Three Dimensional (3D) Echocardiography as a Tool of Left Ventricular Assessment in Children with Dilated Cardiomyopathy: Comparison to Cardiac MRI.
Three Dimensional (3D) Echocardiography as a Tool of Left Ventricular Assessment in Children with Dilated Cardiomyopathy: Comparison to Cardiac MRI.
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DOI：
10.3889/oamjms.2018.270
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发表时间：
2018-12-20
影响因子：
--
通讯作者：
Hussein, Walaa Hamed
中科院分区：
文献类型：
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作者：
Habeeb, Nevin Mohamed;Youssef, Omneya Ibrahim;Hussein, Walaa Hamed
背景：左心室容积和射血分数是扩张型心肌病强有力的预后指标。心脏MRI（CMRI）是LV容积和EF评估的首选技术，因为它具有高空间分辨率和完整的容积数据集。三维超声心动图是一种有前途的新技术正在调查中。目的：评价三维超声心动图作为一种工具，在左室评估DCM儿童有关CMRI。一组20名DCM儿童（左室舒张直径< 2 Z评分，LVEF < 35%），儿童医院，艾因-夏姆斯大学（gp 1）（平均年龄6.6岁）进行了比较，20个年龄和性别匹配的儿童作为对照组（gp 2）。患者接受：临床检查，常规超声心动图，自动3D LV定量，3D斑点追踪超声心动图（3D-STE）（VIVID E9 Vingmed，挪威）和CMRI（Philips Achieva Nova，1.5 T扫描仪）测量左室收缩末期容积（LVESV）、左室舒张末期容积（LVEDV），这些指标与体表面积、EF%和室壁运动异常评估有关。在ESV/BSA和EDV/BSA评估中，自动3D LV定量超声心动图、3D-STE和CMRI之间无统计学显著差异（p = 1，0.99），EF%评估中自动LV量化超声心动图与CMRI之间的差异（p = 0.99）以及CMRI和3D-STE在LV整体运动功能减退检测中的差异（P = 0.255）。至于节段性运动功能减退，CMRI更敏感[45%的患者对40%，（P = 0.036），基底隔运动功能减退85% vs. 75%，（p = 0.045），中间隔运动功能减退80% vs. 65%，（p = 0.012）和侧壁运动减退75% vs. 65%（p = 0.028）]。结论：自动三维左室定量超声心动图和3D-STE是评价CMRI作为标准方法的左室容积和收缩功能的可靠工具。3D斑点超声心动图在检测整体室壁运动功能减退方面与CMRI相当，但在节段性室壁运动功能减退方面灵敏度较低，需要进一步研究。
BACKGROUND: Left ventricular (LV) volumes and ejection fraction (EF) is Strong prognostic indicators for DCM. Cardiac MRI (CMRI) is a preferred technique for LV volumes and EF assessment due to high spatial resolution and complete volumetric datasets. Three-dimensional echocardiography is a promising new technique under investigations.AIM: Evaluate 3D echocardiography as a tool in LV assessment in DCM children about CMRI.PATIENTS AND METHODS: A group of 20 DCM children (LVdiastolic diameter < 2 Z score, LVEF < 35%) at Children s Hospital, Ain-Shams University (gp1) (mean age 6.6 years) were compared to 20 age and sex-matched children as controls (gp2). Patients were subjected to: clinical examination, conventional echocardiography, automated 3D LV quantification, 3D speckle tracking echocardiography (3D-STE) (VIVID E9 Vingmed, Norway) and CMRI (Philips Achieva Nova, 1.5 Tesla scanner) for LV end systolic volume (LVESV), LVend diastolic volume (LVEDV) that were indexed to body surface area, EF% and wall motion abnormalities assessment.RESUTS: No statistically significant difference was found between automated 3D LV quantification echocardiography, 3D-STE, and CMRI in ESV/BSA and EDV/BSA assessment (p = 1, 0.99 respectively), between automated LV quantification echocardiography and CMRI in EF% assessment (p = 0.99) and between CMRI and 3D-STE in LV Global hypokinesia detection (P = 0.255). As for segmental hypokinesia CMRI was more sensitive [45% of patients vs. 40%, (P = 0,036), basal septal hypokinesia 85% vs. 75%, (p = 0.045), mid septal hypokinesia 80% vs. 65%, (p = 0.012) and lateral wall hypokinesia 75% vs. 65%, (p = 0.028)].CONCLUSION: Automated 3D LV quantification echocardiography and 3D-STE are reliable tools in LV volumetric and systolic function assessment about CMRIas a standard method. 3D speckle echocardiography is comparable to CMRI in global wall hypokinesia detection but less sensitive in segmental wall hypokinesia which mandates further studies.