Use of myocardial strain to assess global left ventricular function: A comparison with cardiac magnetic resonance and 3-dimensional echocardiography

被引:131
|
作者
Brown, Joseph [1 ]
Jerkins, Carly [1 ]
Marwick, Thomas H. [1 ]
机构
[1] Univ Queensland, Brisbane, Qld, Australia
关键词
IN-VIVO; DOPPLER-ECHOCARDIOGRAPHY; 2-DIMENSIONAL STRAIN; STANDARDS COMMITTEE; OF-ECHOCARDIOGRAPHY; EJECTION FRACTION; SYSTOLIC FUNCTION; TISSUE-DOPPLER; QUANTIFICATION; RECOMMENDATIONS;
D O I
10.1016/j.ahj.2008.08.032
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Ejection fraction (EF) plays a prominent role in clinical decision making but remains dependent on image quality and left ventricular geometry. Using magnetic resonance imaging (MRI-EF) as the reference standard, we sought whether global longitudinal strain (GLS) could be an alternative to the measurement of EF. Methods Manual and semi-automated tracing was used to measure Simpson's biplane ejection-fraction (2D-EF) and 3D ejection fraction (3D-EF) and MRI in 62 patients with previous infarction. Global longitudinal strain was measured by 2-dimensional strain (2DS) in the apical views. Automated EF was calculated using speckle tracking to detect the end-diastolic and end-systolic endocardial border. Results Strain curves were derived in all segments, with artifactual curves being excluded. The correlation of GLS with MRI-EF (r = -0.69, P < 0001) was comparable to that between 3D-EF and MRI (r = 0.80, P < .0001), and better than that between 2D-EF (r = 0.58, P < .0001) or automated EF and MRI (r = 0.62, P < .0001). To convert GLS into an equivalent MRI-EF, linear regression was used to develop the formula EF = -4.35* (strain + 3.9). Of the 32 patients with a normal MRI-EF (>= 50%), 75% had normal systolic function by GLS, whereas 85% of patients were recognized as having a normal 3D-EF. Fewer patients were recognized as normal by 2D-EF (70%, P = .14) and automated-EF (61%, P = .04). In those with >6 abnormal segments, the correlation of GLS with MRI-EF improved significantly (r = -0.77, P < .0001) and was similar to 3D-EF (r = 0.76, P < .0001). Conclusion Global longitudinal strain is an effective method for quantifying global left ventricular function, particularly in patients with extensive wall motion abnormalities. (Am Heart J 2009;157: 102.e1-102.e5.)
引用
收藏
页码:102 / U15
页数:6
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