The Learning Curve for Competency in Right Ventricular Longitudinal Strain Analysis

The application of myocardial strain by two-dimensional speckle-tracking to quantify right ventricular (RV) function has recently been endorsed by the American Society of Echocardiography/European Association of Cardiovascular Imaging Joint Industry Task Force, with emphasis on the need for standardization and quality control.1 However, there are no specific recommendations to date for the level of training required for accurate RV strain analysis for independent reporting. Our group has previously demonstrated the existence of a learning curve for left ventricular global longitudinal strain analysis,2 while others have demonstrated similar learning curves for wall motion analysis during stress echocardiography3 and visual estimation of left ventricular ejection fraction.4 The aim of this study was to determine whether there is a learning curve for RV longitudinal strain analysis for novice readers to achieve independent competency in consistency and reproducibility.