Division of Cardiothoracic Anesthesiology and Critical Care Medicine, Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710, USA.
J Cardiothorac Vasc Anesth. 2012 Feb;26(1):17-25. doi: 10.1053/j.jvca.2011.06.002. Epub 2011 Aug 11.
The authors hypothesized that the measurement of strain by speckle tracking with transesophageal echocardiography (TEE) is feasible and comparable to transthoracic echocardiography (TTE).
A prospective observational comparative study.
A university hospital.
Adult patients undergoing elective cardiac surgery.
Structured intraoperative TTE and TEE examination.
Images were obtained after the induction of anesthesia from 25 patients to enable speckle tracking of the left ventricle in comparable short- and long-axis (SAX and LAX) views using TTE and TEE. Left ventricular strain was measured offline using both modalities and correlation assessed using the Pearson test with assessment of bias using the Bland-Altman method. Significantly more segments were tracked by TEE than TTE in LAX views but not SAX views. Correlation was moderate between TTE and TEE (r = 0.5-0.6) for longitudinal strain in the LAX views, whereas it was poor for regional radial strain (r = 0.07). Correlation for global circumferential strain was higher for the apical SAX views (r = 0.7) than the basal or mid- SAX views. Speckle tracking by TEE showed excellent reproducibility with small bias.
Strain measured by speckle tracking in TEE correlated moderately with TTE for global strain and poorly for regional strain. This may be explained by differences in scanning frequency and other imaging factors. Nevertheless, because of the high degree of reproducibility, it may be a useful tool to quantify intraoperative changes in ventricular function with TEE. However, equivalence between TTE and TEE cannot be assumed, and limits of comparability should be recognized.
作者假设经食管超声心动图（TEE）的斑点追踪测量应变是可行的，并且与经胸超声心动图（TTE）相当。
前瞻性观察性比较研究。
一所大学医院。
接受择期心脏手术的成年患者。
进行结构性术中 TTE 和 TEE 检查。
从 25 名患者中获得麻醉诱导后的图像，以便使用 TTE 和 TEE 在可比的短轴（SAX）和长轴（LAX）视图中对左心室进行斑点追踪。使用两种方式离线测量左心室应变，并使用 Pearson 检验评估相关性，使用 Bland-Altman 方法评估偏差。在 LAX 视图中，TEE 比 TTE 跟踪的节段更多，但在 SAX 视图中则不然。LAX 视图中，TTE 和 TEE 之间的纵向应变相关性中等（r = 0.5-0.6），而局部径向应变相关性较差（r = 0.07）。心尖 SAX 视图的整体圆周应变相关性较高（r = 0.7），而基底或中部 SAX 视图则较低。TEE 的斑点追踪具有出色的可重复性，偏差较小。
TEE 的斑点追踪测量的应变与 TTE 的整体应变相关性中等，与局部应变相关性较差。这可能是由于扫描频率和其他成像因素的差异所致。尽管如此，由于具有高度的可重复性，它可能是一种有用的工具，可以使用 TEE 定量术中心室功能的变化。但是，不能假设 TTE 和 TEE 之间具有等效性，应该认识到可比性的限制。
