Assessment of Longitudinal Left Ventricle Deformation by 2-Dimensional Speckle Tracking Echocardiography Obtained from Different Views in Cats

Two-dimensional speckle tracking echocardiography (STE) is a novel, angle-independent imaging technique useful to assess myocardial function by strain and strain rate analysis in human and veterinary medicine. Commonly, the left apical four-chamber (LAP4Ch) view is used to assess left ventricular (LV) longitudinal deformation in dogs and cats. However, the right parasternal four-chamber (RP4Ch) view is often more easily obtained than the LAP4Ch view in cats. No studies exist comparing longitudinal strain and strain rate values using STE from different echocardiographic views in cats. Therefore, we examined the agreement between RP4Ch and LAP4Ch for assessment of LV longitudinal strain and strain rate in cats. We acquired 2D echocardiographic cineloops from RP4Ch and LAP4Ch views and analyzed LV longitudinal strain and strain rate in 50 cats (31 healthy cats and 19 cats with different disease states) using Xstrain(TM) software. Peak systolic strain and strain rate values of endocardial and epicardial border were used for the analysis. The two echocardiographic views were compared using limits-of-agreement analyses and intra-observer measurement variability was assessed. We could obtain longitudinal strain and strain rate from the RP4Ch view in all cats. Strain, but not strain rate, had good intra-observer measurement variability (<10% vs. <20%). However, only endocardial strain values obtained with the two views agreed sufficiently to be used interchangeably (95% limits of agreement: −3.28, 2.58). Epicardial strain/strain rate and endocardial strain rate values did not agree sufficiently to be used interchangeably (95% limits of agreement: −11.58, 9.19; −2.28, 1.74; −1.41, 1.36, respectively). Our study suggests that RP4Ch view was feasible for assessment of the LV longitudinal deformation analysis by STE in cats, but only endocardial longitudinal strain values obtained from the two different views were interchangeable.