Feasibility of tissue-tracking mitral annular displacement in single four-chamber view as a simple index of left ventricular longitudinal deformation
Feasibility of tissue-tracking mitral annular displacement in single four-chamber view as a simple index of left ventricular longitudinal deformation
复制标题
单四腔切面组织追踪二尖瓣环位移作为左心室纵向变形简单指标的可行性
DOI：
10.1007/s12574-022-00578-5
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发表时间：
2022
影响因子：
1.6
通讯作者：
Akasaka Takashi
中科院分区：
文献类型：
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作者：
Terada Kosei;Hozumi Takeshi;Fujita Suwako;Takemoto Kazushi;Nishi Takahiro;Khalifa Amir Kh. M.;Kubo Takashi;Tanaka Atsushi;Akasaka Takashi
背景：左心室整体纵向应变（LVGLS）对心脏不良事件具有预后价值。将斑点跟踪技术应用于二尖瓣环，可以方便地评估根尖四腔视野下的组织跟踪二尖瓣环位移（TMAD）。本研究旨在探讨TMAD是否可以作为有或无保留射血分数（EF）患者左室纵向变形的简单指标。方法研究人群为95名连续受试者。从三个顶点角度评估GLS。在根尖4室视图中，TMAD被评价为室间隔（TMADsep）、外侧（TMADlat）和环线中点（TMADmid）从基部到顶点的位移。计算从二尖瓣环中点到舒张末期顶点的TMADmid与左室长度的百分比（%TMADmid）。我们将各TMAD参数与GLS进行线性回归分析比较，并采用受试者工作特征（ROC）曲线对各TMAD参数进行分析，检测左室纵向变形受损（|GLS|< 15.0%）。结果TMAD各参数与GLS具有良好的相关性（TMADsep:r2= 0.59,p< 0.01）。TMADlat:r2= 0.65,p< 0.01。TMADmid:r2= 0.68,p< 0.01。%TMADmid:r2= 0.75,p< 0.01)。ROC曲线显示，判断左室纵向变形受损（|GLS|≤15.0%）的最佳临界值为%TMADmid < 10.5%，灵敏度为95%，特异性为93%。%TMADmid的曲线下面积（AUC）为0.98（95%可信区间（CI） 0.93 ~ 0.99）。结论斑点跟踪超声心动图单心尖四室快速估计stmad可作为检测左室纵向变形受损的简单指标。
BackgroundLeft ventricular global longitudinal strain (LVGLS) has prognostic value for adverse cardiac events. Application of speckle-tracking technology to mitral annulus provides easy assessment of tissue-tracking mitral annular displacement (TMAD) in apical four-chamber view. The study aimed to examine whether TMAD can be used as a simple index of LV longitudinal deformation in patients with and without preserved ejection fraction (EF).MethodsThe study population consisted of 95 consecutive subjects. GLS was assessed from three apical views. TMAD was evaluated as the base-to-apex displacement of septal (TMADsep), lateral (TMADlat), and mid-point of annular line (TMADmid) in apical 4-chamber view. The percentage of TMADmid to LV length from the mid-point of mitral annuls to the apex at end-diastole (%TMADmid) was calculated. We compared each TMAD parameter with GLS by linear regression analysis, and analyzed each TMAD parameter by receiver operating characteristic (ROC) curve to detect impaired LV longitudinal deformation (|GLS|< 15.0%).ResultsThere were good correlations between each TMAD parameter and GLS (TMADsep:r2= 0.59,p< 0.01. TMADlat:r2= 0.65,p< 0.01. TMADmid:r2= 0.68,p< 0.01. %TMADmid:r2= 0.75,p< 0.01). According to ROC curve, %TMADmid < 10.5% was the best cut-off value in determining impaired LV longitudinal deformation (|GLS|≤ 15.0%) with a sensitivity of 95% and a specificity of 93%. The area under the curve (AUC) of %TMADmid was 0.98 (95% confidence intervals (CI) 0.93–0.99).ConclusionsTMAD using speckle-tracking echocardiography quickly estimated from single apical four-chamber view can be used as a simple index for detection of impaired LV longitudinal deformation in patients with and without preserved EF.