Comparison of two-dimensional speckle and tissue Doppler strain measurement during dobutamine stress echocardiography: an angiographic correlation
Comparison of two-dimensional speckle and tissue Doppler strain measurement during dobutamine stress echocardiography: an angiographic correlation
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DOI：
10.1093/eurheartj/ehm188
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发表时间：
2007-07-01
影响因子：
39.3
通讯作者：
Marwick, Thomas H.
中科院分区：
文献类型：
--
作者：
Hanekom, Lizelle;Cho, Goo-Yeong;Marwick, Thomas H.
目的 来自散斑跟踪的二维 (2D) 应变是基于组织速度成像 (TVI) 的应变的替代方案。我们在 150 名接受多巴酚丁胺负荷超声心动图 (DSE) 和冠状动脉造影的患者中比较了它们的可行性和准确性。方法和结果在静息和峰值负荷时的三个心尖视图中获得了 2D 应变和 TVI 应变。在静息和峰值应力下离线测量峰值收缩应变率 (SR)、收缩末期应变 (epsilon(end-sys)) 和峰值应变 (epsilon(peak))，并将结果与室壁运动分析和显着冠状动脉疾病（CAD > 70% 直径狭窄）进行比较。最佳截止值是从哨兵段的受试者工作特征 (ROC) 曲线得出的。最可行的方法是静止时的 2D 应变和峰值应力时的 TVI 应变。对于 2D 应变和 TVI 应变，具有显着 CAD 的患者部位的平均峰值 SR 和峰值应力下的 epsilon(end-sys) 小于无 CAD 患者的部位 (P < 0.0001)，并且峰值应力时的平均 PSI 较高 (P < 0.0001)。对于 CAD 诊断，峰值应力时的峰值收缩 SR 具有 2D-（AUC 0.67）和 TVI-应变（AUC 0.71）的最佳 ROC 面积。 WMS (75%) 诊断每位患者 CAD 的准确性与 2D-SR (69%) 和 TVI-SR (74%) 相似。 2D-SR 和 TVI-SR 在峰值应力下的准确度，对于 LAD 为 78% vs. 79% (P = NS)，对于 LCX 为 67% vs. 73% (P = NS)，对于 RCA 疾病为 59 vs. 74% (P = 0.008)。 结论 DSE 期间散斑跟踪应变的测量是可行的，并且与前循环中的 TVI 应变的精度相似，但在后循环中则不然。
Aims Two-dimensional (2D)-strain derived from speckle-tracking is an alternative to tissue velocity imaging (TVI)-based strain. We compared their feasibility and accuracy in 150 patients undergoing dobutamine stress echocardiography (DSE) and coronary angiography.Methods and results 2D-and TVI-strain were obtained in three apical views at rest and peak stress. Peak systolic strain rate (SR), endsystotic strain (epsilon(end-sys)) and peak strain (epsilon(peak)) were measured off-line at rest and peak stress, and results were compared with wall motion analysis and significant coronary artery disease (CAD >70% diameter stenosis). Optimal cut-offs were derived from receiver operating characteristic (ROC) curves for sentinel segments. The most feasible method was 2D-strain at rest, and TVI-strain at peak stress. The average peak SR and epsilon(end-sys) at peak stress in segments of patients with significant CAD was less than in segments of patients without CAD (P < 0.0001) and mean PSI at peak stress was higher (P < 0.0001) with both 2D-and TVI-strain. Peak systolic SR at peak stress had the best area under the ROC for both 2D- (AUC 0.67) and TVI-strain (AUC 0.71) for the diagnosis of CAD. The accuracy of WMS (75%) for diagnosis of CAD per patient was similar to 2D-SR (69%) and TVI-SR (74%). The accuracy of 2D-SR and TVI-SR at peak stress was 78 vs. 79% (P = NS) for LAD, 67 vs. 73% (P = NS) for LCX, and 59 vs. 74% (P = 0.008) for RCA disease.Conclusion Measurement of speckle tracking strain during DSE is feasible and similar in accuracy to TVI-strain in the anterior, but not in the posterior circulation.