Relationship Between Image Quality and Bias in 3D Echocardiographic Measures: Data From the SABRE (Southall and Brent Revisited) Study.
Relationship Between Image Quality and Bias in 3D Echocardiographic Measures: Data From the SABRE (Southall and Brent Revisited) Study.
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DOI：
10.1161/jaha.120.019183
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发表时间：
2022-05-03
影响因子：
5.4
通讯作者：
Hughes, Alun D.
中科院分区：
文献类型：
--
作者：
Al Saikhan, Lamia;Park, Chloe;Tillin, Therese;Lloyd, Guy;Mayet, Jamil;Chaturvedi, Nish;Hughes, Alun D.
图像质量(IQ)影响了三维超声心动图(3DE)对左心室的评估。病情较重/较虚弱的患者通常智商不佳，因此观察到的关联可能会因智商而产生偏差。我们在一项对老年人的观察性研究中，以及在健康志愿者的智商被实验改变的情况下，研究了它的影响。对1294名参加第二波Southall and Brent Revisted研究的受试者进行了智商测定的3DE可行性评估，并与147名受试者的二维(2D)超声心动图可行性进行比较。在成功分析后，比较智商差和好的个体的射血分数(3D-EF)和整体纵向应变(3D-GLS)(加上2D-EF)的平均值。在两项健康参与者的研究中，3DE-IQ受损的原因是(1)故意使用糟糕的超声心动图技术，以及(2)使用超声衰减材料(氯丁橡胶；2-4 mm)。3DE的可行性为41%，2D-EF，P<；0.0001的可行性为61%。在可接受的图像中(n=529)，根据2015年美国超声心动图学会/欧洲心血管成像协会的标准，3D-EF和3D-GLS的良好智商分别为33.6%(178/529)和71.3%(377/529)。智商低的个体3D-EF和3D-GLS(绝对值)低于智商好的个体(3D-EF：52.8±6.0%比55.7±5.7%，Mean-Δ−2.9[−3.9，1.8]；3D-GLS：18.6±3.2%比19.2±2.9%，Mean-Δ−0.6[−1.1，0.0])。在两个智商低下的实验模型中(均为36例)，3D-EF和3D-GLS的平均差值分别为(−2.6~−3.2)和(−1.2~−2.0)。其他3DE左心室容量和应变参数也发现了类似的结果。3DE参数的可行性较低，在智商较低的个体中，3DE参数系统性较低。虽然3D-EF和3D-GLS与常规超声心动图相比具有潜在的优势，但仍需进一步的技术改进以提高3DE在临床上的实用性。
Image‐quality (IQ) compromises left ventricle assessment by 3‐dimensional echocardiography (3DE). Sicker/frailer patients often have suboptimal IQ, and therefore observed associations may be biased by IQ. We investigated its effect in an observational study of older people and when IQ was modified experimentally in healthy volunteers. 3DE feasibility by IQ was assessed in 1294 individuals who attended the second wave of the Southall and Brent Revisited study and was compared with 2‐dimensional (2D)‐echocardiography feasibility in 147 individuals. Upon successful analysis, means of ejection fraction (3D‐EF) and global longitudinal strain (3D‐GLS) (plus 2D‐EF) were compared in individuals with poor versus good IQ. In 2 studies of healthy participants, 3DE‐IQ was impaired by (1) intentionally poor echocardiographic technique, and (2) use of a sheet of ultrasound‐attenuating material (neoprene rubber; 2–4 mm). The feasibility was 41% (529/1294) for 3DE versus 61% (89/147) for 2D‐EF, P<0.0001. Among acceptable images (n=529), good IQ by the 2015 American Society of Echocardiography/European Association of Cardiovascular Imaging criteria was 33.6% (178/529) and 71.3% (377/529) for 3D‐EF and 3D‐GLS, respectively. Individuals with poor IQ had lower 3D‐EF and 3D‐GLS (absolute) than those with good IQ (3D‐EF: 52.8±6.0% versus 55.7±5.7%, Mean‐Δ −2.9 [−3.9, 1.8]; 3D‐GLS: 18.6±3.2% versus 19.2±2.9%, Mean‐Δ −0.6 [−1.1, 0.0]). In 2 experimental models of poor IQ (n=36 for both), mean differences were (−2.6 to −3.2) for 3D‐EF and (−1.2 to −2.0) for 3D‐GLS. Similar findings were found for other 3DE left ventricle volumes and strain parameters. 3DE parameters have low feasibility and values are systematically lower in individuals with poor IQ. Although 3D‐EF and 3D‐GLS have potential advantages over conventional echocardiography, further technical improvements are required to improve the utility of 3DE in clinical practice.