from 4-chamber view. Each dot represents strain at a different setting for spatial and temporal smoothing. The error bars represent standard error of mean. For each graph, the significance (expressed as p values) of spatial smoothing (ps) and temporal smoothing (pt) was calculated, and in case of significance (p < 0.05), the p values are presented above the graphs. In addition, p values for interaction between spatial and temporal smoothing (pi) are presented if significance (p < 0.05). a Basoseptal segment, b Basolateral segment, c Midseptal segment, d Midlateral segment, e Apicoseptal segment, f Apicolateral segment
See this image and copyright information in PMC

References

    1. Breatnach CR, Levy PT, James AT, Franklin O, El-Khuffash A. Novel echocardiography methods in the functional assessment of the newborn heart. Neonatology. 2016;110(4):248–260. doi: 10.1159/000445779. - DOI - PubMed
    1. El-Khuffash A, Schubert U, Levy PT, Nestaas E, de Boode WP, Austin T, Bohlin K, Bravo MC, Breatnach CR, Breindahl M, Dempsey E, Groves AM, Gupta S, Horsberg Eriksen B, McNamara PJ, Molnar Z, Rogerson SR, Roehr CC, Savoia M, Schwarz CE, Sehgal A, Singh Y, Slieker MG, Tissot C, van der Lee R, van Laere D, van Overmeire B, van Wyk L, on behalf of the European Special Interest Group “Neonatologist Performed E” Deformation imaging and rotational mechanics in neonates: a guide to image acquisition, measurement, interpretation, and reference values. Pediatr Res. 2018;84(1):30–45. doi: 10.1038/s41390-018-0080-2. - DOI - PMC - PubMed
    1. Nestaas E, Stoylen A, Brunvand L, Fugelseth D. Longitudinal strain and strain rate by tissue Doppler are more sensitive indices than fractional shortening for assessing the reduced myocardial function in asphyxiated neonates. Cardiol Young. 2011;21(1):1–7. doi: 10.1017/S1047951109991314. - DOI - PubMed
    1. Forsey J, Friedberg MK, Mertens L. Speckle tracking echocardiography in pediatric and congenital heart disease. Echocardiography. 2013;30(4):447–459. doi: 10.1111/echo.12131. - DOI - PubMed
    1. Khan U, Omdal T, Matre K, Greve G. What is left ventricular strain in healthy neonates? A systematic review and meta-analysis. Pediatr Cardiol. 2020;41(1):1–11. doi: 10.1007/s00246-019-02219-8. - DOI - PubMed

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