HELIOS University Medical Center Wuppertal, Children's Hospital, Center for Clinical & Translational Research (CCTR), Witten/Herdecke University, Witten, Germany.
EKO Children's Hospital, Witten/Herdecke University, Oberhausen, Germany.
Sci Rep. 2018 Jun 15;8(1):9185. doi: 10.1038/s41598-018-27412-2.
Speckle tracking echocardiography (STE) is increasingly used during functional assessments. However, reproducibility and dependence on echocardiographic image quality for speckle tracking stress echocardiography in pediatric patients have not been studied to date. 127 consecutive normotensive children without structural heart disease (mean age 13.4 ± 3.0 years, 50.4% female) underwent a stepwise semisupine cycle ergometric protocol. Left ventricular (LV) myocardial peak strain and strain rate were assessed at rest and during exercise. Interobserver and intraobserver assessments were performed and analyzed regarding echocardiographic image quality. LV peak global strain and strain rate were well reproducible with narrow limits of agreement without any significant bias both at rest and during all stages of exercise testing. Moreover, strain rate reproducibility slightly deteriorated in values between -1.5 and -3 s. Surprisingly, there was no significant difference in reproducibility between optimal, intermediate and poor quality of echocardiographic images. STE derived strain and strain rate measurements in children are feasible and highly reproducible during semisupine cycle ergometric stress echocardiography. Echocardiographic image quality does not seem to influence strain (rate) reproducibility. Myocardial deformation measurements in images with suboptimal visualization quality must be interpreted with caution.
斑点追踪超声心动图（STE）在功能评估中越来越多地被应用。然而，迄今为止，尚未研究斑点追踪负荷超声心动图在儿科患者中的可重复性和对超声心动图图像质量的依赖性。127 例连续的无结构性心脏病的正常血压儿童（平均年龄 13.4±3.0 岁，50.4%为女性）接受了逐步半卧位踏车运动试验方案。在休息和运动期间评估左心室（LV）心肌峰值应变和应变率。进行了观察者间和观察者内评估，并针对超声心动图图像质量进行了分析。LV 峰值整体应变和应变率具有良好的可重复性，在休息和运动测试的所有阶段均具有较窄的一致性界限，没有明显的偏差。此外，应变率的可重复性在-1.5 到-3 s 之间的值略有恶化。令人惊讶的是，超声心动图图像质量的好坏对可重复性没有显著影响。在半卧位踏车运动负荷超声心动图中，STE 衍生的应变和应变率测量在儿童中是可行的，并且具有高度可重复性。超声心动图图像质量似乎不会影响应变（率）的可重复性。在可视化质量欠佳的图像中进行心肌变形测量时，必须谨慎解读。
