Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
J Clin Ultrasound. 2021 Jun;49(5):479-487. doi: 10.1002/jcu.22983. Epub 2021 Feb 1.
This study aimed to investigate whether left ventricular (LV) global longitudinal strain (GLS) evaluated by speckle-tracking echocardiography (STE) can be used as a surrogate marker for the detection of replacement fibrosis by late gadolinium enhancement (LGE) on cardiovascular magnetic resonance (CMR) in patients with nonischemic cardiomyopathy (NICM).
This study analyzed 41 NICM patients who successfully underwent both STE and CMR, and were divided into those with (Group A, n = 18) and those without CMR-LGE (Group B, n = 23). Echocardiographic indexes, including GLS, were compared between the two groups.
No significant differences were observed in LV end-diastolic and end-systolic volume indexes, LV ejection fraction, mitral E/A, deceleration time, E/e', left atrial volume index, and the systolic trans-tricuspid pressure gradient between Groups A and B. STE-GLS was significantly worse in Group A than in Group B (-7.6% ± 3.0% vs -9.9% ± 3.2%, P = .01). Receiver operating characteristic curve analysis showed that STE-GLS of -7.9% was the best cut-off value for detection of CMR-LGE (sensitivity, 78%; specificity, 74%; and area under the curve, 0.74).
STE-GLS may be a potential surrogate marker for the detection of CMR-LGE-derived replacement fibrosis in patients with NICM.
本研究旨在探讨斑点追踪超声心动图（STE）评估的左心室（LV）整体纵向应变（GLS）是否可作为心血管磁共振（CMR）检测非缺血性心肌病（NICM）患者延迟钆增强（LGE）替代纤维化的替代标志物。
本研究分析了 41 例成功接受 STE 和 CMR 检查的 NICM 患者，并将其分为存在（A 组，n = 18）和不存在 CMR-LGE（B 组，n = 23）的患者。比较两组的超声心动图指标，包括 GLS。
A 组和 B 组的 LV 舒张末期和收缩末期容积指数、LV 射血分数、二尖瓣 E/A、减速时间、E/e'、左心房容积指数和收缩期三尖瓣跨瓣压力梯度无显著差异。A 组的 STE-GLS 明显差于 B 组（-7.6%±3.0% vs -9.9%±3.2%，P =.01）。受试者工作特征曲线分析显示，STE-GLS 为-7.9%时，对检测 CMR-LGE 的最佳截断值（灵敏度为 78%，特异性为 74%，曲线下面积为 0.74）。
STE-GLS 可能是 NICM 患者检测 CMR-LGE 替代纤维化的潜在替代标志物。
