Institute of Clinical Medicine, University of Tsukuba, Tsukuba, Japan.
JACC Cardiovasc Imaging. 2011 Apr;4(4):358-65. doi: 10.1016/j.jcmg.2010.12.007.
The aim of this experimental study was to validate area tracking by 3-dimensional (3D) speckle tracking imaging (STI) as a method to measure changes in regional left ventricular (LV) endocardial surface area with sonomicrometry and to assess the usefulness as a wall motion evaluation method compared with 1-dimensional strain parameters.
A 3D-STI allows for tracking a regional endocardial surface area during a cardiac cycle. Area tracking is a new concept that regional wall motion is quantified through the magnitude of deformation in an endocardial surface area.
In each of 8 anesthetized sheep, sonomicrometry crystals were implanted on the endocardium at the LV mid and apical anterior walls. Area change ratio (ACR) that was a novel parameter obtained by area tracking was measured as percentage change in a segmental area during systole. Segmental longitudinal (LS) and circumferential strain (CS) also were measured by 3D-STI. The ACR, LS, and CS were compared with those by sonomicrometry at baseline and during pharmacological stress tests (dobutamine and propranolol infusion) and acute myocardial ischemia induced by occlusion of mid-left ascending artery.
The strong correlation was observed between ACR measurements by 3D-STI and those by sonomicrometry (Y = -4.20 + 0.84X, r = 0.87, p < 0.001). The ACR showed significant relations with both LS and CS (LS: Y = -15.1 + 1.73X, r = 0.73, p < 0.001; CS: Y = -5.85 + 1.06X, r = 0.79, p < 0.001). ACR showed significant differences among baseline, pharmacological stress, and acute myocardial ischemia. In contrast, LS and CS were reduced significantly during acute ischemia studies compared with those during the other studies; no differences were observed among baseline, propranolol infusion, and dobutamine infusion studies.
Area tracking by 3D-STI can estimate changes in LV regional area and might be promising for regional wall motion evaluations.
本实验研究的目的是通过三维（3D）斑点追踪成像（STI）验证面积跟踪作为一种通过超声心动描记术测量局部左心室（LV）心内膜表面面积变化的方法，并评估其作为壁运动评估方法的有效性与一维应变参数相比。
3D-STI 允许在心动周期内跟踪局部心内膜表面面积。面积跟踪是一种新的概念，通过心内膜表面面积的变形幅度来量化局部壁运动。
在 8 只麻醉绵羊中，在 LV 中、心尖前壁的心内膜上植入超声心动描记术晶体。通过面积跟踪获得的新参数面积变化比（ACR），被测量为收缩期节段面积的百分比变化。还通过 3D-STI 测量节段性纵向（LS）和环向应变（CS）。在基线和药物应激试验（多巴酚丁胺和普萘洛尔输注）以及中左升主动脉闭塞引起的急性心肌缺血期间，将 ACR 与超声心动描记术的 LS 和 CS 进行比较。
3D-STI 测量的 ACR 与超声心动描记术测量的 ACR 之间存在很强的相关性（Y=-4.20+0.84X，r=0.87，p<0.001）。ACR 与 LS 和 CS 均有显著关系（LS：Y=-15.1+1.73X，r=0.73，p<0.001；CS：Y=-5.85+1.06X，r=0.79，p<0.001）。ACR 在基线、药物应激和急性心肌缺血之间存在显著差异。相比之下，LS 和 CS 在急性缺血研究中与其他研究相比明显降低；在基线、普萘洛尔输注和多巴酚丁胺输注研究中未观察到差异。
3D-STI 的面积跟踪可以估计 LV 局部区域的变化，并且可能对局部壁运动评估有很大的应用前景。
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