Objectives The aim of this study was to investigate whether cluster analysis of left atrial and left ventricular (LV) mechanical deformation parameters provide sufficient information for Doppler-independent assessment of LV diastolic function.

Background Medical imaging produces substantial phenotyping data, and superior computational analyses could allow automated classification of repetitive patterns into patient groups with similar behavior.

Methods The authors performed a cluster analysis and developed a model of LV diastolic function from an initial exploratory cohort of 130 patients that was subsequently tested in a prospective cohort of 44 patients undergoing cardiac catheterization. Patients in both study groups had standard echocardiographic examination with Doppler-derived assessment of diastolic function. Both the left ventricle and the left atrium were tracked simultaneously using speckle-tracking echocardiography (STE) for measuring simultaneous changes in left atrial and ventricular volumes, volume rates, longitudinal strains, and strain rates. Patients in the validation group also underwent invasive measurements of pulmonary capillary wedge pressure and LV end diastolic pressure immediately after echocardiography. The similarity between STE and conventional 2-dimensional and Doppler methods of diastolic function was investigated in both the exploratory and validation cohorts.

Results STE demonstrated strong correlations with the conventional indices and independently clustered the patients into 3 groups with conventional measurements verifying increasing severity of diastolic dysfunction and LV filling pressures. A multivariable linear regression model also allowed estimation of E/e′ and pulmonary capillary wedge pressure by STE in the validation cohort.

Conclusions Tracking deformation of the left-sided cardiac chambers from routine cardiac ultrasound images provides accurate information for Doppler-independent phenotypic characterization of LV diastolic function and noninvasive assessment of LV filling pressures.

目的这项研究的目的是调查是否对左心房和左心室（LV）机械变形参数进行聚类分析是否能为多普勒独立评估LV舒张功能提供足够的信息。

背景医学成像产生大量的表型数据，并且出色的计算分析可以允许将重复性模式自动分类为具有相似行为的患者组。

方法作者进行了聚类分析，并从最初的130名患者的探索性队列中开发了LV舒张功能模型，随后在接受心脏导管插入术的44名患者的预期队列中对其进行了测试。两个研究组的患者均接受了标准的超声心动图检查，并根据多普勒评估了舒张功能。使用散斑跟踪超声心动图（STE）同时跟踪左心室和左心房，以测量左心房和心室容积，容积率，纵向应变和应变率的同时变化。验证组的患者在超声心动图检查后也立即进行了肺毛细血管楔压和左室舒张末期压力的侵入性测量。

结果STE表现出与常规指标的强相关性，并通过常规测量将患者独立分为3组，从而证实了舒张功能障碍和左室充盈压的严重性增加。多变量线性回归模型还允许在验证队列中通过STE估计E / e'和肺毛细血管楔压。

结论从常规心脏超声图像跟踪左侧心腔变形可为LV舒张功能的多普勒独立表型表征和LV充盈压的无创评估提供准确的信息。