Age-Related Normal Range of Left Ventricular Strain and Torsion Using Three-Dimensional Speckle-Tracking Echocardiography
Age-Related Normal Range of Left Ventricular Strain and Torsion Using Three-Dimensional Speckle-Tracking Echocardiography
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DOI：
10.1016/j.echo.2013.10.002
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发表时间：
2014-01-01
影响因子：
6.5
通讯作者：
Otsuji, Yutaka
中科院分区：
文献类型：
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作者：
Kaku, Kyoko;Takeuchi, Masaaki;Otsuji, Yutaka
背景：三维斑点追踪超声心动图(STE)是一种用于量化左心室(LV)功能的新兴技术。然而，在一大批正常受试者中，3D STE测量LV应变和扭转的准确性和正常值尚未建立。本研究的目的是：(1)对照心脏磁共振(CMR)参考值评价3D STE分析LV应变的准确性；(2)使用实时三维超声心动图(RT3DE)图像建立与年龄相关的LV应变和扭转正常值。方法：在方案1中，19例临床表现为CMR的患者在同一天获得RT3DE数据集和CMR图像。比较两种方式的整体LV纵向、周向和径向应变。在方案2中，使用3D STE测量了313名健康受试者的整体和局部应变以及扭转和扭转。结果：方案1中，RT3DE成像与CMR各应变分量具有良好的相关性(r=0.61~0.86，P<；.001)。在方案2中，正常的整体纵向应变、周向应变、径向应变和三维应变分别为-20.3+/-3.2%、-28.9+/-4.6%、88.0+/-21.8%和-37.6+/-4.8%。观察到全球纵向和三维应变具有显著的年龄相关性。年龄对LV扭转也有影响：儿童和青少年的LV扭转值最低，随后随着年龄的增长而增加，而进一步的衰老与心尖旋转的增加和基础旋转度的逐渐减少有关。结论：本研究提供了从RT3DE图像和正常3D LV应变和扭转的参考值进行3D应变分析的初步验证。LV应变和扭转与年龄相关的差异可能反映了心肌的成熟和老化。
Background: Three-dimensional (3D) speckle-tracking echocardiography (STE) is an emerging technology used to quantify left ventricular (LV) function. However, the accuracy and normal values of LV strain and twist using 3D STE have not been established in a large group of normal subjects. The aims of this study were to (1) to evaluate the accuracy of 3D STE analysis of LV strain against a cardiac magnetic resonance (CMR) reference and (2) to establish age-related normal values of LV strain and torsion using real-time 3D echocardiographic (RT3DE) images.Methods: In protocol 1, RT3DE data sets and CMR images were acquired on the same day in 19 patients referred for clinically indicated CMR. Global LV longitudinal, circumferential, and radial strain was compared between the two modalities. In protocol 2, global and regional strain and twist and torsion were measured in 313 healthy subjects using 3D STE.Results: In protocol 1, good correlations for each LV strain component were noted between RT3DE imaging and CMR (r = 0.61-0.86, P < .001). In protocol 2, normal global longitudinal, circumferential, radial, and 3D strain were -20.3 +/- 3.2%, -28.9 +/- 4.6%, 88.0 +/- 21.8%, and -37.6 +/- 4.8%, respectively. A significant age dependency was observed for global longitudinal and 3D strain. Aging also affected LV torsion: the lowest values were found in children and adolescents, and values subsequently increased with age, while further aging was associated with a gradual reduction in basal rotation accompanied by an increase in apical rotation.Conclusions: This study provides initial validation of 3D strain analysis from RT3DE images and reference values of normal 3D LV strain and torsion. The age-related differences in LV strain and torsion may reflect myocardial maturation and aging.