Department of Cardiology and Vascular Medicine, GRN Hospital Weinheim, Weinheim, Germany.
Department of Internal Medicine/Cardiology, German Heart Center Berlin, Berlin, Germany.
Sci Rep. 2018 Sep 20;8(1):14100. doi: 10.1038/s41598-018-32226-3.
Myocardial strain is a well validated parameter for estimating left ventricular (LV) performance. The aim of our study was to evaluate the inter-study as well as intra- and interobserver reproducibility of fast-SENC derived myocardial strain. Eighteen subjects (11 healthy individuals and 7 patients with heart failure) underwent a cardiac MRI examination including fast-SENC acquisition for evaluating left ventricular global longitudinal (GLS) and circumferential strain (GCS) as well as left ventricular ejection fraction (LVEF). The examination was repeated after 63 [range 49‒87] days and analyzed by two experienced observers. Ten datasets were repeatedly assessed after 1 month by the same observer to test intraobserver variability. The reproducibility was measured using the intraclass correlation coefficient (ICC) and Bland-Altman analysis. Patients with heart failure demonstrated reduced GLS and GCS compared to healthy controls (-15.7 ± 3.7 vs. -20.1 ± 1.4; p = 0.002 for GLS and -15.3 ± 3.7 vs. -21.4 ± 1.1; p = 0.001 for GCS). The test-retest analysis showed excellent ICC for LVEF (0.92), GLS (0.94) and GCS (0.95). GLS exhibited excellent ICC (0.99) in both intra- and interobserver variability analysis with very narrow limits of agreement (-0.6 to 0.5 for intraobserver and -1.3 to 0.96 for interobserver agreement). Similarly, GCS showed excellent ICC (0.99) in both variability analyses with narrow limits of agreement (-1.1 to 1.2 for intraobserver and -1.7 to 1.3 for interobserver agreement), whereas LVEF showed larger limits of agreement (-14.4 to 10.1). The analysis of fast-SENC derived myocardial strain using cardiac MRI provides a highly reproducible method for assessing LV functional performance.
心肌应变成像技术是评估左心室(LV)功能的一种经过充分验证的参数。本研究旨在评估快速心肌应变成像技术衍生的心肌应变量的组内、组间以及观察者内的可重复性。18 名受试者(11 名健康个体和 7 名心力衰竭患者)接受心脏 MRI 检查,包括快速心肌应变成像技术采集,用于评估左心室整体纵向应变(GLS)、整体圆周应变(GCS)和左心室射血分数(LVEF)。检查在 63 天后(范围 49-87 天)重复进行,并由两位有经验的观察者进行分析。同一位观察者在 1 个月后重复评估了 10 份数据集,以测试观察者内的变异性。可重复性通过组内相关系数(ICC)和 Bland-Altman 分析进行测量。心力衰竭患者的 GLS 和 GCS 与健康对照组相比降低(GLS:-15.7±3.7 比-20.1±1.4;p=0.002;GCS:-15.3±3.7 比-21.4±1.1;p=0.001)。测试-再测试分析显示 LVEF(0.92)、GLS(0.94)和 GCS(0.95)的 ICC 非常好。GLS 和 GCS 在观察者内和观察者间变异性分析中均具有极好的 ICC(0.99),一致性界限非常狭窄(观察者内为-0.6 到 0.5;观察者间为-1.3 到 0.96)。同样,GCS 在观察者内和观察者间变异性分析中均具有极好的 ICC(0.99),一致性界限狭窄(观察者内为-1.1 到 1.2;观察者间为-1.7 到 1.3),而 LVEF 的一致性界限较宽(-14.4 到 10.1)。使用心脏 MRI 分析快速心肌应变成像技术衍生的心肌应变提供了一种评估 LV 功能性能的高度可重复方法。