Plášek Jiří, Rychlý Tomáš, Drieniková Diana, Cisovský Ondřej, Grézl Tomáš, Homza Miroslav, Václavík Jan
Department of Internal Medicine and Cardiology, University Hospital Ostrava, 708 52 Ostrava, Czech Republic.
Benedor Cardiology Outpatient Clinic Ltd., 708 00 Ostrava, Czech Republic.
J Clin Med. 2022 Apr 25;11(9):2402. doi: 10.3390/jcm11092402.
Background: Two-dimensional (2D) and three-dimensional (3D) speckle-tracking echocardiography (STE) enables assessment of myocardial function. Here, we examined the agreement between 2D and 3D STE measurement of a global longitudinal strain (GLS) in patients with normal left ventricle, reduced ejection fraction, and cardiac pacing. Methods: Our analysis included 90 consecutive patients (59% males; average age: 73.2 ± 11.2 years) examined between May 2019−December 2020, with valid 2D and 3D loops for further speckle-tracking strain analysis. Linear regression, Pearson correlation, and a Bland−Altman plot were used to quantify the association between 2D and 3D GLS and related segments, using the 17-segment American Heart Association (AHA) model. Analyses were performed in the entire study group and subgroups. Intra- and inter-observer variability of 2D and 3D GLS measurement was also performed in all participants. Results: We observed a strong correlation between 2D and 3D GLS measurements (R = 0.76, p < 0.001), which was higher in males (R = 0.78, p < 0.001) than females (R = 0.69, p < 0.001). Associated segment correlation was poor (R = 0.2−0.5, p < 0.01). The correlation between 2D and 3D GLS was weaker in individuals with ventricular pacing of >50% (R = 0.62, p < 0.001) than <50% (R = 0.8, p < 0.001), and in patients with LVEF of <35% (R = 0.69, p = 0.002) than >35% (R = 0.72, p < 0.001). Intra-observer variability for 2D and 3D GLS was 2 and 2.3%, respectively. Inter-observer variability for 2D and 3D GLS was 3.8 and 3.6%, respectively Conclusion: Overall 2D and 3D GLS were closely associated but not when analyzed per segment. It seems that GLS comparison is more representative of global shortening than local displacement. Right ventricular pacing and reduced left ventricular ejection fraction were associated with a reduced correlation between 2D and 3D GLS.
二维（2D）和三维（3D）斑点追踪超声心动图（STE）可用于评估心肌功能。在此，我们研究了左心室正常、射血分数降低和心脏起搏患者中二维和三维STE测量的整体纵向应变（GLS）之间的一致性。方法：我们的分析纳入了2019年5月至2020年12月期间连续检查的90例患者（59%为男性；平均年龄：73.2±11.2岁），这些患者有有效的二维和三维环用于进一步的斑点追踪应变分析。使用线性回归、Pearson相关性分析和Bland - Altman图，采用美国心脏协会（AHA）的17节段模型来量化二维和三维GLS及相关节段之间的关联。在整个研究组和亚组中进行分析。还对所有参与者进行了二维和三维GLS测量的观察者内和观察者间变异性分析。结果：我们观察到二维和三维GLS测量之间存在强相关性（R = 0.76，p < 0.001），男性（R = 0.78，p < 0.001）的相关性高于女性（R = 0.69，p < 0.001）。相关节段的相关性较差（R = 0.2 - 0.5，p < 0.01）。心室起搏>50%的个体中二维和三维GLS之间的相关性（R = 0.62，p < 0.001）弱于<50%的个体（R = 0.8，p < 0.001），左心室射血分数<35%的患者中二维和三维GLS之间的相关性（R = 0.69，p = 0.002）弱于>35%的患者（R = 0.72，p < 0.001）。二维和三维GLS的观察者内变异性分别为2%和2.3%。二维和三维GLS的观察者间变异性分别为3.8%和3.6%。结论：总体而言，二维和三维GLS密切相关，但按节段分析时并非如此。似乎GLS比较更能代表整体缩短而非局部位移。右心室起搏和左心室射血分数降低与二维和三维GLS之间的相关性降低有关。
