Background

In prior work, the authors demonstrated that two-dimensional speckle-tracking (2DST) correlated well but systematically overestimated global longitudinal strain (LS) and circumferential strain (CS) compared with two-dimensional cardiac magnetic resonance tagging (2DTagg) and had poor agreement on a segmental basis. Because three-dimensional speckle-tracking (3DST) has recently emerged as a new, more comprehensive evaluation of myocardial deformation, this study was undertaken to evaluate whether it would compare more favorably with 2DTagg than 2DST.

Methods

In a prospective two-center trial, 119 subjects (29 healthy volunteers, 63 patients with left ventricular dysfunction, and 27 patients with left ventricular hypertrophy) underwent 2DST, 3DST, and 2DTagg. Global, regional (basal, mid, and apical), and segmental (18 and 16 segments per patient) LS and CS by 2DST and 3DST were compared with 2DTagg using intraclass correlation coefficients (ICCs) and Bland-Altman analysis. Test-retest reproducibility of 3DST and 2DST was compared in 48 other patients.

Results

Both global LS and CS by 3DST agreed better with 2DTagg (ICC = 0.89 and ICC = 0.83, P < .001 for both; bias = 0.5 ± 2.3% and 0.2 ± 3%) than 2DST (ICC = 0.65 and ICC = 0.55, P < .001 for both; bias = −5.5 ± 2.5% and −7 ± 5.3%). Unlike 2DST, 3DST did not overestimate deformation at the regional and particularly the apical levels and at the segmental level had lower bias (LS, 0.8 ± 2.8% vs −5.3 ± 2.4%; CS, −0.01 ± 2.8% vs −7 ± 2.8%, respectively) but similar agreement with 2DST (LS: ICC = 0.58 ± 0.16 vs 0.56 ± 0.12; CS: ICC = 0.58 ± 0.12 vs 0.51 ± 0.1) with 2DTagg. Finally, 3DST had similar global LS, but better global CS test-retest variability than 2DST.

Conclusions

Using 2DTagg as reference, 3DST had better agreement and less bias for global and regional LS and CS. At the segmental level, 3DST demonstrated comparable agreement but lower bias versus 2DTagg compared with 2DST. Also, test-retest variability for global CS by 3DST was better than by 2DST. This suggests that 3DST is superior to 2DST for analysis of global and regional myocardial deformation, but further refinement is needed for both 3DST and 2DST at the segmental level.

中文翻译：

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通过心脏磁共振标签显示的三维斑点追踪与二维斑点追踪，改善了心肌变形评估

背景

在先前的工作中，作者证明了与二维心脏磁共振标签（2DTagg）相比，二维散斑跟踪（2DST）具有很好的相关性，但系统地高估了总体纵向应变（LS）和周向应变（CS），并且一致性较差。在细分基础上。由于三维散斑跟踪（3DST）最近作为一种新的，更全面的心肌变形评估出现，因此进行了这项研究以评估它与2DTagg相比是否比2DST更有利。

方法

在一项前瞻性两中心试验中，对119名受试者（29名健康志愿者，63名左心功能不全的患者和27名左心室肥大的患者）进行了2DST，3DST和2DTagg。使用组内相关系数（ICC）和Bland-Altman分析，将2DST和3DST的整体，区域性（基底，中部和顶端）和分段性（每位患者18和16个区段）的LS和CS与2DTagg进行了比较。在其他48位患者中比较了3DST和2DST的重测重现性。

结果

与2DST（ICC = 0.65和ICC = 0.55，2DTagg（ICC = 0.89和ICC = 0.83，P  <.001;两者均P <.001;偏差= 0.5±2.3％和0.2±3％）相比，全局LS和CS的一致性更好。 两者的P <0.001;偏差= -5.5±2.5％和-7±5.3％）。与2DST不同，3DST并没有高估区域尤其是根尖的变形，而节段的偏斜较低（LS，0.8±2.8％vs -5.3±2.4％; CS，-0.01±2.8％vs -7±2.8分别为％），但与使用2DTagg的2DST（LS：ICC = 0.58±0.16 vs 0.56±0.12； CS：ICC = 0.58±0.12 vs 0.51±0.1）相似。最后，3DST具有相似的全局LS，但比2DST具有更好的全局CS重测变异性。

结论

使用2DTagg作为参考，3DST对于全球和区域LS和CS具有更好的一致性和更少的偏见。在细分市场上，与2DST相比，3DST表现出可比的一致性，但与2DTagg相比偏差更小。而且，通过3DST进行的全局CS的重测变异性要好于通过2DST进行的重测。这表明3DST在分析整体和区域心肌变形方面优于2DST，但在段水平上3DST和2DST都需要进一步完善。