Speckle-tracking echocardiography in dogs: Evaluating imaging parameters and methodological variability in global longitudinal strain assessment

Abstract

Two-dimensional speckle-tracking echocardiography (2D-STE) is an advanced imaging technique that offers quantitative insights into myocardial function by analyzing the motion of speckles created during ultrasound-tissue interactions. This study aims to evaluate the reliability of 2D-STE by examining the impact of key technical parameters on global longitudinal strain (GLS) measurement accuracy and comparing two speckle-tracking analysis methods provided by GE Healthcare: quantitative analysis of the 2D strain (2D strain) and automated function imaging (AFI). The prospective study consisted of two cohorts. In the first cohort, including 16 healthy dogs, the influence of frame rate, heart rate variation, zoom, transducer frequency, and image foreshortening on speckle-tracking values was assessed. In the second cohort, which included 10 healthy dogs, 2D-STE parameters were obtained with the 2D strain and AFI to assess agreement between the methods and observer variability. Our findings indicate that foreshortening (p < 0.01, Cohen's d: 0.52, CI: -17.81 to -24.83) and heart rate variability (p = 0.02, Cohen's d: 0.72, CI: -18.07 to -26.23) significantly affect speckle-tracking measurements. While zoom, frame rate, and frequency did not show a significant impact. Additionally, while the 2D strain and AFI exhibited a strong correlation, a significant systematic bias was identified, with AFI underestimating strain values compared to the 2D strain. Intra- and inter-observer coefficients of variation (CV) were below 9% for both methods, supporting their reliability. These findings emphasize the need to optimize image acquisition and selection criteria, which enhances the accuracy and reliability of the speckle-tracking analysis.