Orloff Elisabeth, Fournier Pauline, Bouisset Frédéric, Moine Thomas, Cournot Maxime, Elbaz Meyer, Carrié Didier, Galinier Michel, Lairez Olivier, Cognet Thomas
Department of Cardiology, Rangueil University Hospital, Toulouse, France.
Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France.
Echocardiography. 2018 Sep;35(9):1300-1309. doi: 10.1111/echo.14022. Epub 2018 May 14.
The aim of this study was to evaluate the value of multilayer strain analysis to the assessment of myocardial viability (MV) through the comparison of both speckle tracking echocardiography and single-photon emission computed tomography (SPECT) imaging. We also intended to determine which segmental longitudinal strain (LS) cutoff value would be optimal to discriminate viable myocardium.
We included 47 patients (average age: 61 ± 11 years) referred to our cardiac imaging center for MV evaluation. All patients underwent transthoracic echocardiography with measures of LS, SPECT, and coronary angiography.
In all, 799 segments were analyzed. We correlated myocardial tracer uptake by SPECT with sub-endocardial, sub-epicardial, and mid-segmental LS values with r = .514 P < .0001, r = .501 P < .0001, and r = .520 P < .0001, respectively. The measurements of each layer strain (sub-endocardial, sub-epicardial, and mid) had the same performance to predict MV viability as defined by SPECT with areas under curve of 0.819 [0.778-0.861, P < .0001], 0.809 [0.764-0.854, P < .0001], and 0.817 [0.773-0.860, P < .0001], respectively. The receiver-operating characteristic analysis yielded a cutoff value of -6.5% for mid-segmental LS with a sensitivity of 76% and specificity of 76% to predict segmental MV as defined by SPECT.
Multilayer strain analysis does not evaluate MV with more accuracy than standard segmental LS analysis.
本研究的目的是通过比较斑点追踪超声心动图和单光子发射计算机断层扫描（SPECT）成像，评估多层应变分析对心肌存活（MV）评估的价值。我们还打算确定哪个节段纵向应变（LS）临界值最适合区分存活心肌。
我们纳入了47例（平均年龄：61±11岁）因MV评估转诊至我们心脏影像中心的患者。所有患者均接受经胸超声心动图检查，测量LS、SPECT和冠状动脉造影。
共分析了799个节段。我们将SPECT测得的心肌示踪剂摄取与心内膜下、心外膜下和节段中部的LS值进行相关性分析，r分别为0.514（P<0.0001）、0.501（P<0.0001）和0.520（P<0.0001）。各层应变（心内膜下、心外膜下和中部）测量预测MV存活的表现相同，SPECT定义的曲线下面积分别为0.819[0.778-0.861，P<0.0001]、0.809[0.764-0.854，P<0.0001]和0.817[0.773-0.860，P<0.0001]。受试者操作特征分析得出节段中部LS的临界值为-6.5%，预测SPECT定义的节段MV的敏感性为76%，特异性为76%。
多层应变分析评估MV的准确性并不高于标准节段LS分析。
