超声心动图自动心肌运动定量技术评测左心室收缩功能的相关性研究

The correlation study of left ventricular systolic function calculated by automated cardiac motion quantification

目的探讨超声心动图自动心肌运动定量（aCMQ）与三维定量分析（3DQA）技术评估左室收缩功能的相关性。方法根据3DQA技术测定的左心室射血分数（LVEF）将患者分为心功能异常组（LVEFG50％）及正常组（LVEF-50％）。获取32例心功能异常患者及119例心功能正常患者的左室长轴两腔心观（AP2）、四腔心观（AP4）及三腔心观（AP3）动态图像，aCMQ测得两腔心纵向应变（AP2LS）、四腔心纵向应变（AP4LS）、三腔心纵向应变（AP3LS）以及整体纵向应变（LVGLS），同时通过aCMQ自带的定量应用软件（quantificationapplication，Q—APP）中的感兴趣区域分析（regionofinterest，ROI）自动驱动自动化计算得出左室舒张末期容量（LVEDV）、左室收缩末期容量（LVESV）、LvEF。比较使用aCMQ与3DQA分别测得左室收缩功能指标的相关性。结果两组间性别构成、体质量指数、年龄比较差异均无统计学意义（均P〉0．05）；异常组使用3QDA技术、aCMQ技术测得的LVEF均低于正常组（均P〈0．01）；异常组AP2LS、AP4LS、AP3LS、LVGI。S绝对值均低于正常组，差异均有统计学意义（均PG0．01）；异常组aCMQ与3QDA技术测得的LVEF呈正相关，相关系数为0．91（P〈0．01）；心功能正常组aCMQ与3QDA技术测得的LVEF呈正相关，相关系数为0．73（P〈0．01）。aCMQ技术测得左室整体纵轴应变（LVGLS）值与3DQA测得LVEF值呈负相关，相关系数为一0．815（PG0．01）。Bland—Altman分析显示，aCMQ与3QDA两种方法均具有较好的可重复性。结论aCMQ技术具有高度可重复性，其所测得LVEF值与3DQA技术测值相关性较高，aCMQ技术可以作为一种评估左室收缩功能新的相对准确的方法。

Objective To explore the correlation of left ventricular systolic function calculated by automated cardiac motion quantification （aCMQ） and three-dimensional quantitative analysis （3DQA）. Methods According to LVEF by 3DQA, patients were divided into abnormal cardiac function group （LVEF〉50 %） and normal cardiac function group （LVEF〉50%）. Dynamic images from two chamber view （AP2）, four chamber view （AP4） and three chamber view（AP3） of left ventricular long axis were acquired from 32 patients with abnormal cardiac function and 119 normal subjects. AP2 longitudinal strain （AP2LS）, AP4 longitudinal strain （AP4LS） and AP3 longitudinal strain （AP3LS） as well as the left ventricular global longitudinal strain （LVGLS） were measured by aCMQ. While left ventricular end diastolic volume （LVEDV）, left ventricular end systolic volume （LVESV） and LVEF were derived through aCMQ automatically calculated region of interest （ROI） driven automation. The correlation of left ventricular systolic function indexes obtained by aCMQ and 3DQA were compared. Results No significant differences were found between the two groups in gender, body mass index（BMI） and age （ P 〈0.05）. LVEF in abnormal group by 3QDA and aCMQ were much lower than those in normal group （P 〈0.01）. Theabsolute values of AP2LS, AP41.S, AP3I.S and I.VGLS in abnormal group were significantly lower than those in normal group （ P 〈0.01）. I.VEF by aCMQ in abnortnal group was positively correlated with I.VEF by 3QDA methods （ r =0.01） , P〈0.01 ） ; I.VEF by aCMQ in normal group was positively correlated with 1.VEF by 3QDA （ r= 0.73, P〈0.01）. The left ventricular global longitudinal strain （LVGI.S） measured by aCMQ was negatively correlated with LVEF by 3QDA（ r =11.815, P 〈0.01）. LVEF measured by aCMQ and 3DQA showed high inter-observer and intra-observer agreements in Bland Altman charts. Conclusions aCMQ has preferable repeatability. Comparing with tim traditional measurement method, I.VEF measured by aCMQ has higher correlation with that measured by 3QDA. aCMQ can be a new and relatively accurate method to evaluate the left ventricular systolic function.