Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan.
J Am Soc Echocardiogr. 2013 Nov;26(11):1274-1281.e4. doi: 10.1016/j.echo.2013.07.006. Epub 2013 Aug 14.
The aim of this study was to investigate the effect of out-of-plane motion on discrepancies in strain measurements between two-dimensional (2D) and three-dimensional (3D) echocardiography.
Two-dimensional and 3D data sets were acquired in 54 patients. Using 2D and 3D speckle-tracking software, global circumferential strain (CS) and longitudinal strain (LS) as well as CS and LS at three left ventricular (LV) levels was measured. The effect of through-plane motion was assessed by mitral annular displacement.
Although a good correlation of global CS was noted between the two methods (r = 0.80, P < .01), mean values of global CS were significantly higher on 3D compared with 2D echocardiography. Correlations of CS and their mean differences were 0.65 and -4.61 at the basal level, 0.76 and -4.17 at the midventricular level, and 0.60 and -2.23 at the apical level, respectively. Correlation of global CS between the two methods was higher in patients who showed mitral annular displacement < 9.4 mm (r = 0.81) compared with those with mitral annular displacement ≥ 9.4 mm (r = 0.61). A good correlation of global LS (r = 0.89, P < .01) was noted, with no significant bias. Correlations of LS and their mean differences were 0.52 and 1.59 at the basal level, 0.89 and -1.17 at the midventricular level, and 0.73 and 1.46 at the apical level, respectively. Correlation of LS between the two methods was higher in patients who showed LV twist < 12.2° (r = 0.94) compared with patients with LV twist ≥ 12.2° (r = 0.68).
Through-plane motion produced discrepancies in CS measurements, especially at the LV basal level. Larger bias of LS at the basal and apical LV levels compared with the midventricular level between the two methods suggests that LV twisting also affects the calculation of 2D LS.
本研究旨在探讨平面外运动对二维（2D）和三维（3D）超声心动图应变测量差异的影响。
在 54 例患者中采集了 2D 和 3D 数据集。使用 2D 和 3D 斑点追踪软件测量了整体圆周应变（CS）和纵向应变（LS）以及左心室（LV）三个水平的 CS 和 LS。通过二尖瓣环位移评估了平面外运动的影响。
尽管两种方法的整体 CS 相关性较好（r = 0.80，P <.01），但 3D 超声心动图的整体 CS 平均值明显高于 2D 超声心动图。CS 的相关性及其平均差值分别为基底水平为 0.65 和-4.61，中间水平为 0.76 和-4.17，心尖水平为 0.60 和-2.23。在二尖瓣环位移<9.4mm 的患者中，两种方法之间 CS 的相关性更高（r = 0.81），而在二尖瓣环位移≥9.4mm 的患者中，相关性较低（r = 0.61）。两种方法的整体 LS 相关性较好（r = 0.89，P <.01），无显著偏倚。LS 的相关性及其平均差值分别为基底水平为 0.52 和 1.59，中间水平为 0.89 和-1.17，心尖水平为 0.73 和 1.46。在 LV 扭转<12.2°的患者中，两种方法之间 LS 的相关性更高（r = 0.94），而在 LV 扭转≥12.2°的患者中，相关性较低（r = 0.68）。
平面外运动导致 CS 测量存在差异，尤其是在 LV 基底水平。两种方法在 LV 基底和心尖水平的 LS 偏差较大，而在中间水平偏差较小，这表明 LV 扭转也会影响 2D LS 的计算。
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