健康受试者中三维斑点追踪超声心动图测量的左心室心肌应变：参考值及其生理和技术决定因素分析
Left ventricular myocardial strain by three-dimensional speckle-tracking echocardiography in healthy subjects: reference values and analysis of their physiologic and technical determinants.
作者信息
Muraru Denisa, Cucchini Umberto, Mihăilă Sorina, Miglioranza Marcelo Haertel, Aruta Patrizia, Cavalli Giacomo, Cecchetto Antonella, Padayattil-Josè Seena, Peluso Diletta, Iliceto Sabino, Badano Luigi P
机构信息
Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy.
Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy.
出版信息
J Am Soc Echocardiogr. 2014 Aug;27(8):858-871.e1. doi: 10.1016/j.echo.2014.05.010. Epub 2014 Jun 26.
BACKGROUND
Despite growing interest in applying three-dimensional (3D) speckle-tracking echocardiography (STE) to measure left ventricular (LV) myocardial deformation in various diseases, normative values for 3D speckle-tracking echocardiographic parameters and the effects of demographic, hemodynamic, and technical factors on these values are unknown.
METHODS
In 265 healthy volunteers (age range, 18-76; 57% women), longitudinal strain (3DLε), circumferential strain (3DCε), radial strain (3DRε), and area strain (3DAε) were measured by using vendor-specific (Vsp) 3D speckle-tracking echocardiographic equipment. LV strain was also measured by using Vsp two-dimensional (2D) and vendor-independent 3D speckle-tracking echocardiographic software packages, for comparison.
RESULTS
Reference values (lower limit of normality) for Vsp 3D STE were -17% to -21% (-15%) for 3DLε, -17% to -20% (-14%) for 3DCε, -31% to -36% (-26%) for 3DAε, and 47% to 59% (38%) for 3DRε. Three-dimensional longitudinal strain decreased, whereas 3DCε increased, with aging (P < .003), with different trends in men and women. Men had lower 3DLε, 3DRε, 3DAε, and 2D longitudinal strain than women (P < .02). LV 3D strain parameters were also influenced by LV volumes and mass, image quality, and temporal resolution (P < .02). Reference values obtained by Vsp 2D STE were -20% to -23% (-18%) for 2D longitudinal strain, -20% to -24% (-17%) for 2D circumferential strain, and 39% to 54% (28%) for 2D radial strain (P < .001 vs Vsp 3D STE). Significantly different 3DCε and 3DRε values were obtained with vendor-independent versus Vsp 3D STE (P < .001).
CONCLUSIONS
In healthy subjects, reference values of LV 3D strain parameters were significantly influenced by demographic, cardiac, and technical factors. Limits of normality of LV strain by Vsp 3D STE should not be used interchangeably with Vsp 2D STE or with Vin 3D STE software.
背景
尽管将三维（3D）斑点追踪超声心动图（STE）应用于测量各种疾病中左心室（LV）心肌变形的兴趣日益浓厚，但3D斑点追踪超声心动图参数的正常参考值以及人口统计学、血流动力学和技术因素对这些值的影响尚不清楚。
方法
在265名健康志愿者（年龄范围18 - 76岁；57%为女性）中，使用特定厂家（Vsp）的3D斑点追踪超声心动图设备测量纵向应变（3DLε）、圆周应变（3DCε）、径向应变（3DRε）和面积应变（3DAε）。还使用Vsp二维（2D）和独立于厂家的3D斑点追踪超声心动图软件包测量LV应变，以作比较。
结果
Vsp 3D STE的参考值（正常下限）为3DLε为-17%至-21%（-15%），3DCε为-17%至-20%（-14%），3DAε为-31%至-36%（-26%），3DRε为47%至59%（38%）。随着年龄增长，三维纵向应变降低，而3DCε增加（P <.003），男性和女性有不同趋势。男性的3DLε、3DRε、3DAε和二维纵向应变低于女性（P <.02）。LV 3D应变参数也受LV容积和质量、图像质量和时间分辨率的影响（P <.02）。Vsp 2D STE获得的参考值为二维纵向应变为-20%至-23%（-18%），二维圆周应变为-20%至-24%（-17%），二维径向应变为39%至54%（28%）（与Vsp 3D STE相比，P <.001）。独立于厂家的3D STE与Vsp 3D STE获得的3DCε和3DRε值有显著差异（P <.001）。
结论
在健康受试者中，LV 3D应变参数的参考值受人口统计学、心脏和技术因素的显著影响。Vsp 3D STE的LV应变正常范围不应与Vsp 2D STE或Vin 3D STE软件互换使用。
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