Benyounes Nadia, Lang Sylvie, Gout Olivier, Ancédy Yann, Etienney Arnaud, Cohen Ariel
Fondation Ophtalmologique A.-de-Rothschild, Cardiology Unit, Paris, France.
Saint-Antoine Hospital, Department of Cardiology, Paris, France.
Arch Cardiovasc Dis. 2016 Oct;109(10):533-541. doi: 10.1016/j.acvd.2016.02.007. Epub 2016 Jun 22.
Transthoracic echocardiography is the most commonly used tool for the detection of left ventricular wall motion (LVWM) abnormalities using "naked eye evaluation". This subjective and operator-dependent technique requires a high level of clinical training and experience. Two-dimensional speckle-tracking echocardiography (2D-STE), which is less operator-dependent, has been proposed for this purpose. However, the role of on-line segmental longitudinal peak systolic strain (LPSS) values in the prediction of LVWM has not been fully evaluated.
To test segmental LPSS for predicting LVWM abnormalities in routine echocardiography laboratory practice.
LVWM was evaluated by an experienced cardiologist, during routine practice, in 620 patients; segmental LPSS values were then calculated.
In this work, reflecting real life, 99.6% of segments were successfully tracked. Mean (95% confidence interval [CI]) segmental LPSS values for normal basal (n=3409), mid (n=3468) and apical (n=3466) segments were -16.7% (-16.9% to -16.5%), -18.2% (-18.3% to -18.0%) and -21.1% (-21.3% to -20.9%), respectively. Mean (95% CI) segmental LPSS values for hypokinetic basal (n=114), mid (n=116) and apical (n=90) segments were -7.7% (-9.0% to -6.3%), -10.1% (-11.1% to -9.0%) and -9.3% (-10.5% to -8.1%), respectively. Mean (95% CI) segmental LPSS values for akinetic basal (n=128), mid (n=95) and apical (n=91) segments were -6.6% (-8.0% to -5.1%), -6.1% (-7.7% to -4.6%) and -4.2% (-5.4% to -3.0%), respectively. LPSS allowed the differentiation between normal and abnormal segments at basal, mid and apical levels. An LPSS value≥-12% detected abnormal segmental motion with a sensitivity of 78% for basal, 70% for mid and 82% for apical segments.
Segmental LPSS values may help to differentiate between normal and abnormal left ventricular segments.
经胸超声心动图是使用“肉眼评估”检测左心室壁运动（LVWM）异常最常用的工具。这种主观且依赖操作者的技术需要高水平的临床培训和经验。为此已提出了依赖操作者程度较低的二维斑点追踪超声心动图（2D - STE）。然而，在线节段性纵向峰值收缩期应变（LPSS）值在预测LVWM中的作用尚未得到充分评估。
在常规超声心动图实验室实践中测试节段性LPSS对LVWM异常的预测能力。
在常规实践中，由一位经验丰富的心脏病专家对620例患者的LVWM进行评估；然后计算节段性LPSS值。
在这项反映现实情况的研究中，99.6%的节段成功追踪。正常基底段（n = 3409）、中间段（n = 3468）和心尖段（n = 3466）的平均（95%置信区间[CI]）节段性LPSS值分别为-16.7%（-16.9%至-16.5%）、-18.2%（-18.3%至-18.0%）和-21.1%（-21.3%至-20.9%）。运动减弱的基底段（n = 114）、中间段（n = 116）和心尖段（n = 90）的平均（95% CI）节段性LPSS值分别为-7.7%（-9.0%至-6.3%）、-10.1%（-11.1%至-9.0%）和-9.3%（-10.5%至-8.1%）。无运动的基底段（n = 128）、中间段（n = 95）和心尖段（n = 91）的平均（95% CI）节段性LPSS值分别为-6.6%（-8.0%至-5.1%）、-6.1%（-7.7%至-4.6%）和-4.2%（-5.4%至-3.0%）。LPSS能够在基底、中间和心尖水平区分正常节段和异常节段。LPSS值≥ - 12%检测到节段运动异常，对基底段的敏感性为78%，对中间段为70%，对心尖段为82%。
节段性LPSS值可能有助于区分正常和异常的左心室节段。
