Service de cardiologie, hôpital Saint-Antoine, AP-HP, université Pierre-et-Marie-Curie, Paris-Sorbonne, Paris VI, 184, rue du Faubourg-Saint-Antoine, 75571 Paris cedex 12, France.
Drug Development Department (DITEP : département d'innovations thérapeutiques et essais précoces), Gustave Roussy Cancer Campus, 94805 Villejuif, France.
Arch Cardiovasc Dis. 2018 Apr;111(4):285-296. doi: 10.1016/j.acvd.2017.11.003.
Global longitudinal strain (GLS) has several sources of variation. Strain multilayer tracking is a new tool that has not yet been validated in clinical practice.
The purpose of this study was to investigate intervendor variability when measuring multilayer strain in patients receiving chemotherapy for cancer.
Patients receiving chemotherapy for cancer, who were referred for echocardiography, were included prospectively. First, the same operator performed two-dimensional echocardiography on each patient using the Vivid E9™ (General Electric, Fairfield, CT, USA) and the ACUSON SC2000™ (Siemens, Munich, Germany) ultrasound systems. Second, we assessed myocardial deformation by using their respective speckle-tracking software. Third, we compared absolute values of GLS for the two vendors in each apical view (four-, three- and two-chamber) and for each layer (endocardial, mid-myocardial and epicardial).
Eighty patients with cancer were included prospectively between February and June 2015. For a given vendor, GLS values decreased from the endocardial layer to the epicardial layer. For a given view, GLS values obtained with the ACUSON SC2000 platform were systematically lower than those obtained with the Vivid E9 platform (P<0.0001). We observed a significant difference between the two platforms, irrespective of the layer, interlayer gradient or chamber view considered (P<0.0001).
There was poor agreement for layer-specific strain evaluation between the Vivid E9 and ACUSON SC2000 platforms, using their dedicated software for strain multilayer assessment. These results suggest that, in clinical practice, the same system and software from the same vendor should be used for longitudinal follow-up.
整体纵向应变（GLS）有多种变异来源。应变多层跟踪是一种新的工具，尚未在临床实践中得到验证。
本研究旨在探讨在接受癌症化疗的患者中，测量多层应变时不同供应商之间的变异性。
前瞻性纳入接受癌症化疗的患者。首先，同一位操作者使用 Vivid E9（通用电气，费尔菲尔德，CT，美国）和 ACUSON SC2000（西门子，慕尼黑，德国）超声系统为每位患者进行二维超声心动图检查。其次，我们使用各自的斑点追踪软件评估心肌变形。第三，我们比较了两种供应商在每个心尖视图（四腔、三腔和两腔）和每个层（心内膜、中层和心外膜）的 GLS 的绝对值。
2015 年 2 月至 6 月期间，前瞻性纳入了 80 例癌症患者。对于给定的供应商，GLS 值从心内膜层到心外膜层逐渐降低。对于给定的视图，ACUSON SC2000 平台获得的 GLS 值始终低于 Vivid E9 平台（P<0.0001）。无论考虑的是层、层间梯度还是腔室视图，我们都观察到两个平台之间存在显著差异（P<0.0001）。
使用专用的应变多层评估软件，Vivid E9 和 ACUSON SC2000 平台之间的层特异性应变评估一致性较差。这些结果表明，在临床实践中，应使用同一供应商的同一系统和软件进行纵向随访。
