Quantitative Evaluation of Regional Left Ventricular Function Using Three-Dimensional Speckle Tracking Echocardiography in Patients With and Without Heart Disease
Quantitative Evaluation of Regional Left Ventricular Function Using Three-Dimensional Speckle Tracking Echocardiography in Patients With and Without Heart Disease
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DOI：
10.1016/j.amjcard.2009.07.060
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发表时间：
2009-12-15
影响因子：
2.8
通讯作者：
Mor-Avi, Victor
中科院分区：
文献类型：
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作者：
Maffessanti, Francesco;Nesser, Hans-Joachim;Mor-Avi, Victor
虽然二维（2D）斑点追踪超声心动图已被证明是有用的局部左心室功能的评估，它是有限的假设，斑点可以跟踪成像平面内的帧到帧，即使心脏运动是三维（3D）的。我们的目标是通过（1）将局部室壁运动测量值与2D-STE图像进行比较，以及（2）测试其识别局部室壁运动异常的能力，来评价新的3D斑点跟踪超声心动图（STE）软件。分析了从32名受试者获得的2D图像和实时3D数据集（东芝），以测量节段径向和纵向位移和旋转，以及径向、纵向和周向应变。技术间比较包括回归和Bland-Altman分析。此外，由一名专家对同一天采集的心脏磁共振图像（Siemens 1.5 T）进行审查，并将节段分类为正常或异常。比较正常节段与异常节段的各项3D-STE指数值。3D-STE和2D-STE指数相关性不好（r = 0.16 - 0.76），尽管偏差很小，但技术间一致性的范围很宽（2 SD：位移5 - 6 mm，旋转14度，应变17%-52%），表明这2种技术不可互换。在正常节段中，3D-STE显示出更大的位移，反映了平面外运动分量;更小的SD，表明更严格的正常范围;径向和纵向位移逐渐减少，从基部到顶点旋转逆转。在异常节段中，所有3D-STE指标均降低，6个指标中有5个达到显著性。总之，这是第一项评价新的3D-STE技术测量局部室壁运动指数的研究。我们的研究结果表明，它优于2D-STE。(C)2009 Elsevier Inc. All rights reserved. (Am J Cardiol 2009;104：1755-1762）
Although 2-dimensional (2D) speckle tracking echocardiography has been shown to be useful in the assessment of regional left ventricular function, it is limited by the assumption that speckles can be tracked frame-to-frame within the imaging plane, even though the cardiac motion is 3-dimensional (3D). Our goal was to evaluate new 3D-speckle tracking echocardiographic (STE) software by (1) comparing the regional wall motion measurements against 2D-STE images, and (2) testing its ability to identify regional wall motion abnormalities. The 2D images and real-time 3D data sets (Toshiba) obtained from 32 subjects were analyzed to measure segmental radial and longitudinal displacements and rotation, as well as the radial, longitudinal, and circumferential strains. The intertechnique comparisons included regression and Bland-Altman analyses. Additionally, cardiac magnetic resonance images (Siemens 1.5 T) acquired the same day were reviewed by an expert who classified the segments as normal or abnormal. The values of each 3D-STE index were compared between the normal and abnormal segments. The 3D-STE and 2D-STE indexes did not correlate well (r = 0.16 to 0.76) and showed wide limits in intertechnique agreement (2 SD: 5 to 6 mm for displacements, 14 degrees rotation, 17% to 52% strains) despite only minimal biases, indicating that these 2 techniques are not interchangeable. In normal segments, 3D-STE showed greater displacements, reflecting the out-of-plane motion component; smaller SDs, indicating tighter normal ranges; and a gradual decrease in radial and longitudinal displacement and a reversal in rotation from the base to the apex. In the abnormal segments, all 3D-STE indexes were reduced, reaching significance for 5 of 6 indexes. In conclusion, this is the first study to evaluate the new 3D-STE technique for measurement of regional wall motion indexes. Our findings have demonstrated its superiority over 2D-STE. (C) 2009 Elsevier Inc. All rights reserved. (Am J Cardiol 2009;104:1755-1762)