Schmid Johannes, Kaufmann Reinhard, Grübler Martin R, Verheyen Nicolas, Weidemann Frank, Binder Josepha S
Division of Cardiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
Division of General Radiology, Department of Radiology, Medical University of Graz, Graz, Austria.
Echocardiography. 2016 Mar;33(3):372-8. doi: 10.1111/echo.13100. Epub 2015 Oct 30.
Myocardial strain and strain rate (SR) can be derived from either tissue Doppler (TDI) information or two-dimensional speckle tracking. As conventional TDI analysis (TDI-manual) is time-consuming with poor reproducibility, we developed a faster semiautomated approach (TDI-ST). We aimed to study the comparability of TDI-ST with TDI-manual, an established method for measuring strain and SR.
Forty healthy subjects (mean age 38.3 ± 12.8 years) and 16 patients with FHL-1 cardiomyopathy (CMP) (36.8 ± 14.2 years) were analyzed with TDI-manual and TDI-ST. TDI-ST was performed with commercial software, using speckle tracking for myocardial tracking and TDI information to derive longitudinal strain and SR from high frame rate TDI recordings. Measurements of longitudinal systolic strain (S) and global S (GLS) made with the two methods were compared with Bland-Altman plots and Deming regression. Receiver operating characteristics (ROC) curves were used to compare discrimination between healthy individuals and patients.
Mean S was -20.11 ± 4.85% (healthy) and -16.12 ± 4.44% (CMP) with TDI-ST and -21.15 ± 5.68% (healthy) and -16.27 ± 6.44 (CMP) with TDI-manual. Using all measured segments, the mean bias was 0.78% strain toward less negative S with TDI-ST; the Deming regression slope was 0.7 for S and 0.9 for GLS. Intra- and inter-observer CVs were 5.4% and 7.0%, respectively. ROC curves showed no significant differences between the methods.
The described S and SR measurements with TDI-ST are comparable to conventional manual analysis. Thus, using TDI-ST, it is possible to quickly and easily extract high-resolution deformation data.
心肌应变和应变率（SR）可从组织多普勒（TDI）信息或二维散斑追踪得出。由于传统的TDI分析（TDI-手动）耗时且重复性差，我们开发了一种更快的半自动方法（TDI-ST）。我们旨在研究TDI-ST与TDI-手动（一种测量应变和SR的既定方法）的可比性。
对40名健康受试者（平均年龄38.3±12.8岁）和16名FHL-1型心肌病（CMP）患者（36.8±14.2岁）进行TDI-手动和TDI-ST分析。TDI-ST使用商业软件进行，利用散斑追踪进行心肌追踪，并使用TDI信息从高帧率TDI记录中得出纵向应变和SR。用两种方法测量的纵向收缩期应变（S）和整体S（GLS）通过Bland-Altman图和Deming回归进行比较。采用受试者工作特征（ROC）曲线比较健康个体与患者之间的鉴别能力。
TDI-ST测得的平均S在健康受试者中为-20.11±4.85%，在CMP患者中为-16.12±4.44%；TDI-手动测得的平均S在健康受试者中为-21.15±5.68%，在CMP患者中为-16.27±6.44%。使用所有测量节段，TDI-ST测得的S向较不负值方向的平均偏差为0.78%应变；S的Deming回归斜率为0.7，GLS的为0.9。观察者内和观察者间变异系数分别为5.4%和7.0%。ROC曲线显示两种方法之间无显著差异。
所述的TDI-ST测量的S和SR与传统的手动分析具有可比性。因此，使用TDI-ST可以快速、轻松地提取高分辨率变形数据。
