Global and regional myocardial function quantification by two-dimensional strain - Application in hypertrophic cardiomyopathy
Global and regional myocardial function quantification by two-dimensional strain - Application in hypertrophic cardiomyopathy
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DOI：
10.1016/j.jacc.2005.10.061
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发表时间：
2006-03-21
影响因子：
24
通讯作者：
Lafitte, S
中科院分区：
文献类型：
--
作者：
Serri, K;Reant, P;Lafitte, S
目标 最近，开发了一种从标准二维图像测量应变的新方法。我们的目标是使用该技术来表征肥厚型心肌病 (HCM) 患者的整体和区域收缩功能异常。背景 应变已被提议作为检测 HCM 早期收缩功能异常的敏感工具。然而，常规多普勒衍生应变的临床应用由于重复性差和角度依赖性而受到限制。方法对26例非梗阻性HCM患者和45例健康受试者进行超声心动图检查。使用专用软件包，对二维采集进行分析，以测量心尖视图中的纵向和横向应变以及胸骨旁短轴视图中的周向和径向应变。 结果 尽管左心室收缩功能明显正常，但 HCM 中所有应变成分均显着降低。 HCM 患者和对照组的平均纵向、横向、周向和径向应变分别为 -15.1 +/- 6.2% 对比 -20.3 +/- 5.6%、23.3 +/- 17.0% 对比 27.2 +/- 14.9%、-16.8 +/- 7.1% 对比 19.6 +/- 5.2%、25.2 +/- 13.9% 对比分别为 36.8 +/- 17.2%（所有 p < 0.001）。在不对称 HCM 患者中，纵向间隔应变显着低于其他左心室节段的总和：- 9.2 +/- 4.7% 对比 -12.7 +/- 7.1% (p = 0.001)。观察者间和观察者内的平均变异性分别为 11% 和 11.3%。 结论 二维应变是一种测量收缩期应变不同组成部分的简单、快速且可重复的新方法。这项技术可以识别出左心室收缩功能明显正常的 HCM 患者的早期异常。
OBJECTIVES Recently, a novel method to measure strain from standard two-dimensional images has been developed. Our goal was to characterize global and regional systolic function abnormalities using this technique in patients with hypertrophic cardiomyopathy (HCM).BACKGROUND Strain has been proposed as a sensitive tool to detect early systolic function abnormalities in HCM. However, the clinical application of conventional Doppler-derived strain has been limited by poor reproducibility and angle dependency.METHODS Echocardiographic examinations were performed in 26 patients with nonobstructive HCM and 45 healthy subjects. Using a dedicated software package, bidimensional acquisitions were analyzed to measure longitudinal and transverse strain in apical views and circumferential and radial strain in parasternal short-axis view.RESULTS Despite apparently normal left ventricular systolic function, all components of strain were significantly reduced in HCM. Average longitudinal, transverse, circumferential, and radial strain in patients with HCM and controls were -15.1 +/- 6.2% versus -20.3 +/- 5.6%, 23.3 +/- 17.0% versus 27.2 +/- 14.9%, -16.8 +/- 7.1% versus 19.6 +/- 5.2%, and 25.2 +/- 13.9% versus 36.8 +/- 17.2%, respectively (all p < 0.001). In patients with asymmetrical HCM, longitudinal septal strain was significantly lower than for other left ventricular segments combined: - 9.2 +/- 4.7% versus -12.7 +/- 7.1% (p = 0.001). Average interobserver and intraobserver variabilities were 11% and 11.3%, respectively.CONCLUSIONS Two-dimensional strain is a new simple, rapid, and reproducible method to measure different components of systolic strain. This technique identified early abnormalities in patients with HCM that have apparently normal left ventricular systolic function.