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2016 ; 33
(3
): 386-97
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Archeological Echocardiography: Digitization and Speckle Tracking Analysis of
Archival Echocardiograms in the HyperGEN Study
#MMPMID26525308
Aguilar FG
; Selvaraj S
; Martinez EE
; Katz DH
; Beussink L
; Kim KY
; Ping J
; Rasmussen-Torvik L
; Goyal A
; Sha J
; Irvin MR
; Arnett DK
; Shah SJ
Echocardiography
2016[Mar]; 33
(3
): 386-97
PMID26525308
show ga
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 ? = -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.