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斑点追踪超声心动图和特征追踪心脏磁共振成像的整体纵向应变和整体周向应变:与左心室射血分数的比较。

Global longitudinal strain and global circumferential strain by speckle-tracking echocardiography and feature-tracking cardiac magnetic resonance imaging: comparison with left ventricular ejection fraction.

机构信息

University of Pittsburgh, Pittsburgh, Pennsylvania.

Sundsvall Hospital, Sundsvall and Karolinska Institutet, Stockholm, Sweden.

出版信息

J Am Soc Echocardiogr. 2015 May;28(5):587-96. doi: 10.1016/j.echo.2014.11.018. Epub 2015 Jan 7.

Abstract

BACKGROUND

Left ventricular (LV) ejection fraction (EF) is a routine clinical standard to assess cardiac function. Global longitudinal strain (GLS) and global circumferential strain (GCS) have emerged as important LV functional measures. The objective of this study was to determine the relationships of GLS and GCS by speckle-tracking echocardiography and featuring-tracking cardiac magnetic resonance (CMR) to CMR EF as a standard of reference in the same patients.

METHODS

A total of 73 consecutive patients aged 55 ± 15 years clinically referred for both CMR and echocardiography (EF range, 8%-78%) were studied. Routine steady-state free precession CMR images were prospectively analyzed offline using feature-tracking software for LV GLS, GCS, volumes, and EF. GLS was averaged from three standard longitudinal views and GCS from the mid-LV short-axis plane. Echocardiographic speckle-tracking was used from the similar imaging planes for GLS, GCS, LV volumes, and EF.

RESULTS

Feature-tracking CMR strain was closely correlated with speckle-tracking strain in the same patients: GLS, r = -0.87; GCS, r = -0.92 (P < .0001). End-diastolic and end-systolic volumes and EF by feature-tracking CMR were significantly correlated with standard manual tracing of multiple CMR short-axis images (r = 0.97, r = 0.98, and r = 0.97, P < .0001 for all). GLS and GCS by echocardiography and CMR feature-tracking were closely correlated with standard CMR EF: r = -0.85 and r = -0.95, respectively (P < .001). Global strain measures (in absolute values) were correlated with EF using the formula EF = 3(GLS) + 8% or EF = 2.5(GCS) + 8%.

CONCLUSIONS

GLS and GCS by feature-tracking CMR analysis was a rapid means to obtain myocardial strain similar to speckle-tracking echocardiography. GLS and GCS were closely correlated with CMR EF in this patient series and may play a role in the clinical assessment of LV function.

摘要

背景

左心室(LV)射血分数(EF)是评估心功能的常规临床标准。整体纵向应变(GLS)和整体周向应变(GCS)已成为重要的 LV 功能测量指标。本研究的目的是确定斑点追踪超声心动图和特征追踪心脏磁共振(CMR)的 GLS 和 GCS 与同一患者 CMR EF 的关系。

方法

对 73 例年龄 55±15 岁的连续患者进行了临床 CMR 和超声心动图检查(EF 范围为 8%-78%)。前瞻性分析使用特征追踪软件进行的常规稳态自由进动 CMR 图像,用于 LV GLS、GCS、容积和 EF。GLS 从三个标准的纵向视图平均,GCS 从中 LV 短轴平面。超声心动图斑点追踪用于相同的成像平面进行 GLS、GCS、LV 容积和 EF。

结果

特征追踪 CMR 应变与同一患者的斑点追踪应变密切相关:GLS,r=-0.87;GCS,r=-0.92(P<.0001)。特征追踪 CMR 的舒张末期和收缩末期容积和 EF 与标准的多个 CMR 短轴图像的手动追踪显著相关(r=0.97,r=0.98,r=0.97,P<.0001 均)。超声心动图和 CMR 特征追踪的 GLS 和 GCS 与标准 CMR EF 密切相关:r=-0.85 和 r=-0.95(P<.001)。整体应变测量值(绝对值)与 EF 呈正相关,公式为 EF=3(GLS)+8%或 EF=2.5(GCS)+8%。

结论

CMR 分析的 GLS 和 GCS 是获得与斑点追踪超声心动图相似的心肌应变的快速方法。在该患者系列中,GLS 和 GCS 与 CMR EF 密切相关,可能在 LV 功能的临床评估中发挥作用。

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