二维超声心动图和心脏磁共振成像评估左心室力学：高分辨率斑点追踪和特征追踪的比较。
Left ventricular mechanics assessed by two-dimensional echocardiography and cardiac magnetic resonance imaging: comparison of high-resolution speckle tracking and feature tracking.
机构信息
Department of Internal Medicine III, Cardiology, Angiology and Pneumology, University of Heidelberg, Im Neuenheimer Feld 410, Heidelberg 69120, Germany
Department of Internal Medicine III, Cardiology, Angiology and Pneumology, University of Heidelberg, Im Neuenheimer Feld 410, Heidelberg 69120, Germany.
出版信息
Eur Heart J Cardiovasc Imaging. 2016 Dec;17(12):1370-1378. doi: 10.1093/ehjci/jew042. Epub 2016 Mar 24.
AIMS
Assessment of left ventricular (LV) systolic function plays a central role in cardiac imaging. Calculation of ejection fraction (EF) is the current method of choice; however, its limited intermodal comparability represents a major drawback. The assessment of myocardial mechanics by strain imaging may better reflect the complex myocardial contractility. We aimed to evaluate different methods for quantification of LV strain on global and regional levels with a focus on the new non-proprietary feature tracking (FT) algorithm.
METHODS AND RESULTS
Measurements of LV deformation were performed by means of high-resolution two-dimensional (2D) speckle tracking echocardiography (STE) and compared with values obtained by 2D feature tracking echocardiography (FT-E) and feature tracking cardiac magnetic resonance imaging (FT-CMR). Assessments with echocardiography started within 30 min after CMR examination to minimize time-dependent variations in myocardial function. Forty-seven patients were included. Assessments by STE were -15.7 ± 5.0% for global longitudinal strain (GLS), -14.6 ± 4.5% for global circumferential strain (GCS), and 21.6 ± 13.3% for global radial strain (GRS), while values obtained with FT-E were -13.1 ± 4.0, -13.6 ± 4.0, 20.3 ± 9.5, and with FT-CMR -15.0 ± 4.0, -16.9 ± 5.4, and 35.0 ± 10.8, respectively. Linear regression and the Bland-Altman analysis showed the best intramodal association for STE GLS and FT-E GLS (r = 0.88, bias = -2.7%, LOA = ±4.7%). The correlation for GCS and GRS was weaker, and for regional strain was poor. In contrast to EF, GLS showed a better intermodal correlation between echocardiography and CMR (r = 0.81 by speckle tracking, r = 0.8 by FT, and r = 0.78 by EF).
CONCLUSION
In our study, measurement of global longitudinal LV strain using the new FT algorithm with CMR and echocardiography was comparable with measurements obtained by high-resolution STE. Compared with echocardiographic EF determination, FT-E GLS shows a better reproducibility and a better intermodal agreement with CMR, representing a fair non-proprietary solution for this assessment.
CLINICAL TRIAL REGISTRATION
clinicaltrials.gov. Unique identifier: NCT01275963.
目的
评估左心室（LV）收缩功能在心脏成像中起着核心作用。射血分数（EF）的计算是目前的首选方法；然而，其模态间的有限可比性是一个主要的缺点。应变成像评估心肌力学可以更好地反映复杂的心肌收缩性。我们旨在评估不同方法在全局和局部水平上定量 LV 应变，重点是新的非专用特征跟踪（FT）算法。
方法和结果
通过高分辨率二维（2D）斑点追踪超声心动图（STE）进行 LV 变形测量，并与 2D 特征跟踪超声心动图（FT-E）和特征跟踪心脏磁共振成像（FT-CMR）获得的值进行比较。超声心动图评估在 CMR 检查后 30 分钟内开始，以最大程度地减少心肌功能的时间依赖性变化。共纳入 47 例患者。STE 评估的整体纵向应变（GLS）为-15.7±5.0%，整体圆周应变（GCS）为-14.6±4.5%，整体径向应变（GRS）为 21.6±13.3%，而 FT-E 获得的值分别为-13.1±4.0、-13.6±4.0、20.3±9.5，FT-CMR 获得的值分别为-15.0±4.0、-16.9±5.4 和 35.0±10.8。线性回归和 Bland-Altman 分析显示，STE GLS 和 FT-E GLS 的模态内相关性最好（r=0.88，偏差=-2.7%，LOA=±4.7%）。GCS 和 GRS 的相关性较弱，而局部应变的相关性较差。与 EF 相比，GLS 在超声心动图和 CMR 之间的模态间相关性更好（STE 为 r=0.8，FT 为 r=0.8，EF 为 r=0.78）。
结论
在我们的研究中，使用新的 FT 算法与 CMR 和超声心动图测量全局纵向 LV 应变与使用高分辨率 STE 测量的结果相当。与超声心动图 EF 测定相比，FT-E GLS 具有更好的可重复性和与 CMR 更好的模态间一致性，代表了这种评估的一种公平的非专用解决方案。
临床试验注册
clinicaltrials.gov。独特标识符：NCT01275963。
Zotero 插件