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How Does Regional Hypertrophy Affect Strain Measurements With Different Speckle-Tracking Methods?
Journal of the American Society of Echocardiography ( IF 5.4 ) Pub Date : 2019-07-31 , DOI: 10.1016/j.echo.2019.06.008
Monica Dobrovie 1 , Stėphanie Bėzy 2 , Serkan Ünlü 3 , Bidisha Chakraborty 2 , Aniela Petrescu 2 , Jürgen Duchenne 2 , Ahmed Salem Beela 4 , Jens-Uwe Voigt 2
Affiliation  

BACKGROUND In this study, we evaluate the impact of abnormal myocardial shapes, such as regional hypertrophy, on longitudinal strain measurements with different tracking approaches. METHODS We selected 40 patients with normal ejection fraction and prominent septal bulge. We assessed longitudinal strain with full wall (FW) tracking, (GE EchoPAC) as well as endo-, mid-, and epicardial (EME) tracking (Tomtec ImageArena), on the same image acquired with a GE machine (using raw data and full frame rate DICOM data, respectively). We used a region of interest (ROI) which follows precisely the endo- and epicardial contours (true contour ROI) and one where the bulging region was excluded (straight ROI). RESULTS In segments with bulge, absolute segmental longitudinal strain values were in all myocardial layers significantly higher with a straight ROI compared to a true contour ROI, both with FW tracking and EME tracking. The highest difference was found in the endocardial layer (3.4 ± 2.5% and 7.7 ± 7.1%, respectively, both P < 0.001). In the bulged segments, the effect of ROI shape was more pronounced in EME tracking software compared to FW tracking software. Bulged segments also influenced global longitudinal strain measurements, mostly in the endocardial layer (P < 0.001). Global longitudinal strain values obtained with the straight ROI correlated better with longitudinal fractional shortening of the LV. CONCLUSIONS Regional bulging has a significant effect on both global and segmental strain measurements. Endocardial strain values obtained with EME tracking and a true contour ROI were most sensitive to bulging. Midwall strain values derived from FW tracking using a straight ROI were most robust.

中文翻译:

区域肥大如何通过不同的斑点跟踪方法影响应变测量?

背景技术在这项研究中,我们评估了异常心肌形状(例如区域肥大)对采用不同跟踪方法进行的纵向应变测量的影响。方法选择40例射血分数正常,中隔突出的患者。我们在使用GE机器获得的同一图像上使用全壁(FW)跟踪,(GE EchoPAC)以及心内膜​​,中膜和心外膜(EME)跟踪(Tomtec ImageArena)评估了纵向应变(使用原始数据和全帧速率DICOM数据)。我们使用的关注区域(ROI)恰好遵循心内膜和心外膜的轮廓(真实轮廓ROI),而排除凸起区域的区域(直线ROI)。结果在带有凸起的路段中,在FW跟踪和EME跟踪下,与真实轮廓ROI相比,直线ROI时所有心肌层的绝对节段纵向应变值均显着更高。心内膜层之间的差异最大(分别为3.4±2.5%和7.7±7.1%,两者均P <0.001)。在凸起部分,与FW跟踪软件相比,在EME跟踪软件中ROI形状的影响更为明显。隆起的节段也影响整体纵向应变测量,主要是在心内膜层(P <0.001)。用笔直的ROI获得的整体纵向应变值与LV的纵向分数缩短更好地相关。结论区域膨胀对整体和分段应变测量都具有显着影响。通过EME跟踪获得的心内膜应变值和真实轮廓ROI对膨胀最敏感。使用直接ROI从FW跟踪得出的中壁应变值最可靠。
更新日期:2019-07-31
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