Department of Cardiology and Institute for Cardiovascular Research, VU University Medical Center, Amsterdam, The Netherlands.
Am J Cardiol. 2011 Oct 1;108(7):1038-44. doi: 10.1016/j.amjcard.2011.05.042. Epub 2011 Jul 23.
In an era of rapidly expanding and evolving 3-dimensional echocardiographic (3DE) technology, 1 of the issues facing the 3DE quantification of chamber volumes and function is that different software vendors use different methodologies and algorithms. The aim of this study was to evaluate the comparability and reproducibility of 3DE direct volumetric and speckle-tracking methods for left ventricular (LV) and left atrial (LA) chamber quantification. A total of 120 subjects (mean age 53 ± 17 years, 65% men), including 88 unselected patients and 32 healthy volunteers, underwent 3DE acquisitions and analysis using direct volumetric and speckle-tracking methods successively. Measurements of LV and LA volumes and LV function were compared between the 2 3DE methods. Additionally, intraobserver and interobserver reproducibility was assessed in 40 randomly selected patients. Measurements of LV end-diastolic volume, end-systolic volume, and ejection fraction by 3DE direct volumetric and 3DE speckle-tracking methods were comparable, with good correlations (r = 0.98, r = 0.98, and r = 0.87, respectively), small biases, and narrow limits of agreement (-1 ± 8 ml, -1 ± 8 ml, and 0 ± 6%, respectively). For measurements of LA end-systolic volume and end-diastolic volume, similar correlations (r = 0.96 for both), small biases, and narrow limits of agreement (-2 ± 6 and -1 ± 5 ml, respectively) were found between the 2 methods. Intraobserver and interobserver reproducibility for LV and LA quantification were comparable for the 2 methods. In conclusion, 3DE direct volumetric and speckle-tracking methods give comparable and reproducible quantification of LV and LA volumes and function, making interchangeable application a viable option in daily clinical practice.
在三维超声心动图(3DE)技术迅速发展和演变的时代,3DE 容积和功能定量所面临的问题之一是,不同的软件供应商使用不同的方法和算法。本研究旨在评估 3DE 直接容积和斑点追踪方法用于左心室(LV)和左心房(LA)容积和功能定量的可比性和可重复性。共有 120 例患者(平均年龄 53 ± 17 岁,65%为男性),包括 88 例非选择性患者和 32 例健康志愿者,分别使用直接容积和斑点追踪方法进行 3DE 采集和分析。比较了 2 种 3DE 方法的 LV 和 LA 容积和 LV 功能测量值。此外,还在 40 例随机选择的患者中评估了观察者内和观察者间的可重复性。3DE 直接容积法和 3DE 斑点追踪法测量 LV 舒张末期容积、收缩末期容积和射血分数具有良好的相关性(r = 0.98、r = 0.98 和 r = 0.87),较小的偏差和较窄的一致性限度(-1 ± 8 ml、-1 ± 8 ml 和 0 ± 6%)。对于 LA 收缩末期容积和舒张末期容积的测量,两种方法之间也存在相似的相关性(r = 0.96),较小的偏差和较窄的一致性限度(分别为-2 ± 6 和-1 ± 5 ml)。两种方法对 LV 和 LA 定量的观察者内和观察者间可重复性相当。总之,3DE 直接容积法和斑点追踪法可对 LV 和 LA 容积和功能进行可比且可重复的定量,使得在日常临床实践中可互换应用成为一种可行的选择。