Relationships of global longitudinal strain with s`, long-axis systolic excursion, left ventricular length and heart rate

Roger E. Peverill; Kevin Cheng; James Cameron; Lesley Donelan; Philip M. Mottram

doi:10.1371/journal.pone.0235791

Peer Review History

Original SubmissionMarch 7, 2020
13 May 2020 Decision Letter - Giuseppina Novo, Editor PONE-D-20-06704 Relationships of global longitudinal strain with s`, long-axis systolic excursion, left ventricular length and heart rate PLOS ONE Dear Dr Peverill, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. The authors investigates relation of GLS with TDI measures. The comments of the reviewer were conflicting. In my opinion findings are not innovative, moreover there are methodological concerns especially related to the retrospective nature of the study. We will reconsider the paper after a comprehensive revision. We would appreciate receiving your revised manuscript by Jun 27 2020 11:59PM. When you are ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. To enhance the reproducibility of your results, we recommend that if applicable you deposit your laboratory protocols in protocols.io, where a protocol can be assigned its own identifier (DOI) such that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). This letter should be uploaded as separate file and labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. This file should be uploaded as separate file and labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. This file should be uploaded as separate file and labeled 'Manuscript'. Please note while forming your response, if your article is accepted, you may have the opportunity to make the peer review history publicly available. The record will include editor decision letters (with reviews) and your responses to reviewer comments. If eligible, we will contact you to opt in or out. We look forward to receiving your revised manuscript. Kind regards, Giuseppina Novo Academic Editor PLOS ONE Journal Requirements: When submitting your revision, we need you to address these additional requirements. 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf 2. In your Methods section, please provide additional information about the participants included in the analysis. Please ensure you have provided sufficient details to replicate the analyses such as: a) a description of any inclusion/exclusion criteria that were applied to participant inclusios, c) a table of relevant demographic details, d) a statement as to whether your sample can be considered representative of a larger population, e) descriptions of where participants were recruited and where the research took place. 3. Please amend your list of authors on the manuscript to ensure that each author is linked to an affiliation. Authors’ affiliations should reflect the institution where the work was done (if authors moved subsequently, you can also list the new affiliation stating “current affiliation:….” as necessary). [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes Reviewer #2: Partly Reviewer #3: Yes ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: No Reviewer #3: Yes ****** 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #2: No Reviewer #3: Yes ****** 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes Reviewer #3: Yes ****** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: Your manuscript is interesting and well written. In your manuscript you investigated the relationships of GLS with TDI measurements of SExc and s`, LVEDL and heart rate in a group of subjects without a history of heart failure.Your manuscript is interesting in the purpose and results. It is technically sound and well written. Reviewer #2: The authors investigates relation of GLS with TDI measures. They concludes that GLS is more closely related to Long-axis systolic excursion (SExc) than peak systolic velocity (s’) of mitral annular motion, and is also independently and inversely related to LV end-diastolic length (LVEDL) and heart rate. It is well known that SExc and s’ are additional technique to evaluate systolic function even if ejection fraction is within normal values. Therefore, this observation is not innovative. Several studies have shown that GLS is reduced in particular setting of patient with normal EF and this alteration has important therapeutic implications. Techniques to evaluate systolic function proposed by authors can be used when the images are not of good quality. In my opinion manuscript is not innovative. This is a retrospective study and analysis was performed on stress echocardiograms and this is a strong limit. GLS evaluated in a retrospective study on stress echocardiograms is not reliable and probably this justifies the results of the study. For these reasons, in my opinion manuscript is not suitable for publication. Reviewer #3: The authors demonstrated, in subjects with normal LVEF but reduced e`, that the absolute value of GLS is more closely related to SExc than s`, and that measurement of SExc may provide an additional or alternative technique for the assessment of LV long-axis function when GLS is not available or not feasible. Some minor comments: - The study claims are convincing and well supported by the experimental data. - The manuscript is clearly written and fair in the treatment of previous literature. However, introduction and discussion sections in some parts are too long and difficult to follow. - Methods: methodology of SExc measurements needs to be described. - The images are coherent, however not easy to interpret. Please provide descriptive figure legends. - Please add the reference lines (+/- 1,96 SD) to the Bland Altman plots; - A figure with scatter plots describing the GLS linear correlations may render the paper more accessible. ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review?** For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No Reviewer #2: No Reviewer #3: No [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files to be viewed.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email us at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0235791.r001
Revision 1
23 May 2020 Author Response 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf Author response: The manuscript has been checked that it meets PLOS ONE requirements. 2. In your Methods section, please provide additional information about the participants included in the analysis. Please ensure you have provided sufficient details to replicate the analyses such as: a) a description of any inclusion/exclusion criteria that were applied to participant inclusions, Author response: A number of exclusion criteria were already listed in the Subjects subsection of the Methods section but an adjustment has also been to this subsection to provide some additional information about the exclusion and inclusion criteria for the study. c) a table of relevant demographic details, Author response: Table 1 already provides relevant demographic details about the subjects. d) a statement as to whether your sample can be considered representative of a larger population, Author response: The main aim of this study was methodological, with the subject selection largely based on methodological issues and not on the desire to describe a particular population. There is already a limitations paragraph in the Discussion which says that It cannot be assumed that the relationships we found would be present in subjects selected on the basis of different criteria. A statement has been added to this paragraph related to the methodological issue (which applies to any study in which the relationship of GLS with other variables is examined) that if GLS is not measurable in a subject then it cannot be compared to TDI variables. e) descriptions of where participants were recruited and where the research took place. Author response: There is now an additional phrase in the Subjects subsection which indicates that the echocardiographic studies were performed in our institution (Monash Health). 3. Please amend your list of authors on the manuscript to ensure that each author is linked to an affiliation. Authors’ affiliations should reflect the institution where the work was done (if authors moved subsequently, you can also list the new affiliation stating “current affiliation:….” as necessary). Author response: The affiliation for each author has been added. Comments to the Author We thank all the reviewers for their interest and comments. Reviewer #1: Your manuscript is interesting and well written. In your manuscript you investigated the relationships of GLS with TDI measurements of SExc and s`, LVEDL and heart rate in a group of subjects without a history of heart failure. Your manuscript is interesting in the purpose and results. It is technically sound and well written. Author response: We are very pleased that Reviewer 1 found the manuscript to be interesting, technically sound and well written. Reviewer #2: The authors investigates relation of GLS with TDI measures. They concludes that GLS is more closely related to Long-axis systolic excursion (SExc) than peak systolic velocity (s’) of mitral annular motion, and is also independently and inversely related to LV end-diastolic length (LVEDL) and heart rate. It is well known that SExc and s’ are additional technique to evaluate systolic function even if ejection fraction is within normal values. Therefore, this observation is not innovative. Several studies have shown that GLS is reduced in particular setting of patient with normal EF and this alteration has important therapeutic implications. Techniques to evaluate systolic function proposed by authors can be used when the images are not of good quality. In my opinion manuscript is not innovative. Author response: Reviewer 2 seems to have misunderstood the aim of this study. There was no suggestion made by the authors that the techniques of s` and SExc were considered innovative. Indeed, that s`, SExc and GLS had all been studied before in subjects with a normal EF was clearly described in the Introduction and elaborated further in the Discussion. However, whether the systolic TDI variables provide the same information as GLS cannot be assumed. The aim of this study was to investigate the relationships of GLS with s`, SExc, LVEDL and heart rate, a systematic investigation of which is new, as to the best of our knowledge it has not been performed previously. That GLS is more closely correlated with SExc and s` has not been previously reported. This is a retrospective study and analysis was performed on stress echocardiograms and this is a strong limit. GLS evaluated in a retrospective study on stress echocardiograms is not reliable and probably this justifies the results of the study. For these reasons, in my opinion manuscript is not suitable for publication. Author response: The authors can see no implications for the conclusions of the study related to the subjects being identified retrospectively, particularly as the exclusion and inclusion criteria are clearly stated in the manuscript. Neither can the authors understand why there might be an objection that the study group had all undergone stress echocardiography as stress echocardiography has been performed in previous studies in which inducible ischaemia was an exclusion criteria for the study. We also have tried to address the possibility that there was a misunderstanding regarding the timing of the imaging, with Reviewer 2 possibly thinking that GLS and TDI was performed on images obtained after exercise. GLS, s` and SExc were measured in all subjects on baseline (resting) images obtained with the subjects lying in a left lateral position. The Methods section has been changed to make this clear. Reviewer #3: The authors demonstrated, in subjects with normal LVEF but reduced e`, that the absolute value of GLS is more closely related to SExc than s`, and that measurement of SExc may provide an additional or alternative technique for the assessment of LV long-axis function when GLS is not available or not feasible. Some minor comments: - The study claims are convincing and well supported by the experimental data. - The manuscript is clearly written and fair in the treatment of previous literature. However, introduction and discussion sections in some parts are too long and difficult to follow. Author response: We are very pleased that Reviewer 3 found the study claims convincing and well supported by the experimental data and the manuscript to be clearly written. Without any specific sections highlighted as being problematic, we have not been able to address this issue raised by the Reviewer that some parts of the manuscript being too long or difficult to follow. - Methods: methodology of SExc measurements needs to be described. Author response: An addition has been added to the Methods section with regard to SExc measurement. - The images are coherent, however not easy to interpret. Please provide descriptive figure legends. Author response: A more detailed figure legend has now been included for the Bland Altman plots (now Fig 3A, 3B & 3C in the revised manuscript). Because we did not want the way the data was presented to imply any significance from there being different signs for the biases of GLS and the TDI variables, Table 5 showing reproducibility measurements has been altered so that the one observer who measured both GLS and TDI variables is now shown as Observer 1 and the two other observers, one who measured GLS and one who measured TDI variables, are now shown as Observer 2. This results in all the biases being positive and the plots have been adjusted to show this. The alterations do not change anything fundamental about the interpretation regarding reproducibility. - Please add the reference lines (+/- 1,96 SD) to the Bland Altman plots; Author response: The lines corresponding to the 95% confidence limits (+/- 1,96 SD) have been added to the Bland Altman plots - A figure with scatter plots describing the GLS linear correlations may render the paper more accessible. Author response: There are now figures included which show scatter plots and the correlations of GLS with s` and SExc (Fig 1 and Fig 2). Attachments Attachment Submitted filename: Response to reviewers PONE-D-20-06704.docx https://doi.org/10.1371/journal.pone.0235791.r002
15 Jun 2020 Decision Letter - Giuseppina Novo, Editor PONE-D-20-06704R1 Relationships of global longitudinal strain with s`, long-axis systolic excursion, left ventricular length and heart rate PLOS ONE Dear Dr. Peverill, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that the manuscript is improved but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. Please submit your revised manuscript by Jul 30 2020 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols We look forward to receiving your revised manuscript. Kind regards, Giuseppina Novo Academic Editor PLOS ONE [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation. Reviewer #1: All comments have been addressed Reviewer #3: All comments have been addressed ******** 2. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: (No Response) Reviewer #3: Yes ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: (No Response) Reviewer #3: Yes ****** 4. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: (No Response) Reviewer #3: Yes ****** 5. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: (No Response) Reviewer #3: Yes ****** 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: (No Response) Reviewer #3: The manuscript has been improved considerably. I am happy with the edits that were made in response to my earlier review. ****** 7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review?** For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No Reviewer #3: No [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0235791.r003
Revision 2
19 Jun 2020 Author Response I understand from the Editor that the revised manuscript was accepted and that no further changes are required. Roger Peverill Attachments Attachment Submitted filename: Response to reviewers PONE-D-20-06704.docx https://doi.org/10.1371/journal.pone.0235791.r004
23 Jun 2020 Decision Letter - Giuseppina Novo, Editor Relationships of global longitudinal strain with s`, long-axis systolic excursion, left ventricular length and heart rate PONE-D-20-06704R2 Dear Dr. Peverill, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Giuseppina Novo Academic Editor PLOS ONE Additional Editor Comments (optional): Dear Author, I apologize for the inconvenience. Reviewers' comments: https://doi.org/10.1371/journal.pone.0235791.r005
Formally Accepted
10 Jul 2020 Acceptance Letter - Giuseppina Novo, Editor PONE-D-20-06704R2 Relationships of global longitudinal strain with s`, long-axis systolic excursion, left ventricular length and heart rate Dear Dr. Peverill: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Professor Giuseppina Novo Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0235791.r006

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