Multicentric Atrial Strain COmparison between Two Different Modalities: MASCOT HIT Study
Matteo Cameli, Marcelo Haertel Miglioranza, Julien Magné, Giulia Elena Mandoli, Giovanni Benfari, R. Ancona, Gerolamo Sibilio, Vlatka Rešković Lukšić, Dejan Došen, Leonardo Griseli, Caroline M. Van De Heyning, P Mortelmans, Błażej Michalski, Karolina Kupczyńska, Giovanna Di Giannuario, Fiorella Devito, Raluca Dulgheru, Federica Ilardi, Alessandro Salustri, Galal Abushahba, Doralisa Morrone, Iacopo Fabiani, Martin Pěnička, Asim Katbeh, Giuseppe Sammarco, Roberta Esposito, Ciro Santoro, Maria Concetta Pastore, S. Comenale Pinto, А Калинин, Žanna Pičkure, Katja Ažman Juvan, Anja Zupan Mežnar, Augustin Coisne, Amandine Coppin, Mihaela Opriş, Dan Nistor, Riitta Paakkanen, Tor Biering‐Sørensen, Flemming Javier Olsen, Tomas Lapinskas, Jolanta Justina Vaškelytė, Laura Galián-Gay, Guillem Casas, Andreea Motoc, C Papadopoulos, Savvas Loizos, Gergely Ágoston, István Adorján Szabó, Krasimira Hristová, Svetlin Netkov Tsonev, Elena Galli, Dragoş Vinereanu, S. Mihaila, Denisa Muraru, Sergio Mondillo, Erwan Donal, Maurizio Galderisi, Bernard Cosyns, Thor Edvardsen, Bogdan A. Popescu
Abstract
Two methods are currently available for left atrial (LA) strain measurement by speckle tracking echocardiography, with two different reference timings for starting the analysis: QRS (QRS-LASr) and P wave (P-LASr). The aim of MASCOT HIT study was to define which of the two was more reproducible, more feasible, and less time consuming. In 26 expert centers, LA strain was analyzed by two different echocardiographers (young vs senior) in a blinded fashion. The study population included: healthy subjects, patients with arterial hypertension or aortic stenosis (LA pressure overload, group 2) and patients with mitral regurgitation or heart failure (LA volume-pressure overload, group 3). Difference between the inter-correlation coefficient (ICC) by the two echocardiographers using the two techniques, feasibility and analysis time of both methods were analyzed. A total of 938 subjects were included: 309 controls, 333 patients in group 2, and 296 patients in group 3. The ICC was comparable between QRS-LASr (0.93) and P-LASr (0.90). The young echocardiographers calculated QRS-LASr in 90% of cases, the expert ones in 95%. The feasibility of P-LASr was 85% by young echocardiographers and 88% by senior ones. QRS-LASr young median time was 110 s (interquartile range, IR, 78-149) vs senior 110 s (IR 78-155); for P-LASr, 120 s (IR 80-165) and 120 s (IR 90-161), respectively. LA strain was feasible in the majority of patients with similar reproducibility for both methods. QRS complex guaranteed a slightly higher feasibility and a lower time wasting compared to the use of P wave as the reference.