评估心房颤动患者的左心房力学：二维斑点追踪应变与速度向量成像的比较。
Assessment of left atrial mechanics in patients with atrial fibrillation: comparison between two-dimensional speckle-based strain and velocity vector imaging.
机构信息
Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
出版信息
J Am Soc Echocardiogr. 2012 Apr;25(4):428-35. doi: 10.1016/j.echo.2011.12.020. Epub 2012 Jan 21.
BACKGROUND
Two-dimensional (2D) speckle tracking-derived left atrial (LA) strain (ε) facilitates comprehensive evaluation of LA contractile, reservoir, and conduit function; however, its dependence on the individual software used for assessment has not been evaluated. The aim of this study was to compare LA ε derived from two different speckle-tracking software technologies, Velocity Vector Imaging (VVI) and 2D speckle-tracking echocardiography (STE).
METHODS
VVI-derived and 2D STE-derived global longitudinal LA ε and ε rate (SR) were directly compared in 127 patients (mean age, 62 ± 10 years) with atrial fibrillation. Peak negative, peak positive, and total ε (corresponding to LA contractile, conduit, and reservoir function) were measured during sinus rhythm. Late negative (LA contraction), peak positive (left ventricular systole), and early negative (left ventricular early diastole) SR were also measured.
RESULTS
The measurement of LA ε and SR by both software was feasible in high proportions of patients (93% with VVI and 93% with 2D STE). The average analysis of ε(negative) was -7.24 ± 3.87% by VVI and -7.30 ± 3.37% by 2D STE (P = .84). The average analysis of ε(positive) was 14.52 ± 5.82% by VVI and 10.74 ± 4.51% by 2D STE (P < .01). The average analysis of ε(total) was 21.76 ± 7.39% by VVI and 18.04 ± 5.98% by 2D STE (P < .01). VVI-derived and 2D STE-derived ε(positive), ε(negative), and ε(total) had good correlations with one another (R = 0.79, R = 0.75, and R = 0.80), with low mean differences. Late negative, peak positive, and early negative SR were correlated less well (R = 0.78, R = 0.71, and R = 0.67).
CONCLUSIONS
LA ε measurement using both VVI and 2D STE is feasible in a large proportion of patients in clinical practice. VVI and 2D STE provide comparable LA ε and SR measurements for LA contractile function.
背景
二维（2D）斑点追踪技术衍生的左心房（LA）应变（ε）有助于全面评估 LA 的收缩、储存和传导功能；然而，其对评估中使用的个体软件的依赖性尚未得到评估。本研究旨在比较两种不同的斑点追踪软件技术——速度向量成像（VVI）和二维斑点追踪超声心动图（STE）衍生的 LA ε。
方法
在 127 例心房颤动患者（平均年龄 62±10 岁）中直接比较 VVI 衍生和 2D STE 衍生的整体纵向 LA ε 和 ε 率（SR）。窦性节律时测量峰值负向、峰值正向和总 ε（对应 LA 的收缩、传导和储存功能）。还测量了晚期负向（LA 收缩）、峰值正向（左心室收缩）和早期负向（左心室早期舒张）SR。
结果
两种软件均能对高比例的患者进行 LA ε 和 SR 测量（VVI 为 93%，2D STE 为 93%）。VVI 平均分析的 ε（负向）为-7.24±3.87%，2D STE 为-7.30±3.37%（P=0.84）。VVI 平均分析的 ε（正向）为 14.52±5.82%，2D STE 为 10.74±4.51%（P<0.01）。VVI 平均分析的 ε（总）为 21.76±7.39%，2D STE 为 18.04±5.98%（P<0.01）。VVI 衍生和 2D STE 衍生的 ε（正向）、ε（负向）和 ε（总）之间具有良好的相关性（R=0.79、R=0.75 和 R=0.80），平均差异较小。晚期负向、峰值正向和早期负向 SR 的相关性较差（R=0.78、R=0.71 和 R=0.67）。
结论
在临床实践中，使用 VVI 和 2D STE 均可对大部分患者进行 LA ε 测量。VVI 和 2D STE 可提供用于 LA 收缩功能的可比 LA ε 和 SR 测量值。
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