Department of Medical Sciences, Cardiology and Clinical Physiology, Uppsala University, Uppsala, Sweden.
Department of Radiology, Uppsala University Hospital, Uppsala, Sweden.
Clin Res Cardiol. 2019 Apr;108(4):355-365. doi: 10.1007/s00392-018-1363-7. Epub 2018 Oct 27.
Reliability of left ventricular function measurements depends on actual biological conditions, repeated registrations and their analyses.
To investigate test-retest reliability of speckle-tracking-derived strain measurements and its determinants compared to the conventional parameters, such as ejection fraction (EF), LV volumes and mitral annular plane systolic excursion (MAPSE).
In 30 patients with a wide range of left ventricular function (mean EF 46.4 ± 16.4%, range 14-73%), standard echo views were acquired independently in a blinded fashion by two different echocardiographers in immediate sequence and analyzed off-line by two independent readers, creating 4 data sets per patient. Test-retest reliability of studied parameters was calculated using the smallest detectable change (SDC) and a total, inter-acquisition and inter-reader intra-class correlation coefficient (ICC).
The smallest detectable change normalized to the mean absolute value of the measured parameter (SDCrel) was lowest for MAPSE (10.7%). SDCrel for EF was similar to GLS (14.2 and 14.7%, respectively), while SDCrel for CS was much higher (35.6%). The intra-class correlation coefficient was excellent (> 0.9) for all measures of the left ventricular function. Intra-patient inter-acquisition reliability (ICCacq) was significantly better than inter-reader reliability (ICCread) (0.984 vs. 0.950, p = 0.03) only for EF, while no significant difference was observed for any other LV function parameter. Mean intra-subject standard deviations were significantly correlated to the mean values for CS and LV volumes, but not for the other studied parameters.
In a test-retest setting, both with normal and impaired left ventricular function, the smallest relative detectable change of EF, GLS and MAPSE was similar (11-15%), but was much higher for CS (35%). Surprisingly, reliability of GLS was not superior to that of EF. Acquisition and reader to a similar extent influenced the reliability of measurements of all left ventricular function measures except for ejection fraction, where the reliability was more dependent on the reader than on the acquisition.
左心室功能测量的可靠性取决于实际的生物学条件、重复记录及其分析。
研究斑点追踪衍生应变测量的测试-重测信度及其与传统参数（如射血分数 (EF)、LV 容积和二尖瓣环平面收缩期位移 (MAPSE)）的相关性。
在 30 名左心室功能范围广泛的患者（平均 EF 46.4±16.4%，范围 14-73%）中，由两名不同的超声心动图医师以盲法立即连续采集标准超声心动图图像，并由两名独立的读者离线进行分析，每位患者生成 4 组数据。使用最小可检测变化 (SDC) 和总、采集间和读者内组内相关系数 (ICC) 计算研究参数的测试-重测信度。
与测量参数的平均绝对值归一化的最小可检测变化 (SDCrel) 最低的是 MAPSE（10.7%）。EF 的 SDCrel 与 GLS 相似（分别为 14.2%和 14.7%），而 CS 的 SDCrel 高得多（35.6%）。所有左心室功能测量的组内相关系数均很高（>0.9）。患者内采集间信度（ICCacq）明显优于读者间信度（ICCread）（0.984 与 0.950，p=0.03），仅 EF 如此，而任何其他 LV 功能参数均无显著差异。平均受试者内标准差与 CS 和 LV 容积的平均值显著相关，但与其他研究参数无关。
在测试-重测设置中，正常和受损的左心室功能下，EF、GLS 和 MAPSE 的最小相对可检测变化相似（11-15%），但 CS（35%）高得多。令人惊讶的是，GLS 的可靠性并不优于 EF。除射血分数外，采集和读者对所有左心室功能测量的可靠性都有相似的影响，而射血分数的可靠性更多地取决于读者而不是采集。
