BACKGROUND Cardiomyopathies with increased left ventricular wall thickness such as cardiac amyloidosis, septal hypertrophic cardiomyopathy (HCM), and apical HCM exhibit characteristic regional longitudinal strain (LS) patterns. However, between-vendor agreement of segmental and regional LS has not been tested in these diseases. We sought to assess LS values among vendors in specific cardiomyopathies that exhibit regional strain variation: cardiac amyloidosis, septal HCM, and apical HCM. METHODS This was a prospective, cross-sectional study of 69 patients (18 amyloidosis, 30 septal HCM, 6 apical HCM, and 15 controls) who underwent clinically indicated outpatient echocardiography at the Cleveland Clinic. Peak systolic segmental, regional (basal, mid, and apical), and global LS were evaluated using GE (EchoPAC), Siemens (Velocity Vector Imaging), and Phillips (QLab) systems in the same imaging session. Between-vendor, differences were analyzed using correlation coefficients, Bland Altman plots, and a mixed model. RESULTS Global LS was highly correlated among the 3 software packages and most abnormal in patients with amyloidosis (P<0.001). Regional LS analysis demonstrated that QLab software tended to produce more negative LS values, driven by differences in apical strains. EchoPAC had the greatest ability to discriminate patients with amyloidosis using regional strain values (area under the curve, 0.932) as compared with Velocity Vector Imaging and QLab (P<0.001). CONCLUSIONS Global and regional variations in LS exist between-vendors in patients with cardiomyopathies with increased left ventricular wall thickness (amyloidosis, septal HCM, and apical HCM). It is important to be aware of these differences for diagnosis, prognosis, and serial examinations in these conditions.

中文翻译：

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由于左心室壁厚度增加而引起的心肌病患者在各个供应商的纵向应变中的区域变异性。

背景技术具有增加的左心室壁厚度的心肌病，例如心脏淀粉样变性，中隔肥厚性心肌病（HCM）和心尖HCM，表现出特征性的区域纵向应变（LS）模式。但是，尚未在这些疾病中测试过分段和区域性LS的供应商之间的协议。我们试图评估表现出局部应变变化的特定心肌病厂商中的LS值：心脏淀粉样变性，间隔HCM和根尖HCM。方法这是一项前瞻性，横断面研究，共对69例患者（18例淀粉样变性，30例HCM室间隔，6例顶端HCM和15例对照）进行了临床指示，并在克利夫兰诊所进行了门诊超声心动图检查。使用GE（EchoPAC），Siemens（Velocity Vector Imaging）评估了收缩期的峰值节段性，区域性（基底，中部和顶端）和整体LS。和Phillips（QLab）系统在同一成像会话中。供应商之间的差异使用相关系数，Bland Altman图和混合模型进行了分析。结果Global LS与3个软件包之间的相关性最高，淀粉样变性患者的异常程度最高（P <0.001）。区域性LS分析表明，QLab软件倾向于产生更多的负LS值，这是由心尖菌株的差异所驱动。与Velocity Vector Imaging和QLab相比，EchoPAC具有使用区域应变值（曲线下面积为0.932）区分淀粉样变性患者的最大能力（P <0.001）。结论心肌病患者左室壁厚度增加（淀粉样变性，间隔HCM和根尖HCM）在供应商之间存在LS的整体和区域差异。