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首页> 外文期刊>The International Journal of Cardiovascular Imaging >Two-dimensional strain analysis of the global and regional myocardial function for the differentiation of pathologic and physiologic left ventricular hypertrophy: a study in athletes and in patients with hypertrophic cardiomyopathy
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Two-dimensional strain analysis of the global and regional myocardial function for the differentiation of pathologic and physiologic left ventricular hypertrophy: a study in athletes and in patients with hypertrophic cardiomyopathy

机译：全局和区域心肌功能的二维应变分析，用于区分病理性和生理性左心室肥大：一项针对运动员和肥厚型心肌病患者的研究

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摘要

Two-dimensional strain (2DS) is a novel method to measure strain from standard two-dimensional echocardiographic images by speckle tracking, which is less angle dependent and more reproducible than conventional Doppler-derived strain. The objective of our study was to characterize global and regional function abnormalities using 2DS and strain rate analysis in patients (pts) with pathological left ventricular hypertrophy (LVH) caused by non-obstructive hypertrophic cardiomyopathy (HCM), in top level athletes, and in healthy controls. The hypothetical question was, if 2DS might be useful as additional tool in differentiating between pathologic and physiologic hypertrophy in top-level athletes. We consecutively studied 53 subjects, 15 pts with hypertrophic cardiomyopathy (HCM), 20 competitive top-level athletes, and a control group of 18 sedentary normal subjects by standard echocardiography according to ASE guidelines. Global longitudinal strain (GLS) and regional peak systolic strain (PSS) was assessed by 2DS in the apical four-chamber-view using a dedicated software. All components of strain were significantly reduced in pts with HCM (GLS: ?8.1 ± 3.8%; P < 0.001) when compared with athletes (?15.2 ± 3.6%) and control subjects (?16.0 ± 2.8%). In general, there was no significant difference between the strain values of the athletes and the control group, but in some of the segments, the strain values of the control group were significantly higher than those in the athletes. A cut-off value of GLS less than ?10% for the diagnosis of pathologic hypertrophy (HCM) resulted in a sensitivity of 80.0% and a specificity of 95.0%. The combination of TDI (averaged S′, E′) and 2DS (GLS) cut-off values for the detection of pathologic LVH in HCM demonstrated a sensitivity of 100%, and a specificity of 95%. Two-dimensional strain is a new simple and rapid method to measure GLS and PSS as components of systolic strain. This technique could offer a unique approach to quantify global as well as regional systolic dysfunction, and might be used as new additional tool for the differentiation between physiologic and pathologic LVH.
机译：二维应变（2DS）是一种通过斑点跟踪从标准二维超声心动图图像测量应变的新颖方法，与常规多普勒衍生应变相比，该方法对角度的依赖性较小，并且可重复性更高。我们研究的目的是使用2DS和应变率分析来表征顶级运动员和非阻塞性肥厚性心肌病（HCM）引起的病理性左心室肥厚（LVH）的患者（pts）的整体和区域功能异常。健康对照。假设的问题是，是否2DS可用作区分顶级运动员的病理性和生理性肥大的附加工具。我们按照ASE指南通过标准超声心动图连续研究了53名受试者，15名肥厚型心肌病（HCM），20名竞技顶级运动员和对照组的18名久坐正常受试者。使用专用软件通过2DS在心尖四腔视图中评估整体纵向应变（GLS）和区域峰值收缩期应变（PSS）。与运动员（？15.2±3.6％）和对照受试者（？16.0±2.8％）相比，HCM患者的所有应变成分均显着降低（GLS：±8.1±3.8％; P <0.001）。通常，运动员的应变值与对照组之间没有显着差异，但在某些细分市场中，对照组的应变值显着高于运动员。诊断病理性肥大（HCM）的GLS临界值小于10％，因此灵敏度为80.0％，特异性为95.0％。用于检测HCM中病理性LVH的TDI（平均S'，E'）和2DS（GLS）截止值的组合显示出100％的灵敏度和95％的特异性。二维应变是一种测量GLS和PSS收缩压成分的简便，快速的新方法。该技术可以提供一种量化整体以及区域收缩功能障碍的独特方法，并且可以用作区分生理性和病理性LVH的新的附加工具。

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    T. Butz; F. van Buuren; K. P. Mellwig; C. Langer; G. Plehn; A. Meissner; H. J. Trappe; D. Horstkotte; L. Faber;

  • 作者单位

    Department of Cardiology Heart and Diabetes Centre North Rhine-Westphalia Ruhr-University Bochum Bad Oeynhausen Germany;

    Department of Cardiology Heart and Diabetes Centre North Rhine-Westphalia Ruhr-University Bochum Bad Oeynhausen Germany;

    Department of Cardiology Heart and Diabetes Centre North Rhine-Westphalia Ruhr-University Bochum Bad Oeynhausen Germany;

    Department of Cardiology Heart and Diabetes Centre North Rhine-Westphalia Ruhr-University Bochum Bad Oeynhausen Germany;

    Department of Cardiology and Angiology Marienhospital Herne Ruhr-University Bochum Hoelkeskampring 40 44625 Herne Germany;

    Department of Cardiology and Angiology Marienhospital Herne Ruhr-University Bochum Hoelkeskampring 40 44625 Herne Germany;

    Department of Cardiology and Angiology Marienhospital Herne Ruhr-University Bochum Hoelkeskampring 40 44625 Herne Germany;

    Department of Cardiology Heart and Diabetes Centre North Rhine-Westphalia Ruhr-University Bochum Bad Oeynhausen Germany;

    Department of Cardiology Heart and Diabetes Centre North Rhine-Westphalia Ruhr-University Bochum Bad Oeynhausen Germany;

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  • 正文语种 eng
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  • 关键词

    Myocardial strain; Left ventricular hypertrophy; Global longitudinal strain; Athletes; Hypertrophic cardiomyopathy; Preparticipation screening;

    机译：心肌劳损;左心室肥大;整体纵向劳损;运动员;肥厚型心肌病;参与前筛查;

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