Department of Cardiovascular Diseases, University Hospital Leuven, Leuven, Belgium.
Department of Radiology, University Hospital Leuven, Leuven, Belgium.
JACC Cardiovasc Imaging. 2018 Jan;11(1):25-34. doi: 10.1016/j.jcmg.2017.02.014. Epub 2017 May 17.
The purpose of this study was to compare the accuracy of vendor-specific and independent strain analysis tools to detect regional myocardial function abnormality in a clinical setting.
Speckle tracking echocardiography has been considered a promising tool for the quantitative assessment of regional myocardial function. However, the potential differences among speckle tracking software with regard to their accuracy in identifying regional abnormality has not been studied extensively.
Sixty-three subjects (5 healthy volunteers and 58 patients) were examined with 7 different ultrasound machines during 5 days. All patients had experienced a previous myocardial infarction, which was characterized by cardiac magnetic resonance with late gadolinium enhancement. Segmental peak systolic (PS), end-systolic (ES) and post-systolic strain (PSS) measurements were obtained with 6 vendor-specific software tools and 2 independent strain analysis tools. Strain parameters were compared between fully scarred and scar-free segments. Receiver-operating characteristic curves testing the ability of strain parameters and derived indexes to discriminate between these segments were compared among vendors.
The average strain values calculated for normal segments ranged from -15.1% to -20.7% for PS, -14.9% to -20.6% for ES, and -16.1% to -21.4% for PSS. Significantly lower values of strain (p < 0.05) were found in segments with transmural scar by all vendors, with values ranging from -7.4% to -11.1% for PS, -7.7% to -10.8% for ES, and -10.5% to -14.3% for PSS. Accuracy in identifying transmural scar ranged from acceptable to excellent (area under the curve 0.74 to 0.83 for PS and ES and 0.70 to 0.78 for PSS). Significant differences were found among vendors (p < 0.05). All vendors had a significantly lower accuracy to detect scars in the basal segments compared with scars in the apex (p < 0.05).
The accuracy of identifying regional abnormality differs significantly among vendors.
本研究旨在比较特定供应商和独立应变分析工具在临床环境下检测区域性心肌功能异常的准确性。
斑点追踪超声心动图已被认为是评估区域性心肌功能的一种很有前途的工具。然而，关于不同斑点追踪软件在识别区域性异常方面的准确性，尚未进行广泛研究。
63 名受试者（5 名健康志愿者和 58 名患者）在 5 天内使用 7 种不同的超声机器进行检查。所有患者均经历过心肌梗死，其特征是心脏磁共振检查伴有晚期钆增强。节段性收缩期峰值应变（PS）、收缩末期应变（ES）和收缩后应变（PSS）测量值由 6 种特定供应商软件工具和 2 种独立应变分析工具获得。比较完全瘢痕和无瘢痕节段的应变参数。比较不同供应商之间应变参数和衍生指数区分这些节段的能力的受试者工作特征曲线。
正常节段计算的平均应变值在 PS 为-15.1%至-20.7%，ES 为-14.9%至-20.6%，PSS 为-16.1%至-21.4%。所有供应商均发现，有透壁瘢痕的节段应变值明显较低（p<0.05），PS 为-7.4%至-11.1%，ES 为-7.7%至-10.8%，PSS 为-10.5%至-14.3%。PS 和 ES 的识别透壁瘢痕的准确性范围为可接受至优秀（曲线下面积为 0.74 至 0.83），PSS 的准确性为 0.70 至 0.78。供应商之间存在显著差异（p<0.05）。与心尖相比，所有供应商检测基底段瘢痕的准确性均显著降低（p<0.05）。
识别区域性异常的准确性在供应商之间存在显著差异。
