Current and Evolving Echocardiographic Techniques for the Quantitative Evaluation of Cardiac Mechanics: ASE/EAE Consensus Statement on Methodology and Indications Endorsed by the Japanese Society of Echocardiography
Current and Evolving Echocardiographic Techniques for the Quantitative Evaluation of Cardiac Mechanics: ASE/EAE Consensus Statement on Methodology and Indications Endorsed by the Japanese Society of Echocardiography
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DOI：
10.1093/ejechocard/jer021
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发表时间：
2011-03-01
影响因子：
--
通讯作者：
Zamorano, Jose Luis
中科院分区：
文献类型：
--
作者：
Mor-Avi, Victor;Lang, Roberto M.;Zamorano, Jose Luis
超声心动图成像由于其固有的动态性质而非常适合于心脏力学的评价。因为几十年来，超声心动图一直是唯一允许心脏动态成像的成像方式，所以很自然，用于心脏力学复杂分析的新的、日益自动化的技术已经被超声成像设备的研究人员和制造商所推动。在过去的几十年里，出现了几种这样的技术，以解决读者的经验和解释中的测量差异性问题。其中一些被世界各地的超声心动图医师广泛接受，并成为临床常规的一部分，而另一些则仅限于研究和探索新的临床应用。两种这样的技术已经主导了超声心动图的研究竞技场：（1）基于多普勒的组织速度测量，通常称为组织多普勒或心肌多普勒，以及（2）基于位移测量的斑点跟踪。这两种类型的测量有助于推导出心肌功能的多个参数。本文件的目的是集中在目前可用的技术，允许通过基于图像的局部心肌动力学分析，包括多普勒组织成像和斑点跟踪超声心动图，以及集成的反向散射分析心肌功能的定量评估。本文描述了这些技术的当前和潜在临床应用及其优缺点，简要调查了相关已发表文献的选择，同时强调了不同心血管病理背景下的正常和异常结果，并总结了未解决的问题，未来的研究重点和推荐的临床使用适应症。
Echocardiographic imaging is ideally suited for the evaluation of cardiac mechanics because of its intrinsically dynamic nature. Because for decades, echocardiography has been the only imaging modality that allows dynamic imaging of the heart, it is only natural that new, increasingly automated techniques for sophisticated analysis of cardiac mechanics have been driven by researchers and manufacturers of ultrasound imaging equipment. Several such techniques have emerged over the past decades to address the issue of reader's experience and inter-measurement variability in interpretation. Some were widely embraced by echocardiographers around the world and became part of the clinical routine, whereas others remained limited to research and exploration of new clinical applications. Two such techniques have dominated the research arena of echocardiography: (1) Doppler-based tissue velocity measurements, frequently referred to as tissue Doppler or myocardial Doppler, and (2) speckle tracking on the basis of displacement measurements. Both types of measurements lend themselves to the derivation of multiple parameters of myocardial function. The goal of this document is to focus on the currently available techniques that allow quantitative assessment of myocardial function via image-based analysis of local myocardial dynamics, including Doppler tissue imaging and speckle-tracking echocardiography, as well as integrated back-scatter analysis. This document describes the current and potential clinical applications of these techniques and their strengths and weaknesses, briefly surveys a selection of the relevant published literature while highlighting normal and abnormal findings in the context of different cardiovascular pathologies, and summarizes the unresolved issues, future research priorities, and recommended indications for clinical use.