Challenges associated with retrospective analysis of left ventricular function using clinical echocardiograms from a multicenter research study.
Challenges associated with retrospective analysis of left ventricular function using clinical echocardiograms from a multicenter research study.
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采用多中心研究的临床超声心动图对左心室功能进行回顾性分析的相关挑战。
DOI：
10.1111/echo.14983
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发表时间：
2021-03
期刊：
影响因子：
--
通讯作者：
Nathan PC
中科院分区：
文献类型：
--
作者：
Sachdeva R;Stratton KL;Cox DE;Armenian SH;Bhat A;Border WL;Leger KJ;Leisenring WM;Meacham LR;Sadak KT;Narasimhan S;Chow EJ;Nathan PC
利用为常规临床诊疗获取的超声心动图进行回顾性多中心研究，可能会受到各中心质量问题的阻碍，从而限制了事后研究分析的应用。我们试图评估与一组儿童癌症幸存者存档超声心动图质量较差相关的成像及患者特征。
在一个中心核心实验室，一名单盲评审员对来自5个参与中心的临床超声心动图质量进行分级，重点关注用于得出二维及M型缩短分数（FS）、双平面辛普森射血分数（EF）、心肌性能指数（MPI）、组织多普勒成像（TDI）得出的速度以及整体纵向应变（GLS）的图像。
在2004年至2017年对102名受试者的535项研究分析中，仅7% 的研究能够评估所有心功能指标。虽然超过80% 的研究能够测量二维或M型FS、MPI以及室间隔E/E’，但二尖瓣E/E’ 的测量一致性较差（69%），不过优于EF（52%）和GLS（10%）。66% 的研究至少发现一个质量问题，其中技术问题（如肺部伪影、心内膜显示不清）最为常见（33%）。缺少两腔心和三腔心切面与检查中心有关。与16 - 35岁患者相比，小于5岁的患者在四腔心切面出现心尖截断的可能性更高（相对风险1.99（1.07 - 3.72），p = 0.03）。总体而言，对于任何质量问题，超声检查时间较早以及检查中心是仅有的显著风险因素。
利用多中心汇总的存档超声心动图评估心功能受到显著限制。努力规范临床超声心动图检查方案，纳入心尖两腔心和三腔心切面以及TDI，将提高定量评估左心室功能的能力。
Retrospective multicenter research using echocardiograms obtained for routine clinical care can be hampered by issues of individual center quality, thus limiting the application of post-hoc research analytics. We sought to evaluate imaging and patient characteristics associated with poorer quality of archived echocardiograms from a cohort of childhood cancer survivors. A single blinded reviewer at a central core lab graded quality of clinical echocardiograms from 5 contributing centers focusing on images to derive 2D and M-mode fractional shortening (FS), biplane Simpson ejection fraction (EF), myocardial performance index (MPI), tissue Doppler imaging (TDI) derived velocities and global longitudinal strain (GLS). Of 535 studies analyzed in 102 subjects from 2004 to 2017, all measures of cardiac function could be assessed in only 7%. While FS by 2D or M-mode, MPI and septal E/E’ could be measured in >80% studies, mitral E/E’ was less consistent (69%), but better than EF (52%) and GLS (10%). At least one quality issue was identified in 66% studies, with technical issues (ex. lung artifact, poor endocardial definition) being the most common (33%). Lack of 2- and 3-chamber views was associated with the performing center. Patients < 5 years had a higher chance of apex cut-off in 4-chamber views compared to 16–35 year old (RR 1.99 (1.07–3.72), p = 0.03). Overall, for any quality issue, earlier era of echo and center were the only significant risk factors. Assessment of cardiac function using pooled multicenter archived echocardiograms was significantly limited. Efforts to standardize clinical echocardiographic protocols to include apical 2- and 3-chamber views and TDI will improve the ability to quantitate LV function.
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DOI：
10.1016/j.echo.2015.11.016
发表时间：
2016-03
期刊：
Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
影响因子：
--
作者：
Levy PT;Machefsky A;Sanchez AA;Patel MD;Rogal S;Fowler S;Yaeger L;Hardi A;Holland MR;Hamvas A;Singh GK
通讯作者：
Singh GK
影响因子：
3.4
作者：
Rose-Felker, Kirsten;Border, William L.;Chow, Eric J.
通讯作者：
Chow, Eric J.
影响因子：
1
作者：
Koopman, Laurens P.;Rebel, Bas;Boersma, Eric
通讯作者：
Boersma, Eric
DOI：
10.14694/edbk_175029
发表时间：
2017-01-01
期刊：
American Society of Clinical Oncology educational book. American Society of Clinical Oncology. Annual Meeting
影响因子：
--
作者：
Volchenboum, Samuel L;Cox, Suzanne M;Grossman, Robert
通讯作者：
Grossman, Robert
影响因子：
11.1
作者：
Border, William L.;Sachdeva, Ritu;Chow, Eric J.
通讯作者：
Chow, Eric J.