Department of Cardiovascular Sciences, University of Leicester and the National Institute for Health for Research (NIHR) Leicester Cardiovascular Biomedical Research Centre, Glenfield Hospital, Leicester, LE3 9QF, UK.
Int J Cardiovasc Imaging. 2020 Jun;36(6):1133-1146. doi: 10.1007/s10554-020-01806-8. Epub 2020 Mar 9.
Strain assessment allows accurate evaluation of myocardial function and mechanics in ST-segment elevation myocardial infarction (STEMI). Strain using cardiovascular magnetic resonance (CMR) has traditionally been assessed with tagging but limitations of this technique have led to more widespread use of alternative methods, which may be more robust. We compared the inter-study repeatability of circumferential global peak-systolic strain (Ecc) and peak-early diastolic strain rate (PEDSR) derived by tagging with values obtained using novel cine-based software: Feature Tracking (FT) (TomTec, Germany) and Tissue Tracking (TT) (Circle cvi, Canada) in patients following STEMI. Twenty male patients (mean age 56 ± 10 years, mean infarct size 13.7 ± 7.1% of left ventricular mass) were randomised to undergo CMR 1-5 days post-STEMI at 1.5 T or 3.0 T, repeated after ten minutes at the same field strength. Ecc and PEDSR were assessed using tagging, FT and TT. Inter-study repeatability was evaluated using Bland-Altman analyses, coefficients of variation (CoV) and intra-class correlation coefficient (ICC). Ecc (%) was significantly lower with tagging than with FT or TT at 1.5 T (- 9.5 ± 3.3 vs. - 17.5 ± 3.8 vs. -15.5 ± 5.2, respectively, p < 0.001) and 3.0 T (- 13.1 ± 1.8 vs. - 19.4 ± 2.9 vs. - 17.3 ± 2.1, respectively, p = 0.001). This was similar for PEDSR (.s): 1.5 T (0.6 ± 0.2 vs. 1.5 ± 0.4 vs. 1.0 ± 0.4, for tagging, FT and TT respectively, p < 0.001) and 3.0 T (0.6 ± 0.2 vs. 1.5 ± 0.3 vs. 0.9 ± 0.3, respectively, p < 0.001). Inter-study repeatability for Ecc at 1.5 T was good for tagging and excellent for FT and TT: CoV 16.7%, 6.38%, and 8.65%, respectively. Repeatability for Ecc at 3.0 T was good for all three techniques: CoV 14.4%, 11.2%, and 13.0%, respectively. However, repeatability of PEDSR was generally lower than that for Ecc at 1.5 T (CoV 15.1%, 13.1%, and 34.0% for tagging, FT and TT, respectively) and 3.0 T (CoV 23.0%, 18.6%, and 26.2%, respectively). Following STEMI, Ecc and PEDSR are higher when measured with FT and TT than with tagging. Inter-study repeatability of Ecc is good for tagging, excellent for FT and TT at 1.5 T, and good for all three methods at 3.0 T. The repeatability of PEDSR is good to moderate at 1.5 T and moderate at 3.0 T. Cine-based methods to assess Ecc following STEMI may be preferable to tagging.
应变评估可准确评估 ST 段抬高型心肌梗死 (STEMI) 患者的心肌功能和力学。传统上，使用心血管磁共振 (CMR) 进行应变评估是通过标记法进行的，但该技术的局限性导致更广泛地使用替代方法，这些方法可能更稳健。我们比较了标记法和新型电影基软件（TomTec，德国的 Feature Tracking [FT] 和 Circle cvi，加拿大的 Tissue Tracking [TT]）得出的圆周整体收缩期峰值应变 (Ecc) 和收缩早期峰值应变率 (PEDSR) 在 STEMI 患者中的研究间重复性。20 名男性患者（平均年龄 56±10 岁，平均梗死面积为左心室质量的 13.7±7.1%）在 STEMI 后 1-5 天按随机顺序在 1.5 T 或 3.0 T 下进行 CMR 检查，在同一场强下重复检查 10 分钟。使用标记法、FT 和 TT 评估 Ecc 和 PEDSR。使用 Bland-Altman 分析、变异系数 (CoV) 和组内相关系数 (ICC) 评估研究间重复性。1.5 T（-9.5±3.3 与 -17.5±3.8 与 -15.5±5.2，p<0.001）和 3.0 T（-13.1±1.8 与 -19.4±2.9 与 -17.3±2.1，p=0.001）时，标记法的 Ecc（%）明显低于 FT 和 TT。对于 PEDSR（s）也是如此：1.5 T（0.6±0.2 与 1.5±0.4 与 1.0±0.4，分别用于标记法、FT 和 TT，p<0.001）和 3.0 T（0.6±0.2 与 1.5±0.3 与 0.9±0.3，分别用于标记法、FT 和 TT，p<0.001）。Ecc 在 1.5 T 时的研究间重复性对标记法为良好，对 FT 和 TT 为极好：CoV 分别为 16.7%、6.38%和 8.65%。Ecc 在 3.0 T 时的所有三种技术的重复性均良好：CoV 分别为 14.4%、11.2%和 13.0%。然而，与 Ecc 相比，PEDSR 的重复性通常较低，1.5 T（CoV 分别为 15.1%、13.1%和 34.0%，用于标记法、FT 和 TT）和 3.0 T（CoV 分别为 23.0%、18.6%和 26.2%，用于标记法、FT 和 TT）。STEMI 后，FT 和 TT 测量的 Ecc 和 PEDSR 高于标记法。Ecc 的研究间重复性在标记法时为良好，在 1.5 T 时对 FT 和 TT 为极好，在 3.0 T 时对所有三种方法均为良好。在 1.5 T 时，PEDSR 的重复性为良好至中度，在 3.0 T 时为中度。评估 STEMI 后 Ecc 的电影基方法可能优于标记法。
