BCNatal, Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain.
Fetal Medicine Unit, Department of Obstetrics and Gynecology, Hospital Clínico Universidad de Chile, Santiago de Chile, Chile.
Clin Physiol Funct Imaging. 2021 May;41(3):262-270. doi: 10.1111/cpf.12693. Epub 2021 Feb 27.
Both echocardiography and CMR imaging are used to quantify longitudinal function. Inter-method variability for mitral (MAPSE) and tricuspid (TAPSE) annular plane systolic excursion, and variability between directly measured MAPSE and TAPSE and as based on atrioventricular plane displacement (AVPD) analysis by CMR, are, however, not known. This study, therefore, assessed inter-method variability and variability between annular plane systolic excursion and AVPD-based values in a healthy adult population.
Echocardiography and CMR were performed in 111 adults (35 [32-38] years). Method comparisons were assessed with Deming regression, Bland-Altman analysis and coefficient of variation. Observer reproducibility was assessed by the concordance correlation coefficient.
Echocardiography and semi-automatic CMR agreed on MAPSE (17 ± 2 mm vs. 17 ± 2 mm, p = 0.1) and TAPSE (25 ± 3 mm vs. 25 ± 3 mm, p = 0.5), correlated highly between methods (fitted-slope 1.22 [95% CI 1.07-1.38] and 1.12 [95% CI 0.95-1.29]) and showed low bias (0.42 [95% CI - 2.05 to 2.88] and - 0.18 [95% CI - 4.78 to 4.43]). Intra-/inter-observer reproducibility was high for both methods for both MAPSE (echocardiography 0.96/0.86; CMR 0.87/0.85) and TAPSE (echocardiography 0.96/0.95; CMR 0.97/0.96). MAPSE (16 ± 2 mm vs. 17 ± 2 mm; p < 0.001) and TAPSE (24 ± 3 vs. 25 ± 3 mm; p < 0.001) based on AVPD were similar but statistically different compared with semi-automatic CMR.
Echocardiography and semi-automatic CMR have low variability and provide similar values for MAPSE and TAPSE and are thus interchangeable for follow-up studies. Lateral values based on tracked data from AVPD analysis are not clinically significantly different and could be used as a representation of annular displacement.
超声心动图和 CMR 成像均用于定量评估纵向功能。然而,对于二尖瓣(MAPSE)和三尖瓣(TAPSE)瓣环平面收缩期位移以及直接测量的 MAPSE 和 TAPSE 与 CMR 基于房室平面位移(AVPD)分析之间的差异,目前尚不清楚。因此,本研究评估了健康成年人中两种方法之间的变异性以及瓣环平面收缩期位移和基于 AVPD 值之间的差异。
对 111 例成年人(35 [32-38] 岁)进行了超声心动图和 CMR 检查。采用 Deming 回归、Bland-Altman 分析和变异系数评估方法比较。通过一致性相关系数评估观察者的可重复性。
超声心动图和半自动 CMR 测量的 MAPSE(17 ± 2mm vs. 17 ± 2mm,p=0.1)和 TAPSE(25 ± 3mm vs. 25 ± 3mm,p=0.5)一致,两种方法之间相关性很高(拟合斜率为 1.22 [95%可信区间为 1.07-1.38] 和 1.12 [95%可信区间为 0.95-1.29]),且偏差较小(0.42 [95%可信区间为-2.05 至 2.88] 和-0.18 [95%可信区间为-4.78 至 4.43])。两种方法的 MAPSE(超声心动图 0.96/0.86;CMR 0.87/0.85)和 TAPSE(超声心动图 0.96/0.95;CMR 0.97/0.96)的观察者内和观察者间的可重复性均较高。基于 AVPD 的 MAPSE(16 ± 2mm vs. 17 ± 2mm;p<0.001)和 TAPSE(24 ± 3 vs. 25 ± 3mm;p<0.001)与半自动 CMR 相比相似,但统计学上有差异。
超声心动图和半自动 CMR 具有较低的变异性,对 MAPSE 和 TAPSE 提供相似的数值,因此可用于随访研究。基于 AVPD 追踪数据的侧位值在临床上没有显著差异,可作为瓣环位移的代表。