Karlsen Sigve, Dahlslett Thomas, Grenne Bjørnar, Sjøli Benthe, Smiseth Otto, Edvardsen Thor, Brunvand Harald
Sørlandet Hospital, Arendal, Norway.
St. Olavs Hospital, Trondheim, Norway.
Cardiovasc Ultrasound. 2019 Sep 2;17(1):18. doi: 10.1186/s12947-019-0168-9.
Left ventricular ejection fraction (LVEF) is an established method for evaluation of left ventricular (LV) systolic function. Global longitudinal strain (GLS) by speckle tracking echocardiography seems to be an important additive method for evaluation of LV function with improved reproducibility compared with LVEF. Our aim was to compare reproducibility of GLS and LVEF between an expert and trainee both as echocardiographic examiner and analyst.
Forty-seven patients with recent Acute Coronary Syndrome (ACS) underwent echocardiographic examination by both an expert echocardiographer and a trainee. Both echocardiographers, blinded for clinical data and each other's findings, performed image analysis for evaluation of intra- and inter- observer variability. GLS was measured using speckle tracking echocardiography. LVEF was calculated by Simpson's biplane method.
The trainee measured a GLS of - 19.4% (±3.5%) and expert - 18.7% (±3.2%) with an Intra class correlation coefficient (ICC) of 0.89 (0.74-0.95). LVEF by trainee was 50.3% (±8.2%) and by expert 53.6% (±8.6%), ICC coefficient was 0.63 (0.32-0.80). For GLS the systematic difference was 0.21% (- 4.58-2.64) vs. 4.08% (- 20.78-12.62) for LVEF.
GLS is a more reproducible method for evaluation of LV function than LVEF regardless of echocardiographic training.
左心室射血分数（LVEF）是评估左心室（LV）收缩功能的既定方法。斑点追踪超声心动图测定的整体纵向应变（GLS）似乎是评估LV功能的一种重要补充方法，与LVEF相比，其重复性有所提高。我们的目的是比较专家和实习生作为超声心动图检查者和分析者时GLS和LVEF的重复性。
47例近期急性冠状动脉综合征（ACS）患者接受了专家超声心动图医师和实习生的超声心动图检查。两位超声心动图医师均对临床数据及彼此的检查结果不知情，进行图像分析以评估观察者内和观察者间的变异性。使用斑点追踪超声心动图测量GLS。通过双平面辛普森法计算LVEF。
实习生测得的GLS为-19.4%（±3.5%），专家测得的为-18.7%（±3.2%），组内相关系数（ICC）为0.89（0.74-0.95）。实习生测得的LVEF为50.3%（±8.2%），专家测得的为53.6%（±8.6%），ICC系数为0.63（0.32-0.80）。对于GLS，系统差异为0.21%（-4.58-2.64），而LVEF为4.08%（-20.78-12.62）。
无论超声心动图培训情况如何，GLS都是比LVEF更具重复性的LV功能评估方法。
