BACKGROUND Whether left ventricular (LV) longitudinal peak systolic segmental strain (LPSS) has sufficient reproducibility to be used in clinical practice (e.g., in patient follow-up) remains unclear. The aim of this study was to assess the reproducibility of combined acquisition and measurements of LPSS across the spectrum of LV ejection fraction (LVEF). METHODS In this prospective study, 72 subjects (mean age, 63 ± 14 years; 65% men) were included in four equal groups: group 1, LVEF ≥ 50%, healthy; group 2, LVEF ≥ 50%, presence of cardiovascular disease and/or risk factors; group 3, LVEF 30%-49%; and group 4, LVEF ≤ 29%. Two observers performed four sets of image acquisitions and measurements (three during the same session, one after a median of 1 day) to account for intraobserver, interobserver, and test-retest reproducibility of combined acquisition and measurements. LPSS was measured in each of the 17 LV segments. RESULTS On average, the intraobserver and test-retest intraclass correlation coefficients and mean absolute differences of repeated acquisition and measurement of LPSS were similar across groups. However, interobserver intraclass correlation coefficients and mean absolute differences decreased in group 4 compared with groups 1 to 3. The intraobserver, test-retest, and interobserver coefficients of variation of all LV segments became worse as LVEF decreased, especially in group 4, in which LPSS was not reproducible in most segments. Reproducibility of LPSS in basal LV segments was worse compared with apical segments. The average measurement uncertainty (defined as the 95% limits of agreement of repeated acquisition and measurements) of LPSS in a test-retest scenario was ±8.9%, ±11.8%, ±10.7%, and ±9.0% in groups 1, 2, 3, and 4, respectively. CONCLUSIONS The clinical applicability of LPSS is hindered by suboptimal reproducibility, even if a single observer repeats both acquisition and measurements. Changes in LPSS during patient follow-up should be interpreted with caution.

中文翻译：

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左心室纵向峰节段应变联合采集和测量的可重复性与左心室功能障碍的严重程度有关。

背景技术尚不清楚左心室（LV）纵向峰值收缩期节段应变（LPSS）是否具有足够的可重复性以用于临床实践（例如，在患者随访中）。这项研究的目的是评估LV射血分数（LVEF）频谱中LPSS的联合采集和测量的可重复性。方法在这项前瞻性研究中，将72名受试者（平均年龄63±14岁； 65％的男性）分为四个平等组：第1组，LVEF≥50％，健康；第2组，LVEF≥50％，存在心血管疾病和/或危险因素；第3组，LVEF 30％-49％; 第4组，LVEF≤29％。两名观察员执行了四组图像采集和测量（在同一会话中进行三组，中位数为1天后一组），以说明观察员内部，观察员之间，组合采集和测量的重测和重测重现性。在17个LV段的每一个中测量LPSS。结果平均而言，各组间重复观测和测量LPSS的观察者内和重测组内相关系数以及平均绝对差均相似。但是，与第1组至第3组相比，第4组的观察者间类内相关系数和平均绝对差降低。随着LVEF的降低，所有LV段的观察者间，再测和观察者间变异系数均变差，尤其是在第4组中， LPSS在大多数细分市场中均不可复制。与根尖段相比，基底LV段的LPSS重现性较差。在第1组，第2组和第2组中，LPSS的平均测量不确定度（定义为重复采集和测量的一致性的95％限制）为±8.9％，±11.8％，±10.7％和±9.0％。 3和4。结论LPSS的临床适用性由于无法实现最佳的再现性而受到阻碍，即使单个观察者重复进行采集和测量也是如此。在患者随访期间，LPSS的变化应谨慎解释。