OBJECTIVE: To evaluate the application value of HM in quantifying left heart chamber volume and LVEF in clinical patients.
METHODS: A total of 150 subjects who underwent 2D and 3D echocardiography were divided into 4 groups: (1) 42 patients with normal heart shape and function (control group, Group A); (2) 35 patients with DCM (Group B); (3) 41 patients with LV remodeling after acute myocardial infarction (Group C); and (4) 32 patients with HCM (Group D). The LVEDV, LVESV, LVEF and LAESV obtained by HM with (HM-RE) and without regional endocardial border editing (HM-NE) were compared with those measured by traditional 2D/3D echocardiographic methods to assess the correlation, consistency, and repeatability of all methods.
RESULTS: (1) The parameters measured by HM were significantly different among the groups (P < 0.05 for all). Compared with Groups A, C, and D, Group B had higher LVEDV and LVESV (P < 0.05 for all) and lower LVEF (P < 0.05 for all); (2) HM-NE overestimated LVEDV, LVESV, and LAESV with wide biases and underestimated LVEF with a small bias; contour adjustment reduced the biases and limits of agreement (bias: LVEDV, 28.17 mL, LVESV, 14.92 mL, LAESV, 8.18 mL, LVEF, -0.04%). The correlations between HM-RE and advanced cardiac 3D quantification (3DQA) (r s = 0.91-0.95, P < 0.05 for all) were higher than those between HM-NE (r s = 0.85-0.93, P < 0.05 for all) and the traditional 2D methods. The correlations between HM-RE and 3DQA were good for Groups A, B, and C but remained weak for Group D (LVEDV and LVESV, r s = 0.48-0.54, P < 0.05 for all); and (3) The intraobserver and interobserver variability for the HM-RE measurements were low.
CONCLUSIONS: HM can be used to quantify the LV volume and LVEF in patients with common heart diseases and sufficient image quality. HM with contour editing is highly reproducible and accurate and may be recommended for clinical practice.
目的:评价HM在临床患者左心室容积和LVEF定量中的应用价值。
方法:将150例接受二维和三维超声心动图检查的受试者分为4组:(1)42例心脏形态和功能正常的患者(对照组,A组);(2)35例DCM患者(B组);(3)41例急性心肌梗死后LV重塑患者(C组);(4)32例HCM患者(D组)。LVEDV,LVESV,通过HM(HM-RE)和没有区域心内膜边界编辑(HM-NE)获得的LVEF和LAESV与通过传统2D/3D超声心动图方法测量的LVEF和LAESV进行比较,以评估相关性。一致性,和所有方法的可重复性。
结果:(1)HM测得的参数在各组之间存在显着差异(均P<0.05)。与A组相比,C,D,B组LVEDV和LVESV较高(均P<0.05),LVEF较低(均P<0.05);(2)HM-NE高估LVEDV,LVESV,和LAESV具有较宽的偏差,而LVEF具有较小的偏差;轮廓调整降低了偏差和一致性限制(偏差:LVEDV,28.17mL,LVESV,14.92mL,LAESV,8.18mL,LVEF,-0.04%)。HM-RE与晚期心脏3D定量(3DQA)之间的相关性(rs=0.91-0.95,均P<0.05)高于HM-NE之间(rs=0.85-0.93,均P<0.05)和传统的2D方法。A组HM-RE与3DQA的相关性良好,B,和C,但D组(LVEDV和LVESV,rs=0.48-0.54,全部P<0.05);(3)HM-RE测量的观察者内部和观察者之间的变异性较低。
结论:HM可用于量化常见心脏病患者的LV体积和LVEF,并具有足够的图像质量。具有轮廓编辑功能的HM具有很高的可重复性和准确性,可以推荐用于临床实践。