Park Chloe M, March Katherine, Williams Suzanne, Kukadia Suraj, Ghosh Arjun K, Jones Siana, Tillin Therese, Chaturvedi Nish, Hughes Alun D
International Centre for Circulatory Health, Imperial College London, London, United Kingdom.
PLoS One. 2013 Sep 13;8(9):e75098. doi: 10.1371/journal.pone.0075098. eCollection 2013.
Changes in ventricular rotation measured by two-dimensional speckle tracking echocardiography (2DSTE) are early indicators of cardiac disease. Data on the clinical feasibility of this important measure are scarce and there is no information on the comparability of different software versions. We assessed the feasibility, reproducibility and within patient temporal variability of 2DSTE in a large community based sample of older adults. We additionally compared 2DSTE results to those generated by 3DSTE.
1408 participants underwent transthoracic echocardiography. Using Philips Qlab 8.1 peak LV rotation at either the base or the apex was analysable in 432 (31%) participants. Peak twist measurements were achieved in 274 (20%) participants. 66 participants were randomly selected for the reproducibility study. 20 additional participants had scans 4-6 weeks apart for temporal variability and 3D echocardiography to assess the agreement between 2DSTE and 3DSTE. Reproducibility was evaluated using the intraclass coefficient of correlation (ICC). Better reproducibility for rotation and twist were obtained when measured at the endocardium, and when using more recent software versions, Peak twist and rotation were significantly different using two versions of the same software. Agreement with 3DSTE was better using newer software.
Feasibility of 2DSTE is low in this cohort of elderly individuals severely limiting its utility in clinical settings. However if high quality images can be acquired assessment of ventricular rotation by 2DSTE is reproducible. Caution should be taken when comparing measurements of ventricular rotation by software from different vendors or different versions of software from the same vendor.
二维斑点追踪超声心动图（2DSTE）测量的心室旋转变化是心脏疾病的早期指标。关于这一重要测量方法临床可行性的数据很少，且没有关于不同软件版本可比性的信息。我们在一个基于社区的老年人大样本中评估了2DSTE的可行性、可重复性及患者内部的时间变异性。我们还将2DSTE的结果与三维斑点追踪超声心动图（3DSTE）产生的结果进行了比较。
1408名参与者接受了经胸超声心动图检查。使用飞利浦QLab 8.1软件，432名（31%）参与者的左心室底部或顶部的峰值旋转可进行分析。274名（20%）参与者完成了峰值扭转测量。随机选择66名参与者进行可重复性研究。另外20名参与者在4 - 6周的间隔期内进行扫描，以评估时间变异性，并进行三维超声心动图检查以评估2DSTE与3DSTE之间的一致性。使用组内相关系数（ICC）评估可重复性。在心内膜测量以及使用更新的软件版本时，旋转和扭转的可重复性更好。使用同一软件的两个版本时，峰值扭转和旋转存在显著差异。使用更新软件时与3DSTE的一致性更好。
在这一老年人群体中，2DSTE的可行性较低，严重限制了其在临床环境中的应用。然而，如果能够获取高质量图像，通过2DSTE评估心室旋转是可重复的。在比较不同供应商的软件或同一供应商不同版本软件测量的心室旋转时应谨慎。
