ABSTRACT
Objective To explore the relationship among the left ventricular rotation and twist, Tei index and left ventricular function in chronic heart failure patients and provide reliable indicator of chronic heart left ventricular myocardial function and mechanical movement. Methods Seventy-nine chronic heart failure patients with cardiac function classⅡ(32 cases), cardiac function classⅢ(26 cases) and cardiac function classⅣ(21 cases) and 28 healthy volunteer were included. All subjects underwent conventional echocardiography and two dimensional-speckle tracking imaging. The mitral annulus tissue Doppler spectrums at apical four chambers view, two-dimensional images of left ventricle at basal and apical level were acquired. The left ventricular twist, segmental rotation at short axis view and Tei index were measured. The differences were compared and the correlations were analyzed. Results (1) There were signiifcant differences for Tei index among the four group (χ2=88.31, P<0.01). The Tei index of healthy control group and chronic heart failure patients with cardiac function class Ⅱ , class Ⅲand class Ⅳwere 0.33±0.19, 0.37±0.18, 0.46±0.31 and 0.49±0.33. The Tei index gradually increased when the heart function decreased. (2) The left ventricular twist were also signiifcantly different among the four groups (F=25.99, P<0.01). The left ventricular twist of healthy control group and chronic heart failure patients with cardiac function classⅡ, classⅢ and classⅣwere (12.89±2.65)°, (12.29±1.94)°, (12.38±2.13)° and (8.46±2.90)°. The left ventricular twist gradually decreased when the heart function decreased. The differences between chronic heart failure patients with cardiac function classⅣand healthy control group, chronic heart failure patients with cardiac function classⅡand classⅢwere signiifcant (q=6.43, 5.71 and 4.17, all P<0.05). (3) The left ventricular segmental rotations at basal level were significantly different among healthy control group and chronic heart failure patients with cardiac function classⅡ,ⅢandⅣ(F=9.51, 9.47, 7.41, 10.27, 9.42 and 11.34, all P<0.01 ). The left ventricular segmental rotations were positively correlated with Tei index and the segmental rotation of anterior wall was most correlated with Tei index (r=0.327, 0.277, 0.266, 0.321, 0.306 and 0.325, all P<0.01). (4) The left ventricular segmental rotations at apical level were signiifcantly different among four groups (F=6.17, 3.49, 3.46, 3.50, 3.48 and 2.81, all P<0.01). The left ventricular segmental rotations were negatively correlated with Tei index and the segmental rotation of anterior wall was most correlated with Tei index (r=-0.362,-0.278,-0.251,-0.279,-0.290 and-0.288, all P<0.01). (5) The left ventricular twist and Tei index were negatively correlated (r=-0.443, P<0.01). Conclusions The left ventricular twist and segmental rotation at short axis view in patients with chronic heart failure decreased and Tei index gradually increased. The left ventricular twist and Tei index were negatively correlated. The combination of two-dimensional speckle tracking technology and Tei index could achieve noninvasive assessment of left ventricular mechanical movement and left heart function in chronic heart failure patients.