Inter-technique agreement of left atrial and ventricular deformation analysis: a comparison between transthoracic echocardiography and cardiovascular magnetic resonance imaging.
Aseel Alfuhied, Jian L Yeo, Gaurav S Gulsin, Abhishek Dattani, Kelly Parke, Christopher D Steadman, Manjit Sian, Anna-Marie Marsh, Gerry P McCann, Anvesha Singh
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引用次数: 0
Abstract
Background: Myocardial strain measurements are increasingly used in research and clinical practice. However, there are limited data on inter-modality agreement and reproducibility. We aimed to investigate the inter-technique agreement of transthoracic echocardiography (TTE) and cardiovascular magnetic resonance (CMR) imaging derived left atrial (LA) and left ventricular (LV) deformation parameters.
Methods: Subjects with or without cardiovascular disease were prospectively recruited and had TTE and CMR on the same day. Ten subjects with type 2 diabetes (T2D) had both scans repeated within two weeks for test-retest reproducibility assessment. Myocardial deformation analyses were undertaken including LA strain (LAS) corresponding to LA reservoir, conduit and booster pump phases, LV global longitudinal strain (GLS) and peak early/late diastolic strain rate (PE/PLDSR) and LV mid-circumferential strain (Mid-CS) and strain rates.
Results: 222 participants (T2D (n = 87); severe aortic stenosis (n = 78) and healthy volunteers (n = 57)) were included. There were no significant differences between TTE and CMR measured LAS parameters, with moderate agreement between imaging modalities (ICC = 0.55-0.69). LV parameters were significantly higher on CMR except for Mid-CS which was higher on TTE (-19.3 ± 3.19 vs. -23.0 ± 4.37; p < 0.001). Inter-technique agreement was poor for all LV deformation parameters, except PLDSR with modest agreement (ICC = 0.52-0.66). CMR test-retest reproducibility was good to excellent for LAS and LV strain rate parameters (ICC = 0.73-0.90). TTE test-retest reproducibility was good for conduit LAS and LV_PEDSR (ICC = 0.80).
Conclusion: There is modest agreement between TTE and CMR for LAS and poor agreement for LV strain assessment, suggesting that these techniques cannot be used inter-changeably. In a small subset of participants CMR test-retest reproducibility was overall better than TTE.
背景:心肌应变测量越来越多地应用于研究和临床实践。然而,关于模态间一致性和可重复性的数据有限。我们的目的是探讨经胸超声心动图(TTE)和心血管磁共振(CMR)成像得出的左心房(LA)和左心室(LV)变形参数的技术间一致性。方法:前瞻性招募有或无心血管疾病的受试者,并在同一天进行TTE和CMR。10名2型糖尿病(T2D)患者在两周内重复两次扫描,以评估测试-再测试的可重复性。进行心肌变形分析,包括左室储层、导管和增压泵阶段对应的左室应变(LAS)、左室整体纵向应变(GLS)和舒张早期/晚期应变率峰值(PE/PLDSR)、左室中周应变(Mid-CS)和应变率。结果:222名受试者(T2D, n = 87);重度主动脉瓣狭窄(n = 78)和健康志愿者(n = 57)被纳入研究。TTE和CMR测量的LAS参数之间没有显著差异,成像方式之间的一致性中等(ICC = 0.55-0.69)。除了Mid-CS在TTE上更高(-19.3±3.19 vs -23.0±4.37)外,CMR上的LV参数显著更高(-19.3±3.19 vs. -23.0±4.37);p结论:TTE和CMR在LAS上有适度的一致性,而在LV应变评估上的一致性较差,表明这两种技术不能互换使用。在一小部分参与者中,CMR测试-重测的重现性总体上优于TTE。
期刊介绍:
Echo Research and Practice aims to be the premier international journal for physicians, sonographers, nurses and other allied health professionals practising echocardiography and other cardiac imaging modalities. This open-access journal publishes quality clinical and basic research, reviews, videos, education materials and selected high-interest case reports and videos across all echocardiography modalities and disciplines, including paediatrics, anaesthetics, general practice, acute medicine and intensive care. Multi-modality studies primarily featuring the use of cardiac ultrasound in clinical practice, in association with Cardiac Computed Tomography, Cardiovascular Magnetic Resonance or Nuclear Cardiology are of interest. Topics include, but are not limited to: 2D echocardiography 3D echocardiography Comparative imaging techniques – CCT, CMR and Nuclear Cardiology Congenital heart disease, including foetal echocardiography Contrast echocardiography Critical care echocardiography Deformation imaging Doppler echocardiography Interventional echocardiography Intracardiac echocardiography Intraoperative echocardiography Prosthetic valves Stress echocardiography Technical innovations Transoesophageal echocardiography Valve disease.