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基于模型和基于斑点追踪的左心室容积与功能自动三维超声心动图定量分析的比较:一项多中心研究。

Comparison of model-based and speckle tracking-based automated three-dimensional echocardiographic quantification of left ventricular volumes and function: A multicenter study.

作者信息

Li Shi-Wen, Dong Tian-Xin, Bai Ruo-Cen, Wang Chun-Feng, Pan Xiao-Fang, Lai Yu-Qiong, Cong Tao, Wu Jun, Lu Gui-Lin, Tan Jing, Chen Xin-Yun, Ding Ming-Yan, Zhang Su-Li, Hong Lin-Wei, Li Yu-Hong, Chen Cheng-Cai, Liu Yi-Lin, Yang Dong-Mei, Li Yan-Hua, Sun Hai-Xia, Jin Xin, Ding Xu-Meng, Zhang Li, Xie Ming-Xing, Ren Wei-Dong, Ma Chun-Yan

机构信息

Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, China.

Department of Cardiovascular Ultrasound, Fushun, Mineral Hospital of Liaoning Provincial Health Industry Group, Fushun, China.

出版信息

Int J Cardiol. 2025 Oct 15;437:133426. doi: 10.1016/j.ijcard.2025.133426. Epub 2025 May 28.

Abstract

BACKGROUND

Three-dimensional echocardiography (3DE) provides accurate and reproducible measurements of left ventricular (LV) volumes and ejection fraction (LVEF). Speckle tracking-based 4D LV-Analysis and model-based Dynamic Heart Model (DHM) are commonly used automated 3DE software. However, the potential discrepancies in quantification between these two software have not been fully elucidated. Therefore, this study aimed to determine the differences between the two methods.

METHODS

A total of 770 healthy individuals aged 18 to 79 years were enrolled in 38 hospitals throughout China. LV volumes and LVEF were measured using both speckle tracking-based 4D LV-Analysis and model-based DHM.

RESULTS

The measurements of LV end-diastolic volume, end-systolic volume, stroke volume, and LVEF by DHM were found to be 16.6 mL, 5.1 mL, 11.6 mL, and 1.0 % higher, respectively, compared with 4D LV-Analysis (all P values were < 0.001). DHM showed shorter analysis time in comparison with 4D LV-Analysis, whether manual adjustment is required or not. Although both methods exhibited high reproducibility, the reproducibility of DHM was less influenced by variations in image quality. Due to the differences between the two software, age- and sex-specific reference ranges for LV volumes and LVEF were established for the DHM.

CONCLUSION

There are notable differences between DHM and 4D LV-Analysis in LV quantification. Specifically, LV volumes and LVEF measured using DHM are significantly higher. These discrepancies should be carefully considered in clinical practice, and distinct reference ranges should be employed accordingly.

摘要

背景

三维超声心动图(3DE)可对左心室(LV)容积和射血分数(LVEF)进行准确且可重复的测量。基于斑点追踪的4D左心室分析和基于模型的动态心脏模型(DHM)是常用的自动化3DE软件。然而,这两种软件在定量方面的潜在差异尚未完全阐明。因此,本研究旨在确定这两种方法之间的差异。

方法

在中国各地的38家医院共纳入了770名年龄在18至79岁之间的健康个体。使用基于斑点追踪的4D左心室分析和基于模型的DHM测量LV容积和LVEF。

结果

发现与4D左心室分析相比,DHM测量的左心室舒张末期容积、收缩末期容积、每搏输出量和LVEF分别高16.6 mL、5.1 mL、11.6 mL和1.0%(所有P值均<0.001)。无论是否需要手动调整,与4D左心室分析相比,DHM的分析时间更短。尽管两种方法均具有高重复性,但DHM的重复性受图像质量变化的影响较小。由于两种软件之间存在差异,因此为DHM建立了LV容积和LVEF的年龄和性别特异性参考范围。

结论

DHM和4D左心室分析在LV定量方面存在显著差异。具体而言,使用DHM测量的LV容积和LVEF明显更高。在临床实践中应仔细考虑这些差异,并相应地采用不同的参考范围。

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