Leischik R, Dworrak B, Hensel K
Department of Cardiology, Section Prevention and Sports Medicine, Witten/Herdecke University, Faculty of Health, School of Medicine, Hagen, Germany.
Helios Children Hospital, Witten/Herdecke University, Faculty of Health, School of Medicine, Wuppertal, Germany.
Open Cardiovasc Med J. 2014 Oct 17;8:102-9. doi: 10.2174/1874192401408010102. eCollection 2014.
Strain echocardiography (StE) promises to be a new tool for quantitative assessment of cardiac function. Analysis of intra- and interobserver reliability is an important aspect in the process of developing these novel techniques from theory to the implementation into daily routine diagnostics.The purpose of the study was to estimate reliability of the segmental StE.
Left ventricular strain analysis for radial strain (RS), circumferential strain (CS) and longitudinal strain (LS) was performed in 21 healthy volunteers. RS and CS values were obtained in the parasternal short axis at the level of the papillary muscles. LS values were determined in the apical 2-, 3- and 4-chamber views. Cine-loops were recorded and quantitative analyses were conducted on an off-line workstation.
Intraobserver reproducibility was highest using LS in the 4-chamber view (9 ± 13.6 % mean deviation, rho = 0.624, p = 0.003), followed by CS (13.3 ± 8.3 %, rho = 0.406, p = 0.068) and lowest in RS (26.3 ± 30.1 %, rho = 0.391, p = 0.080). Interobserver analyses of LS derived from 3-chamber view showed lowest deviation (11.9 ± 9.5 %, rho = 0.513, p = 0.017), followed by CS (15.2 ± 12.0 %, 0.263, p = 0.249) and the least consistent measurements in RS (35.9 ± 46.3 %, rho 0.382, p = 0.088).
This study shows that the clinical utility of StE depends on the regional differences of LV wall motion and image quality. LS-values showed promising intra- and interobserver reproducibility values. For quantitative follow-up studies LS should be preferred.
应变超声心动图（StE）有望成为定量评估心功能的新工具。分析观察者内和观察者间的可靠性是将这些新技术从理论发展到日常诊断应用过程中的一个重要方面。本研究的目的是评估节段性StE的可靠性。
对21名健康志愿者进行左心室应变分析，包括径向应变（RS）、圆周应变（CS）和纵向应变（LS）。RS和CS值在乳头肌水平的胸骨旁短轴获取。LS值在心尖两腔、三腔和四腔视图中测定。记录电影环，并在离线工作站上进行定量分析。
观察者内再现性在四腔视图中使用LS时最高（平均偏差9±13.6%，rho = 0.624，p = 0.003），其次是CS（13.3±8.3%，rho = 0.406，p = 0.068），RS最低（26.3±30.1%，rho = 0.391，p = 0.080）。从三腔视图得出的LS的观察者间分析显示偏差最低（11.9±9.5%，rho = 0.513，p = 0.017），其次是CS（15.2±12.0%，0.263，p = 0.249），RS测量的一致性最差（35.9±46.3%，rho 0.382，p = 0.088）。
本研究表明StE的临床效用取决于左心室壁运动的区域差异和图像质量。LS值显示出良好 的观察者内和观察者间再现性值。对于定量随访研究，应首选LS。
