Reproducibility of Left Ventricular Dyssynchrony Indices by Three-Dimensional Speckle-Tracking Echocardiography: The Impact of Sub-optimal Image Quality
Reproducibility of Left Ventricular Dyssynchrony Indices by Three-Dimensional Speckle-Tracking Echocardiography: The Impact of Sub-optimal Image Quality
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DOI：
10.3389/fcvm.2019.00149
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发表时间：
2019-10-10
影响因子：
3.6
通讯作者：
Hughes, Alun D.
中科院分区：
文献类型：
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作者：
Al Saikhan, Lamia;Park, Chloe;Hughes, Alun D.
背景：3D 斑点追踪超声心动图 (3D-STE) 是一种量化左心室 (LV) 机械不同步的新方法。 3D-STE 受到图像质量的影响，但对其对 3D-STE 得出的左室收缩不同步指数 (SDI) 的影响程度及其重测重现性的研究有限。方法：3D-STE 分两组进行，每组包括 18 名具有良好超声心动图窗口的健康志愿者。在研究 1 中，通过故意采用较差的超声心动图技术来获取最佳和低质量的图像。在研究 2 中，通过使用氯丁橡胶片（厚度 2、3 和 4 毫米）分别模拟轻度、中度和严重受损的图像来削弱超声传播，从而获得次优质量图像。测量（标准化为心动周期持续时间）是基于体积和应变的 SDI，定义为时间到最小分段值的标准差，以及体积和应变衍生的离散指数。对这两项研究的重测重现性进行了评估。结果：当将分析限制在高质量图像时，大多数指数的重测重现性更好；然而，只有体积、周向应变和主切向应变衍生的左心室不同步指数达到了相当好的可靠性。没有证据表明由于图像质量次优而导致系统偏差。体积、周向应变和主切向应变衍生的 SDI 密切相关。径向应变和纵向应变 SDI 分别与体积 SDI 呈中度或弱相关。结论：次优图像质量损害了 3D-STE 导出的不同步指数的可靠性，但不会在健康个体中引入系统偏差。即使具有最佳质量的图像，也只有基于体积、周向应变和主切向应变的 3D-STE 指数显示出可接受的重测可靠性。
Background: 3D speckle-tracking echocardiography (3D-STE) is a novel method to quantify left ventricular (LV) mechanical dyssynchrony. 3D-STE is influenced by image quality, but studies on the magnitude of its effect on 3D-STE derived LV systolic dyssynchrony indices (SDIs) and their test-retest reproducibility are limited.Methods: 3D-STE was performed in two groups, each comprising 18 healthy volunteers with good echocardiographic windows. In study 1, optimal and inferior-quality images, by intentionally poor echocardiographic technique, were acquired. In study 2, sub-optimal quality images were acquired by impairing ultrasound propagation using neoprene rubber sheets (thickness 2, 3, and 4mm) mimicking mildly, moderately, and severely impaired images, respectively. Measures (normalized to cardiac cycle duration) were volume- and strain-based SDIs defined as the standard deviation of time to minimum segmental values, and volume- and strain-derived dispersion indices. For both studies test-retest reproducibility was assessed.Results: Test-retest reproducibility was better for most indices when restricting the analysis to good quality images; nevertheless, only volume-, circumferential strain-, and principal tangential strain-derived LV dyssynchrony indices achieved fair to good reliability. There was no evidence of systematic bias due to sub-optimal quality image. Volume-, circumferential strain-, and principal tangential strain-derived SDIs correlated closely. Radial strain- and longitudinal strain-SDI correlated moderately or weakly with volume-SDI, respectively.Conclusions: Sub-optimal image quality compromised the reliability of 3D-STE derived dyssynchrony indices but did not introduce systematic bias in healthy individuals. Even with optimal quality images, only 3D-STE indices based on volume, circumferential strain and principal tangential strain showed acceptable test-retest reliability.