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心脏再同步治疗候选者中应变成像技术的比较:心脏磁共振标记成像、心脏磁共振特征追踪和斑点追踪超声心动图。

Comparison of strain imaging techniques in CRT candidates: CMR tagging, CMR feature tracking and speckle tracking echocardiography.

作者信息

van Everdingen Wouter M, Zweerink Alwin, Nijveldt Robin, Salden Odette A E, Meine Mathias, Maass Alexander H, Vernooy Kevin, De Lange Frederik J, van Rossum Albert C, Croisille Pierre, Clarysse Patrick, Geelhoed Bastiaan, Rienstra Michiel, Van Gelder Isabelle C, Vos Marc A, Allaart Cornelis P, Cramer Maarten J

机构信息

Department of Cardiology, University Medical Centre Utrecht, Utrecht, The Netherlands.

Department of Cardiology, and Institute for Cardiovascular Research (ICaR-VU), VU University Medical Centre, Amsterdam, The Netherlands.

出版信息

Int J Cardiovasc Imaging. 2018 Mar;34(3):443-456. doi: 10.1007/s10554-017-1253-5. Epub 2017 Oct 17.

Abstract

Parameters using myocardial strain analysis may predict response to cardiac resynchronization therapy (CRT). As the agreement between currently available strain imaging modalities is unknown, three different modalities were compared. Twenty-seven CRT-candidates, prospectively included in the MARC study, underwent cardiac magnetic resonance (CMR) imaging and echocardiographic examination. Left ventricular (LV) circumferential strain was analysed with CMR tagging (CMR-TAG), CMR feature tracking (CMR-FT), and speckle tracking echocardiography (STE). Basic strain values and parameters of dyssynchrony and discoordination obtained with CMR-FT and STE were compared to CMR-TAG. Agreement of CMR-FT and CMR-TAG was overall fair, while agreement between STE and CMR-TAG was often poor. For both comparisons, agreement on discoordination parameters was highest, followed by dyssynchrony and basic strain parameters. For discoordination parameters, agreement on systolic stretch index was highest, with fair intra-class correlation coefficients (ICC) (CMR-FT: 0.58, STE: 0.55). ICC of septal systolic rebound stretch (SRS) was poor (CMR-FT: 0.41, STE: 0.30). Internal stretch factor of septal and lateral wall (ISF) showed fair ICC values (CMR-FT: 0.53, STE: 0.46), while the ICC of the total LV (ISF) was fair for CMR-FT (0.55) and poor for STE (ICC: 0.32). The CURE index had a fair ICC for both comparisons (CMR-FT: 0.49, STE 0.41). Although comparison of STE to CMR-TAG was limited by methodological differences, agreement between CMR-FT and CMR-TAG was overall higher compared to STE and CMR-TAG. CMR-FT is a potential clinical alternative for CMR-TAG and STE, especially in the detection of discoordination in CRT-candidates.

摘要

使用心肌应变分析的参数可能预测心脏再同步治疗(CRT)的反应。由于目前可用的应变成像模式之间的一致性尚不清楚,因此对三种不同的模式进行了比较。27名CRT候选者前瞻性纳入MARC研究,接受了心脏磁共振(CMR)成像和超声心动图检查。使用CMR标记(CMR-TAG)、CMR特征跟踪(CMR-FT)和斑点追踪超声心动图(STE)分析左心室(LV)圆周应变。将CMR-FT和STE获得的基本应变值以及不同步和不协调参数与CMR-TAG进行比较。CMR-FT与CMR-TAG的一致性总体一般,而STE与CMR-TAG之间的一致性往往较差。对于这两种比较,不协调参数的一致性最高,其次是不同步和基本应变参数。对于不协调参数,收缩期伸展指数的一致性最高,组内相关系数(ICC)一般(CMR-FT:0.58,STE:0.55)。室间隔收缩期反弹伸展(SRS)的ICC较差(CMR-FT:0.41,STE:0.30)。室间隔和侧壁的内部伸展因子(ISF)显示出一般的ICC值(CMR-FT:0.53,STE:0.46),而左心室整体(ISF)的ICC对于CMR-FT一般(0.55),对于STE较差(ICC:0.32)。CURE指数在两种比较中ICC均一般(CMR-FT:0.49,STE 0.41)。尽管STE与CMR-TAG的比较受到方法学差异的限制,但CMR-FT与CMR-TAG之间的一致性总体上高于STE与CMR-TAG。CMR-FT是CMR-TAG和STE的一种潜在临床替代方法,尤其是在检测CRT候选者的不协调方面。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6470/5847211/f9f93bc67de1/10554_2017_1253_Fig1_HTML.jpg

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