两种斑点追踪分析软件及时相选择方案对健康成年人左心房应变定量分析比较

Quantitative Analysis of Left Atrial Strain in Healthy Adults by Two Spot Tracking Analysis Software and Time Phase Selection Scheme:A Comparative Study

目的评估斑点追踪成像用于临床检测健康成年人左心房功能的稳定性,观察不同分析软件、不同零应变时相选择所测左心房功能参数的差异。资料与方法前瞻性选取2020年1月—2021年1月在北京医院体检中心查体的100名健康成年人,分别用Echopac及Tomtec软件对其进行超声心动图图像分析,最终纳入87名,获取左心房储存期(LASr)、通道期(LAScd)、收缩期应变(LASct)、左心房最大容积和容积指数,比较两种方法测得上述指标的差异,评价相应软件测得上述指标的可重复性。结果Tomtec软件测得的各个应变值绝对值除LASct R-Wave和LASct P-Wave外均较Echopac软件测得值大。其中(Tomtec、Echopac)LASr R-Wave分别为(42.32±0.89)%、(37.09±0.90)%(t=-2.709,P=0.008);LAScd R-Wave分别为(-27.59±0.74)%、(-22.68±0.72)%(t=5.600,P<0.000);LASct R-Wave分别为(-14.73±0.57)%、(-14.37±0.46)%(t=-2.074,P=0.041);LASr P-Wave分别为(40.00±0.75)%、(32.25±0.70)%(t=-7.314,P<0.000);LAScd P-Wave分别为(-25.71±0.84)%、(-19.92±0.62)%(t=7.357,P<0.000);LASct P-Wave分别为(-13.88±0.52)%、(-12.46±0.32)%(t=0.023,P=0.982)。两种软件测得的左心房功能参数重复性均较高(Tomtec ICC 0.982~1、Echopac ICC 0.846~0.958)。使用以R波起始处为零应变时相测得的左心房应变数值较以P波为零应变时相测得的左心房各应变值大。结论两种分析软件及零应变时相选取方案对健康成年人左心房功能测量的稳定性均较好,但是两种软件及两种零应变时相选取方案测得的应变值不应作为相互比较的依据。

Purpose To evaluate the stability of speckle tracking echocardiography in clinical detection of left atrial function in healthy adults,and to observe the difference of left atrial function parameters measured by different analysis software and different zero strain time phases.Materials and Methods Echopac and Tomtec software were used to analyze the echocardiographic images of 100 healthy adults examined in the Physical Examination Center of Beijing Hospital from January 2020 to January 2021,to obtain the left atrial storage period,conduit period,atrial contraction period strain,left atrial maximum volume and volume index,and the differences between the above indicators measured by the two methods were compared,and the repeatability of the above indicators measured by the corresponding software was evaluated.Results The absolute value of each strain value measured by Tomtec software was significantly greater than that of Echopac except for LASct R-Wave and LASct P-Wave.Among them,(Tomtec value comed first and Echopac value comed last)LASr R-Wave results were(42.32±0.89)%and(37.09±0.90)%,respectively(t=-2.709,P=0.008);LAScd R-Wave results were(-27.59±0.74)%and(-22.68±0.72)%,respectively(t=5.600,P<0.000);LASct R-Wave results were(-14.73±0.57)%and(-14.37±0.46)%,respectively(t=-2.074,P=0.041);the LASr P-Wave results were(40.00±0.75)%and(32.25±0.70)%,respectively(t=-7.314,P<0.000);the LAScd P-Wave results were(-25.71±0.84)%and(-19.92±0.62)%,respectively(t=7.357,P<0.000);the LASct P-Wave results were(-13.88±0.52)%and(-12.46±0.32)%,respectively(t=0.023,P=0.982).Higher repeatability of left atrial functional parameters was obtained from both ultrasound analysis software(Tomtec ICC 0.982-1,Echopac ICC 0.846-0.958).When the value of left atrial strain in the phase with zero strain at the beginning of the R wave was larger than the value of each left atrial strain in the phase with P wave as zero strain.Conclusion The two analysis software and zero strain phase selection scheme have good stability in measuring the left atrial function of healthy adults,but the strain values measured by the two analysis software or the two zero-strain phase selection schemes should not be used as the basis for mutual comparison.