Applications of Speckle Tracking Echocardiography in Stress Echocardiography: A Systematic Review on Feasibility, Diagnostic, and Clinical Utility

IF 1.4 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques Pub Date : 2025-08-06 DOI:10.1111/echo.70251

Johannes Kersten, Achim Jerg, Johannes Kirsten, Hasema Persch, Sarah Krieg, Yuefei Liu, Jon Magne Letnes, Jana Schellenberg

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引用次数: 0

Abstract

Purpose

This review evaluates the applications of speckle-tracking echocardiography (STE) in stress echocardiography, focusing on feasibility, physiological adaptations, and its diagnostic and prognostic utility in cardiovascular conditions.

Methods

A systematic search of PubMed identified studies published up to December 28, 2024, using terms related to STE, stress echocardiography, and myocardial strain. Grey literature was excluded. Eligible studies assessed myocardial strain under stress conditions and reported on feasibility, diagnostic accuracy, or prognostic outcomes.

Results

Sixty-four studies were included, covering healthy individuals, athletes, at-risk populations, and patients with cardiovascular conditions. Feasibility studies demonstrated high interobserver reliability, with strain parameters measurable in > 80% of cases (intraclass correlation coefficient [ICC] 0.80 to 0.92). In healthy individuals and athletes, STE revealed myocardial adaptations and exercise-induced changes. In at-risk populations, such as those with diabetes or after cardiotoxic therapies, STE identified subclinical myocardial dysfunction, facilitating early intervention. For coronary artery disease (CAD) and heart failure (HF), stress-induced changes in global and segmental strain improved diagnostic accuracy and risk stratification, with thresholds such as a > 15% reduction in global longitudinal strain under stress aiding therapeutic decision-making.

Conclusions

STE enhances the diagnostic and prognostic utility of stress echocardiography by providing reproducible strain parameters and facilitating early detection of dysfunction in high-risk populations. Future research should focus on standardizing strain analysis and integrating artificial intelligence (AI) to optimize clinical applications.

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斑点跟踪超声心动图在应激超声心动图中的应用：可行性、诊断和临床应用的系统综述

本文综述了斑点跟踪超声心动图（STE）在应激超声心动图中的应用，重点讨论了其可行性、生理适应性及其在心血管疾病诊断和预后中的应用。方法系统检索PubMed截止到2024年12月28日发表的研究，使用STE、应激超声心动图和心肌应变相关术语。灰色文献被排除。符合条件的研究评估了应激条件下的心肌应变，并报告了可行性、诊断准确性或预后结果。结果纳入64项研究，涵盖健康个体、运动员、高危人群和心血管疾病患者。可行性研究表明，观察者之间的可靠性很高，应变参数在>；80%的病例（类内相关系数[ICC] 0.80 ~ 0.92）。在健康个体和运动员中，STE显示心肌适应和运动引起的变化。在高危人群中，如糖尿病患者或接受心脏毒性治疗的患者，STE可识别亚临床心肌功能障碍，促进早期干预。对于冠状动脉疾病（CAD）和心力衰竭（HF），应力引起的整体和节段应变变化提高了诊断准确性和风险分层，阈值如a >；在压力下减少15%的整体纵向应变，有助于治疗决策。结论STE通过提供可重复的应变参数和促进高危人群功能障碍的早期发现，提高了应激超声心动图的诊断和预后价值。未来的研究应着眼于规范应变分析和整合人工智能（AI），以优化临床应用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques 医学-心血管系统

CiteScore

2.40

自引率

6.70%

发文量

211

审稿时长

3-6 weeks

期刊介绍： Echocardiography: A Journal of Cardiovascular Ultrasound and Allied Techniques is the official publication of the International Society of Cardiovascular Ultrasound. Widely recognized for its comprehensive peer-reviewed articles, case studies, original research, and reviews by international authors. Echocardiography keeps its readership of echocardiographers, ultrasound specialists, and cardiologists well informed of the latest developments in the field.