Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, China.
Department of Ultrasound, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, China.
J Clin Ultrasound. 2021 Jul;49(6):563-572. doi: 10.1002/jcu.22987. Epub 2021 Feb 10.
The echocardiographic measurement of left ventricular (LV) ejection fraction (EF) is dependent on professional experience and adequate visualization. Tissue motion of mitral annular displacement (TMAD) can be easily assessed using speckle-tracking echocardiography (STE), even in patients with poor acoustic windows. Therefore, this study aimed to assess whether left ventricular ejection fraction (LVEF) can be estimated using STE-derived TMAD when LVEF is not available.
Four-hundred fifty-six outpatients were enrolled after excluding the patients whose LVEF measurements remained challenging or TMAD value could be confounded. An optimized regression model for LVEF-TMAD was developed in the derivation set (n = 287), and its reliability was verified in the validation set (n = 123) and regional wall motion abnormalities (RWMA) set (n = 46).
In the derivation set, the power models had the highest F-value. Therefore, the power equations were chosen to estimate LVEF by TMAD in the validation set. There was a near-zero bias and a narrow range between the observed and estimated LVEF. The highest intra-class correlation coefficient was found between the observed and the estimated LVEF by normalized TMAD at the midpoint of mitral annular (nTMADmid). Moreover, there were no significant differences between the observed and the estimated LVEF in the RWMA set.
The LVEF can be estimated with STE-derived TMAD, even for patients with RWMA, and nTMADmid may be the optimal parameter.
左心室（LV）射血分数（EF）的超声心动图测量依赖于专业经验和充分的可视化。即使在声窗不佳的患者中，也可以使用斑点追踪超声心动图（STE）轻松评估二尖瓣环位移（TMAD）的组织运动。因此，本研究旨在评估在无法获得 LVEF 的情况下，是否可以使用 STE 衍生的 TMAD 来估计 LVEF。
排除了那些 LVEF 测量仍然具有挑战性或 TMAD 值可能受到干扰的患者后，共有 456 名门诊患者入组。在推导组（n=287）中建立了用于 LVEF-TMAD 的优化回归模型，并在验证组（n=123）和区域性壁运动异常（RWMA）组（n=46）中验证了其可靠性。
在推导组中，幂模型的 F 值最高。因此，选择幂方程来通过 TMAD 估计验证组中的 LVEF。观察到的和估计的 LVEF 之间几乎没有偏差，且范围较窄。通过二尖瓣环中部的归一化 TMAD（nTMADmid）观察到的和估计的 LVEF 之间的内类相关系数最高。此外，RWMA 组中观察到的和估计的 LVEF 之间没有显著差异。
即使对于 RWMA 患者，也可以使用 STE 衍生的 TMAD 来估计 LVEF，并且 nTMADmid 可能是最佳参数。
