Sundqvist Martin G, Salman Katrin, Tornvall Per, Ugander Martin
Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, and Cardiology Clinic, Södersjukhuset, SE-188 83, Stockholm, Sweden.
Department of Clinical Physiology, Karolinska Institutet, and Karolinska University Hospital, SE-171 76, Stockholm, Sweden.
BMC Med Imaging. 2016 Oct 27;16(1):60. doi: 10.1186/s12880-016-0162-8.
Early diastolic left ventricular (LV) filling can be accurately described using the same methods used in classical mechanics to describe the motion of a loaded spring as it recoils, a validated method also referred to as the Parameterized Diastolic Filling (PDF) formalism. With this method, each E-wave recorded by pulsed wave (PW) Doppler can be mathematically described in terms of three constants: LV stiffness (k), viscoelasticity (c), and load (x ). Also, additional parameters of physiological and diagnostic interest can be derived. An efficient software application for PDF analysis has not been available. We aim to describe the structure, feasibility, time efficiency and intra-and interobserver variability for use of such a solution, implemented in Echo E-waves, a freely available software application ( www.echoewaves.org ).
An application was developed, with the ability to open DICOM files from different vendors, as well as rapid semi-automatic analysis and export of results. E-waves from 20 patients were analyzed by two investigators. Analysis time for a median of 34 (interquartile range (IQR) 29-42) E-waves per patient (representing 63 %, IQR 56-79 % of the recorded E-waves per patient) was 4.3 min (IQR 4.0-4.6 min). Intra-and intraobserver variability was good or excellent for 12 out of 14 parameters (coefficient of variation 2.5-18.7 %, intraclass correlation coefficient 0.80-0.99).
Kinematic analysis of diastolic function using the PDF method for Doppler echocardiography implemented in freely available semiautomatic software is highly feasible, time efficient, and has good to excellent intra-and interobserver variability.
舒张早期左心室（LV）充盈可以使用经典力学中描述加载弹簧回弹运动的相同方法进行准确描述，这种经过验证的方法也称为参数化舒张期充盈（PDF）形式。使用这种方法，脉冲波（PW）多普勒记录的每个E波都可以用三个常数进行数学描述：左心室僵硬度（k）、粘弹性（c）和负荷（x）。此外，还可以得出具有生理和诊断意义的其他参数。目前尚未有用于PDF分析的高效软件应用程序。我们旨在描述一种在免费软件应用程序Echo E-waves（www.echoewaves.org）中实现的此类解决方案的结构、可行性、时间效率以及观察者内和观察者间的变异性。
开发了一个应用程序，它能够打开来自不同供应商的DICOM文件，并能进行快速半自动分析和结果导出。两名研究人员对20名患者的E波进行了分析。每位患者中位数为34个（四分位间距（IQR）为29 - 42个）E波的分析时间（占每位患者记录的E波的63%，IQR为56 - 79%）为4.3分钟（IQR为4.0 - 4.6分钟）。14个参数中的12个参数的观察者内和观察者间变异性良好或极佳（变异系数为2.5 - 18.7%，组内相关系数为0.80 - 0.99）。
在免费的半自动软件中使用PDF方法对多普勒超声心动图的舒张功能进行运动学分析是高度可行、时间高效的，并且观察者内和观察者间变异性良好或极佳。
