Poyraz Esra, Kemaloglu Oz Tugba, Çetin Güvenç Rengin, Guvenc Tolga Sinan
Department of Cardiology, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Research and Training Hospital, Istanbul, Turkey.
Department of Cardiology, Haydarpasa Numune Hospital, Istanbul, Turkey.
Echocardiography. 2019 May;36(5):897-904. doi: 10.1111/echo.14336. Epub 2019 Apr 19.
Recent advances had allowed measurement of myocardial deformation parameters using 3D speckle-tracking echocardiography (STE). Agreement between these two modalities and interchangeability of findings remain as an issue since 2DSTE is more widely available than 3DSTE. The aim of this study was to investigate the correlation and agreement between 2DSTE and 3DSTE in healthy volunteers and in patients with mild mitral stenosis (MS).
Data from 31 patients with mild MS and 27 healthy volunteers were included in this study. Data were analyzed for the correlation and agreement between 2DSTE and 3DSTE for volumetric, strain, and rotational parameters.
There were no significant differences between 2DSTE and 3DSTE in both control and MS groups for left ventricular volumetric and rotational parameters. 3D global longitudinal strain (GLS) and global circumferential strain (GCS) were significantly higher in healthy volunteers (P < 0.001 for both), while only 3DGCS was significantly higher than 2DGCS in MS group (P < 0.001). The correlation between 3DSTE and 2DSTE was weak-to-moderate in both groups for strain and rotational parameters, and overall, correlation coefficients were higher in MS group. An exception was GLS in MS group, where coefficient of correlation was excellent (r = 0.907). Agreement between two modalities was poor for strain and rotational parameters, and the average bias was high.
Overall, the agreement between 2DSTE and 3DSTE for strain and rotational measures was poor with a high average bias. The agreement between 2DSTE and 3DSTE is affected by the presence of underlying MS and the direction of strain.
近期进展使得利用三维斑点追踪超声心动图（3D-STE）测量心肌变形参数成为可能。由于二维斑点追踪超声心动图（2D-STE）比三维斑点追踪超声心动图应用更为广泛，这两种方法之间的一致性以及结果的可互换性仍是一个问题。本研究的目的是探讨2D-STE和3D-STE在健康志愿者和轻度二尖瓣狭窄（MS）患者中的相关性和一致性。
本研究纳入了31例轻度MS患者和27名健康志愿者的数据。分析了2D-STE和3D-STE在容积、应变和旋转参数方面的相关性和一致性。
在对照组和MS组中，2D-STE和3D-STE在左心室容积和旋转参数方面均无显著差异。健康志愿者的三维整体纵向应变（GLS）和整体圆周应变（GCS）显著更高（两者均P<0.001），而在MS组中只有3D-GCS显著高于2D-GCS（P<0.001）。两组中，3D-STE和2D-STE在应变和旋转参数方面的相关性为弱到中度，总体而言，MS组的相关系数更高。MS组的GLS是个例外，其相关系数极佳（r=0.907）。两种方法在应变和旋转参数方面的一致性较差，平均偏差较高。
总体而言，2D-STE和3D-STE在应变和旋转测量方面的一致性较差，平均偏差较高。2D-STE和3D-STE之间的一致性受潜在MS的存在和应变方向的影响。
