二维斑点追踪超声心动图左房和左室软件测量左房机械形变功能的一致性分析

A consistency analysis of left atrial deformation function measured by two-dimensional speckle tracing echocardiography of left atrial software and left ventricular software

目的评估二维斑点追踪超声心动图(2D-STE)左房和左室软件测量左房整体纵向应变和应变率的一致性。方法选取32例无心血管高危因素和32例有心血管高危因素的受检者(共64例)为研究对象,由两名接受过规范化培训的超声医师应用2D-STE左房和左室软件获得左房整体纵向收缩期应变(Sct)、通道期应变(Scd)、左房储存期应变(Sr=Sct+Scd)、收缩期应变率(SRct)、通道期应变率(SRcd)、储存期应变率(SRr)。比较测量者内和测量者间获得的左房应变和应变率测值,应用Bland-Altman法评估两种软件测量的一致性。结果 (1)应用左室软件时,仅测量者间SRcd比较差异有统计学意义(P=0.01);(2)Bland-Altman一致性检验提示两种软件散布趋势和一致性界限宽度均较好,但左房软件测值较左室软件偏倚小,一致性区间较左室软件范围小;(3)测量者信度分析显示左房软件测值较左室软件一致性好。结论 2D-STE左房软件较左室软件测值偏倚小,一致性范围稳定,测量者的重测信度优秀,值得临床推广应用。

Objective To evaluate the consistency of left atrium global longitudinal strain and strain rate measured by two- dimensional speckle tracing eehoeardiography （2D- STE ） of left atrial software and left ventrieular software. Methods Thirty-two subjects without cardiovascular risk factors and 32 subjects with cardiovascular risk factors were selected （total were 64 subjects）. Two standardized trained physicians used 2D-STE left atrial and left ventrieular software to obtain left atrial global longitudinal strain during contraction phase （Set）, strain during conduit phas （Sed）, strain during reservoir phase （Sr=Set＋Sed）, strain rate during contraction phase （SRet）, strain rate during conduit phase （SRed）, strain rate during reservoir phase（SRr）, respectively. The consistency of left atrial strain and strain rate measured by Bland-Airman emfformanee test between interobserver and intraobserver was evaluated. Results ①Only the SRed measured by the left ventrieular software had significant difference between intraobserver （P=0.01）.②Bland-Mtman conformance test indicated that the two kinds of software in distribution trends and consistency boundary widths were good. Compared with the left ventrieular software, the data measured by the left atrial software had a smaller bias and a narrower consistency interval. ③The reliability analysis showed that the left atrial software measurements had better consistency than the left ventrieular software.Conclusion Compared with the left ventrieular soflware,2D-STE left atrial software has less bias,stable range of consistency,and excellent reliability- of retest,so it is worth popularizing and applying in the analysis of left atrial function.