Mandoli G E, Pastore M C, Procopio M C, Pica A, Vigna M, Benfari G, Diviggiano E E, Martini L, Lunghetti S, Focardi M, Henein M Y, Cameli M
Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Viale Mario Bracci, 1, 53100 Siena, Italy.
Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
Eur Heart J Imaging Methods Pract. 2024 Jun 24;2(1):qyae061. doi: 10.1093/ehjimp/qyae061. eCollection 2024 Jan.
Speckle tracking echocardiography increasingly supports left atrial (LA) strain (LAS) analysis for diagnosis and prognosis of various clinical conditions. Prior limitations, such as the absence of dedicated software, have been overcome by validated ventricular-based software. A newly automated real-time and offline LA-specific software have now become available on echocardiographs and dedicated workstations. This study aimed at comparing LA strain measures obtained from new fully automated software vs. traditional semi-automated ventricular-based methods in different groups of patients.
Two operators acquired LA images in a mixed population of healthy individuals and patients with pressure overload (hypertension and aortic stenosis) or pressure-volume overload (mitral regurgitation and heart failure). Subjects with prosthetic valves, heart transplant, or atrial fibrillation were excluded. Strain analysis was performed twice by old semi-automated software and new LA dedicated. LAS was then measured online on the scanning echocardiograph. Overall, 100 patients were analysed (41 healthy subjects, 28 pressure overload, 31 volume overload). LAS proved to be highly reproducible with both software. The dedicated method exhibited slightly superior inter- and intra-operator reproducibility. The online software results showed a nearly perfect reproducibility with offline software [intraclass correlation coefficient = 0.99 [0.99; 1.00]] in addition to being able to save an average of ∼30 s.
The recently developed fully automated software for dedicated LAS analysis demonstrates excellent inter- and intra-operator reproducibility, making it a reliable and efficient strain calculation method in routine clinical practice. Another advantage of online LAS calculation is time efficiency.
斑点追踪超声心动图越来越多地支持对左心房（LA）应变（LAS）进行分析，以用于各种临床病症的诊断和预后评估。先前的局限性，如缺乏专用软件，已通过经过验证的基于心室的软件得以克服。如今，一种新的自动化实时和离线LA专用软件已可在超声心动图仪和专用工作站上使用。本研究旨在比较不同患者组中从新型全自动软件与传统半自动基于心室的方法获得的LA应变测量值。
两名操作人员在健康个体以及患有压力负荷过重（高血压和主动脉瓣狭窄）或压力-容量负荷过重（二尖瓣反流和心力衰竭）的患者的混合人群中采集LA图像。排除有人工瓣膜、心脏移植或心房颤动的受试者。通过旧的半自动软件和新的LA专用软件进行两次应变分析。然后在扫描超声心动图仪上在线测量LAS。总共分析了100例患者（41名健康受试者，28例压力负荷过重，31例容量负荷过重）。两种软件的LAS均具有高度可重复性。专用方法在操作者间和操作者内的可重复性略优。在线软件结果显示与离线软件具有近乎完美的可重复性[组内相关系数=0.99[0.99；1.00]]，此外平均还能节省约30秒。
最近开发的用于专用LAS分析的全自动软件在操作者间和操作者内均显示出出色的可重复性，使其成为常规临床实践中一种可靠且高效的应变计算方法。在线LAS计算的另一个优点是时间效率。
