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Objective:To investigate the value of routine echocardiography and two-dimensional speckle tracking echocardiography in evaluating the left ventricular function of patients with gestational diabetes mellitus (GDM) prenatal and postpartum.Methods:Twenty-two patients with clinically confirmed GDM in Xiamen Zhongshan Hospital from October 2019 to December 2020 were chosed as the case group, and 22 healthy pregnant women were chosed as the control group. Routine echocardiography and two-dimensional speckle tracking echocardiography were performed in the third trimester and about 3 months postpartum. Routine echocardiographic parameters and longitudinal strain (LS), circumfirential strain (CS) were obtained. The correlation between global longitudinal strain(GLS) and other cardiac function parameters was analyzed. The relationship between clinical parameters of pregnant women and GLS was analyzed by multiple linear regression.Results:In comparison with the control group, the interventricular septal diameter at disatole, left ventricular posterior wall diameter at diastole, Tei index were increased, e′ was decreased in GDM group(all P<0.05); the GLS, each layer LS of GDM group were lower than the control group(all P<0.05), the GLS, each layer LS and torsion parameters were improved at 3 months postpartum(all P<0.05). There was a negative correlation between GLS and Tei( r=-0.224, P=0.036). GLS and HbA 1c was linearly correlated with the regression equation: GLS=-27.458+ 1.534×HbA 1c( R2=0.115). Conclusions:The left heart function of pregnant women with GDM in the third trimester are significantly impaired, but the cardiac function recovers to a certain extent about 3 months after delivery. Two-dimentional speckle-tracking echocardiography is a more accurate and sensitive technique to evaluate the early damage of cardiac function in pregnant women with GDM.
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Objective To analyze left ventricular (LV) global systolic function in patients with coronary artery disease(CAD) and their changes after percutaneous coronary intervention(PCI) using velocity vector imaging(VVI). Methods Eighteen healthy adults and twenty two patients with CAD were enrolled in this study. Two-dimensional dynamic images of standard apical four-chambers, two-chambers and parasternal short-axis views at the level of mitral valve and apex were obtained in VVI condition. All patients were examined 1 day before PCI, 1 week, 1 month and 3 months after PCI respectively. LV rotation degree, rotation velocity at baseline and apex were measured using the off-line syngo US workplace software and LV twist, torsion were calculated as global motion condition. Results LV ejection fraction(LVEF) and peak torsion at myocardial infarction group were lower than those at normal control and myocardial ischemia group. After PCI, LVEF were gradually improved in both myocardial infarction group and myocardial ischemia group,while changes of LV apex rotation degree and velocity, peak twist and peak torsion between two groups were opposite: those parameters of the former increased 1 week or 1 month after PCI but decreased 3 months after PCI,while those of the latter decreased 1 week after PCI but increased gradually 1 month and 3 months after PCI. Conclusions LV twist and torsion can be evaluated exactly by VVI.Compared with LVEF, LV twist and torsion can preferably reflect the different characteristic of LV global systolic function after coronary artery recanalization in myocardial infarction group and myocardial ischemia group.
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Objective To evaluate the value of left ventricular (LV) torsion for assessing left ventricular function in adult heart transplant patients using two-dimensional speckle tracking imaging.Methods Basal and apical LV short-axis view and apical LV long-axis view of two-demensional images were acquired in 30 heart transplant patients and 17 healthy volunteers. Using two-dimensional strain software,LV basal and apical rotation versus time profiles were obtained at their short-axis level respectively. LV torsion was defined as apical rotation relative to the base, so the LV torsion versus time profiles could be drawn. LV basal rotation,apical rotation,global torsion and their time to peak were respectively measured,and the rate of LV untwisting was calculated. Statistical analysis was used to find the difference between the two groups and to investigate the relationship between LV torsion or the rate of LV untwisting and echocardiographic parameters. Results LV apical rotation and LV global torsion in heart transplant group were significantly lower than those in normal group. LV global torsion inversely correlated with LV end systolic volume,positively with LV ejection fraction. There was no significant difference between the two groups in the rate of LV untwisting. The rate of LV untwisting didn't correlate with echocardiographic parameters. Conclusions LV torsion can be measured exactly by two-dimensional speckle tracking imaging, it can be used to quantify LV global systolic function in heart transplant patients.