ABSTRACT
Objective:To explore the value of layer-specific strain technique in evaluating the changes of left ventricular myocardial systolic function in patients with aortic stenosis(AS).Methods:From January 2019 to March 2022, 90 AS patients with left ventricular ejection fraction (LVEF) ≥ 50% in Hunan Provincial People's Hospital were selected, including 30 mild AS patients, 30 moderate AS patients, and 30 severe AS patients. In addition, 30 health examinees in the same period were selected as the control group. The normal echocardiographic parameters of the control group and the AS groups with different degrees were compared. The global systolic peak longitudinal strain (GLS) and global circumferential strain (GCS) of the left ventricular three-layer myocardium were measured by the layer-specific strain technique, and the correlation between the strain parameters and the peak systolic velocity (Vmax) of the aortic valve was analyzed.Results:The levels of interventricular septal depth (IVSD), left ventricular posterior wall depth (LVPWD), mean pressure gradient (MPG), and Vmax in mild, moderate and severe AS group were higher than those in the control group (all P<0.05); the GLS of each layer of left ventricle in mild, moderate and severe AS group was lower than those in control group (all P<0.05); the GCS of each layer of left ventricle in moderate and severe AS group was lower than those in control group (all P<0.05). The GLS of left ventricular endocardium in moderate AS group was lower than those in mild AS group (all P<0.05); the GLS and GCS of left ventricular layers in severe AS group were lower than those in mild and moderate AS group (all P<0.05). In AS group, GLS and GCS in endocardium, middle layer and epicardium were negatively correlated with Vmax ( r=-0.716, -0.660, -0.669, P<0.001; r=-0.669, -0.686, -0.598, P<0.001). Conclusions:The layer-specific strain can reflect the changes of left ventricular myocardial function in patients with AS, and has certain application value.
ABSTRACT
Objective:To assess the left ventricular (LV) myocardial mechanical dysfunction in patients with cirrhosis using ultrasonic layer-specific strain imaging and to explore its value in clinical application.Methods:A total of 80 consecutive cirrhosis patients without cardiovascular diseases were prospectively enrolled from October 2020 to March 2021 in Sichuan Provincial People′s Hospital, 39 of whom were assigned to the compensated group and 41 were assigned to the decompensated group according to the occurrence of portal hypertension. Forty-three healthy volunteers during the same period were randomly recruited as the control group. Transthoracic echocardiography was performed to assess the LV configuration and functional parameters. LV global longitudinal strain in endocardial, middle and epicardial myocardium (GLSendo, GLSmid, GLSepi), and longitudinal strain (LS) in basal, middle and apical segments, and peak strain dispersion (PSD) were obtained using ultrasonic layer-specific strain imaging. ΔLS was calculated by the formula of GLSendo-GLSepi. Then, the differences of related parameters among three groups were compared.Results:①Conventional echocardiography: compared with the control group, the interventricular septum end-diastolic thickness (IVSTd), left ventricular posterior wall end-diastolic thickness (LVPWd), left ventricular mass (LVM) and LVM index (LVMI) were increased in compensated and decompensated groups (all P<0.05), while no significant differences in conventional echocardiographic parameters were identified between the two cirrhosis groups (all P>0.05). ②Global layer-specific strain: compared with the control group, GLSendo, GLSmid, GLSepi and ΔLS were decreased and PSD was increased in compensated and decompensated groups (all P<0.05); Moreover, the decompensated group showed a more impaired GLSendo, GLSmid and GLSepi than compensated group (all P<0.05), whereas there were no significant differences of ΔLS and PSD between the two groups(all P>0.05). ③Segmental layer-specific strain: compared with the control group, LS values of three layers in compensated and decompensated groups were reduced at basal, middle and apical levels (all P<0.05); Compared with the compensated group, LS values of three layers in decompensated group tended to be reduced at above there levels, but only apical segments had significant differences (all P<0.05). Conclusions:There are different degrees of LV mechanical dysfunction in patients with variable severity of cirrhosis. Ultrasonic layer-specific strain imaging has the potential to quantitatively assess the state of cardiac involvement in patients with cirrhosis and to provide visual evidence for the early and accurate diagnosis of myocardial injuries.
ABSTRACT
Objective:To assess the changes of left ventricular systolic function and global myocardial work in heart failure with preserved ejection fraction (HFpEF) patients by speckle tracking layer-specific strain combined with myocardial work technique and explore the diagnostic value of each parameter for HFpEF.Methods:From December 2019 to December 2020, 38 HFpEF patients (HFpEF group) and 38 healthy individuals with age- and sex-matched (control group) were enrolled consecutively in the Fourth Affiliated Hospital of Harbin Medical University. Conventional ultrasound parameters were collected. Layer-specific strain and myocardial work techniques were used to obtain the global longitudinal strain (GLS) of the left ventricular endocardium, mid-myocardium, and epicardium (GLSendo, GLSmid, GLSepi), global myocardial work index (GWI), global myocardial work efficiency (GWE), global constructive work (GCW), and global wasted work (GWW). The absolute difference of GLS(ΔGLS) between endocardium and epicardium were calculate.All parameters were analyzed statistically. ROC curves were plotted to compare the effectiveness of layer-specific strain and myocardial work parameters in predicting left ventricular systolic function impairment in HFpEF patients.Results:①Left atrial diameter, interventricular septum at end-diastole, left ventricular posterior wall at end-diastole, relative wall thickness, left ventricular mass index, and average early diastolic peak velocity (E)/early diastolic tissue velocity (e′) in HFpEF group were significantly higher compared with control subjects, while late diastolic peak velocity (A), E/A, and e′ were significantly lower (all P<0.05); E, left ventricular end-diastolic diameter, left ventricular end-diastolic volume, left ventricular end-systolic volume, fraction shortening, and left ventricular ejection fraction were not different between HFpEF and control groups (all P>0.05). ②The global longitudinal strain of the left ventricule was highest in the endocardium and lowest in the epicardium. ③Compared with control subjects, HFpEF patients demonstrated significantly decreased GLSendo, GLSmid, GLSepi, ΔGLS, GWI, GWE, GCW and increased GWW (all P<0.01). ④The ROC results showed that the area under the curve of ΔGLS and GWE for predicting left ventricular contractile function impairment in HFpEF group, was 0.884 and 0.882, respectively; The cutoff values were -5.8% and 95%; The sensitivity were 84.2% and 71.1%, and the specificity was 84.2% and 89.5%, respectively. ⑤The ROC curve of combining the two technologies showed that the maximum area under the curve of the ΔGLS in tandem with GWE was 0.944, the sensitivity was 81.6%, and the specificity was 97.4%. Conclusions:Both speckle tracking layer-specific strain and myocardial work techniques can sensitively detect left ventricular myocardial function impairment in HFpEF patients at an early stage. ΔGLS and GWE are more reliable indexes for predicting left ventricular systolic function damage in HFpEF patients. Combining the two techniques can improve the diagnostic performance in HFpEF patients.
ABSTRACT
Objective:To evaluate the diagnostic value of exercise stress echocardiography combined with left ventricular two-dimensional speckle tracking layer-specific strain technique in evaluating subclinical myocardial damage and reserve function in patients with hypertension.Methods:A total of 51 healthy subjects(control group) and 55 hypertensive patients (hypertension group) were enrolled in the treadmill exercise stress test in Sichuan Provincial People′s Hospital from October 2018 to January 2020. According to the European Guidelines for the Prevention and Treatment of Hypertension, the inclusion criteria for patients with hypertension were: blood pressure≥140/90 mmHg or who explicitly took antihypertensive drugs, and related cardiovascular diseases were excluded. The conventional parameters of resting and peak exercise, including left ventricular mass index, left ventricular end-diastolic volume index and left ventricular ejection fraction et al, were analyzed by speckle tracking software in two groups. According to the standard images in the resting and peak exercise, the endocardium /mid-myocardium /epicardium of left ventricular (three-, two-, four-chamber and global) longitudinal strain and circumferential strain (papillary muscle level) were compared respectively in two groups. The characteristics of strain differences and the systolic function reserve between the resting and peak exercise were evaluated.Results:There were significant differences in conventional ultrasound parameters between resting and peak exercise period in hypertension group, except E/A and e/a ratio (all P<0.05), and E/e value increased significantly(12.1±0.38) during peak exercise, indicating impaired diastolic reserve function. The longitudinal and circumferential layer-specific strain values from endocardial to epicardial were gradually decreased in both two groups. Compared with the control group, the resting longitudinal and circumferential endocardial strain values in hypertensive group were decreased, and the differences were more obvious at peak status, for instance global longitudinal endocardium strain at rest[control group (24.4±1.5)%, hypertension group (20.4±2.3)%], peak status[control group (30.8±2.8)%, hypertension group (22.8±2.9)%]( P<0.05). There were no significant differences of the partial layer-specific strain values between the peak exercise and resting status in hypertension group, while peak layer-specific strain of the control group were all significantly increased, suggesting that the left ventricular systolic reserve function of hypertension patients was lower than that of the control group. Conclusions:Left ventricular layer-specific strain can effectively evaluate the myocardial function in patients with hypertension, especially the endocardial strain can be used as an indicator parameter, and the peak exercise stress state is more sensitive. The systolic and diastolic reserve function of the left ventricle in patients with hypertension at the peak period are reduced to different degrees. Exercise stress echocardiography combined with left ventricular layer-specific strain technique can be used as a new method for detection of myocardial function impairment in patients with hypertension.
ABSTRACT
Objective To evaluate the damage of longitudinal mechanical parameters of left ventricular myocardium by ultrasonic layer‐specific strain imaging in patients with systemic lupus erythematosus ( SLE ) without conventional evidence of cardiovascular system involvement . Methods Seventy‐eight patients suffered from SLE without conventional evidence of cardiovascular system involvement ( SLE group ) and 48 healthy volunteers with age and sex matched ( control group ) were selected for this study . T he left ventricular conventional structure and functional parameters were measured by conventional echocardiography . T hen layer‐specific strain imaging was performed in both groups to obtain left ventricular endocardial myocardial global longitudinal strain ( GLSendo ) ,mid‐myocardial GLS ( GLSmid) ,epicardial GLS ( GLSepi) and basal segment ,middle segment and apex longitudinal strain ( LS) of all three layers of the myocardium . T hen the transmural difference of the GLS ( ΔLS ＝ GLSendo －GLSepi) were calculated . T he related parameters between these two groups were compared for difference and correlation analysis of related mechanical parameters were also made . Results ① T here was no significant difference in the left ventricular ejection fraction ( LVEF ) and left ventricular stroke volume ( LVSV ) between the two groups ( all P ＞0 .05 ) ; Compared with the control group ,the mean E/e in the SLE group was increased and the E/A ,E ,e were decreased ( all P ＜0 .05) ; however ,the incidence of left ventricular diastolic dysfunction in the SLE group ( 2/78 ) was not significantly different from that in the control group ( 0/48 ) ( P ＞0 .05 ) . ② T he myocardial global longitudinal strain( GLS ) of the two groups were decreased from endocardial to epicardial gradient ; the values of GLS and segmental LS of all three layers in the SLE group were decreased ( all P ＜0 .05) ; the ΔLS of the SLE group was decreased compared with the control group ( P ＜ 0 .05 ) ; the value of peak strain dispersion ( PSD ) were increased in SLE patients ( P ＜ 0 .05 ) . ③ T he correlation analysis showed the GLS of each layer of myocardium in SLE patients were negatively correlated with disease duration ( rs ＝ －0 .34～ －0 .36 ,all P ＜ 0 .05 ) and SLE disease activity index ( SLEDAI) ( rs ＝ －0 .25～ －0 .30 ,all P ＜0 .05 ) . Conclusions T he ultrasonic layer‐specific strain imaging can quantitatively detect the damage of mechanical parameters of left ventricle in SLE patients ,w hich is more sensitive than the conventional echocardiography in evaluating left ventricular systolic function . It may provide visual evidence for early diagnosis of cardica dysfunction in SLE patients .
ABSTRACT
Objective To investigate the value of ultrasonic two‐dimensional speckle tracking imaging ( 2D‐ST I) layer‐specific strain and transmural gradient in evaluating the changes of hypertensive patients′left ventricular three layers myocardial function . Methods Thirty‐five hypertensive patients without renal insufficiency were selected as group A ,and 25 hypertensive patients with renal insufficiency as group B .For comparison ,40 healthy volunteers were gathered as control group . T hen ,the systolic peak longitudinal strain of the left ventricle( LPS) ,endocardium( LPS Endo ) ,mid‐cardium ( LPSMid ) and epicardium ( LPSEpi ) were collected .After that ,features of transmural gradient ( ΔLS ) and its percentage ( ΔLS% ) were analyzed . Results For each group ,gradient features exist in each layer of left ventricular myocardium :LPS Endo ＞LPSMid＞LPSEpi . For each group ,the differences between LPSEndo and LPSMid ,and that between LPSEndo and LPSEpi were both statistically significant( P ＜0 .05) . When it came to the differences between LPS Mid and LPSEpi ,those of group A and control group were both statistically significant ( P ＜0 .05 ) . Compared with control group ,the LPSEndo of group A ,and LPSEndo ,LPSMid and LPSEpi of group B declined ,all the differences were statistically significant ( P ＜0 .05 ) . Compared with group A ,LPS Endo ,LPSMid and LPSEpi of group B declined ,the differences were statistically significant ( all P ＜0 .05) . For ΔLS′s differences among all three groups ,there was no statistical significance( P ＞0 .05) . Compared with control group ,the ΔLS% Endo‐Mid of group A rised , and the ΔLS% Endo‐Mid , ΔLS% Mid‐Epi of group B rised , the differences were statistically siginificant ( all P ＜ 0 .05 ) . Compared with group A ,the ΔLS% Endo‐Mid ,ΔLS% Mid‐Epi of group B rised ,the differences were statistically siginificant( all P ＜0 .05) . Conclusions T he layer‐specific strain technique can quantitatively evaluate the changes of systolic function of the left ventricular myocardium in hypertensive patients . ΔLS% may have better sensitivity than ΔLS in dection of systolic function damage of the left ventricular myocardium and can provide more reference for the evaluation of left ventricular systolic function .
ABSTRACT
Objective To investigate the clinical application value of longitudinal peak strain( LPS ) and peak strain dispersion ( PSD ) in evaluating left ventricular systolic function and synchrony in patients with essential hypertension . Methods Fifty‐five patients with essential hypertension were enrolled , including 30 patients with non‐left ventricular hypertrophy ( NLV H ) , 25 patients with left ventricular hypertrophy ( LV H ) , at the same time , 30 healthy volunteers were selected as the control group . Echocardiography was performed in all three groups ,and two‐dimensional dynamic images of the left ventricular apical four‐chamber ,three‐chamber ,and two‐chamber′s long‐axis view s were collected for three consecutive cardiac cycles . T he myocardial layer‐specific strain was used to measure the LPS of the left ventricular myocardium of subendocardium ,the middle layer ,the subepicardium ,and the myocardial strain and the PSD of the w hole myocardial layers . Correlation analysis and ROC curve analysis were performed . Results T he LPS in the control group ,NLV H group and LV H group were decreased in turn from inner to out myocardial layers . Compared with the control group , the LPS in the subendocardial , middle , subepicardial ,and w hole myocardial layer of NLV H group were decreased ( P ＜ 0 .05 ) , and the subepicardial myocardial LPS was slightly lower than that in the control group ,the difference was not statistically significant ( P ＞ 0 .05 ) . T he LPS in the subendocardial , middle , subepicardial ,and whole myocardial layer of LV H group were all reduced ( P＜0 .05) . Between the NLV H group and LV H group , the declines of the LPS in the subendocardial and middle layer in the LV H group were statistically significant ( P ＜0 .05) ,the LPS in the subepicardial layer and the w hole myocardial layer had no significant difference ( P ＞0 .05) . Compared with the control group ,the PSD of the NLVH group and the LVH group increased ( P ＜ 0 .05 ) . Compared with the NLV H group ,the PSD of the LV H group increased ( P ＜0 .05) . Inter‐ventricular septum thickness ( IVSd) and the LPS in the subendocardial ,middle ,subepicardial , and w hole myocardial layer were negatively correlated ( r ＝ －0 .537 ,－0 .518 ,－0 .266 ,－0 .471 ; all P ＜0 .05) , left ventricle posterior wall thickness ( LVPWd ) and the LPS in the subendocardial , middle , subepicardial ,and whole myocardial layer were negatively correlated ( r ＝ －0 .539 , －0 .524 , －0 .283 ,－0 .478 ;all P ＜0 .05) . T he area under the ROC curve ( AUC) of the LPS in the subendocardial ,middle , subepicardial ,and w hole myocardial layer and PSD for the diagnosis of hypertension were 0 .685 ,0 .652 , 0 .510 ,0 .623 ,0 .995 ,respectively . T he cut‐off values were －21 .70% ,－18 .90% ,－16 .95% ,－19 .45% , 46 .50 ms , and the sensitivities were 94 .4% , 83 .3% , 77 .8% , 94 .4% , 100% , respectively , and the specificities were 47 .8% ,52 .2% ,39 .1% ,39 .1% ,95 .7% ,respectively . Conclusions T he layer‐specific strain can quantitatively evaluate myocardial longitudinal strain in patients with essential hypertension , provide a non‐invasive test for early diagnosis of hypertensive heart disease ,and the evaluation of left ventricular myocardial stratification . PSD for evaluating primary synchronous changes in left ventricular myocardial contraction in patients with hypertension has certain advantages .
ABSTRACT
Objective@#To investigate the value of layer-specific strain in evaluating the changes of left ventricular three layers and segmental myocardial function in patients with different degree of aortic stenosis (AS).@*Methods@#Ninety-eight AS patients were selected as AS group from December 2017 to June 2019 in Henan Provincial People′s Hospital, they were divided into mild AS group(30 cases), moderate AS group(33 cases), severe AS group(35 cases); 30 healthy subjects were enrolled as control group.Longitudinal strain (LS), circumferential strain (CS) of endocardium, mid-myocardium, epicardium, global full thickness and each segment of left ventricular myocardium were measured by layer-specific strain and then compared.@*Results@#Compared with the control group, Vmax, PPG, interventricular septal thickness in diastole(IVSD), left ventricular posterior wall thickness in diastole(LVPWD), left ventricular mass index(LVMI), and E/e increased in all three AS groups(all P<0.05). There were stepwise decreases of global full-thickness LS, CS with the increases of AS degree(all P<0.05). LS of endocardial, mid-myocardial, epicardial and global full-thickness myocardium layers in basal and middle left ventricular(LV) segments of different AS groups were decreased compared with the control group (all P<0.05). LS of three myocardium layers in apical LV segment were decreased in severe AS group compared with control group(all P<0.05). Compared with the mild AS group, the endocardial myocardium LS in moderate AS group decreased, and the difference was statistically significant(P<0.05), and LS and CS of mid-myocardial, epicardial myocardium decreased, but the difference was statistically insignificant (all P>0.05). There were no significant difference in CS of endocardial, mid-myocardial, epicardial and global full-thickness myocardium layers in basal, middle and apical LV segments between mild AS group and control group(all P>0.05). CS of endocardial, mid-myocardial, epicardial and global full-thickness myocardium layers were decreased in moderate AS and severe AS groups compared with control group(all P<0.05). CS of endocardial, mid-myocardial myocardium layers in basal and middle LV segments were decreased in moderate AS group compared with control group(all P<0.05). CS of three myocardium layers in basal, middle and apical LV segments were decreased in severe AS group compared with control group(all P<0.05).@*Conclusions@#Layer-specific strain can quantitatively evaluate left ventricular three layers and segmental myocardial function in patients with aortic stenosis, and has certain clinical application value.
ABSTRACT
Objective To assess the clinical ultrasound value of layer‐specific strain in evaluation of left ventricular systolic myocardial dysfunction of uremia patients after long‐time dialysis at different time . Methods A total of 68 uremia patients accepted maintenance hemodialysis ( M HD ) were enrolled . T he patients were divided into two groups according to the dialysis duration :dialysis time ＜3 years ( group B , n＝31) and dialysis time ≥3 years ( group C , n ＝37) . T he age and sex mached healthy cases were selected as control group ( group A , n ＝ 30 ) . T he standard dynamic two‐dimensional echocardiographic viewes of apical four‐chamber ,three‐chamber ,two‐chamber and the short‐axis view at three levels of mitral valve , papillary muscle and apex were acquired for three cardiac cycles . T he highest value of peak systolic longitudinal strain ( LS ) ,circumferential strain ( CS ) at different levels ,left venrticular global longitudinal strain ( GLS ) and global circumferential strain ( GCS ) were respectively assessed from endocardium ,mid‐myocardium and epicardium using GE EchoPAC workstation . T he comparisons of those parameters were performed among the 3 groups for differences . T he efficacies of GLS and GCS at different myocardial layers in diagdosing the left ventricular systolic function of M HD patients were analyzed by the ROC curve . Results ① Global transmural parameters :compared with those in group A ,the values of GLS at three myocardial layers in both M HD groups were significantly decreased ( all P ＜ 0 .01 ) ,the value of GLS at three myocardial layers in group C was also decreased ,and was statistically different from that in group B ( P＜0 .01) . Compared with those in group A ,the values of GCS at mid‐myocardium in group B and three myocardial layers in group C were also decreased ( all P ＜0 .01) . T here was no significant difference of GCS between group B and C ( P ＞0 .05) . ②Longitudinal transmural parameters at different levels :the values of LS at three myocardial layers of mitral valve ,papillary muscle and apex were decreased in group B and C compared with those in group A ( P ＜0 .05 or P ＜0 .01) ; T he values of LS at three myocardial layers of mitral valve ,papillary muscle and apical levels were also decreased in group C compared with those in group B ( P ＜0 .05 or P ＜0 .001) . ③Short‐axis transmural parameters at different levels :compared with those in group A ,the value of CS at mid‐myocardium of mitral valve level was decreased in group B ( P ＜0 .05) ,the values of CS at three myocardial layers of the mitral valve level and mid‐myocardium of papillary muscle level and apical level were decreased in group C ( P ＜0 .05 or P ＜0 .01) . Besides ,compared with those in group B ,the values of CS at mid‐myocardium and epicardium of mitral valve level were also decreased in group C ( P ＜0 .05) . ④ROC curve showed that determining left ventricular systolic dysfunction in M HD patients using GLS ,GCS at different myocardial layers ,when the area under the curve ( AUC ) of GLS of intima was 0 .851 ,the cut‐off value was －21 .45% ,the sensitivity was 72 .7% ,and the specificity was 93 .3% ; when the AUC of GCS of mid‐myocardium was 0 .683 ,the cut‐off value was －17 .08% , the specificity was 58 .5% , and the specificity was 83 .3% . Conclusions T he left ventricular systolic myocardial function is progressively damaged with the extended dialysis duration time . Ultrasonic layer‐specific strain technology could be used to quantitatively evaluate left ventricular systolic transmural myocardial dysfunction and might contribute to the evaluation of the severity of left ventricular myocardial dysfunction clinically for a more accurate intervention .
ABSTRACT
Objective To quantitatively evaluate left ventricular ( LV ) systolic function in bicuspid aortic valve (BAV) using layer-specific strain ( LSS) . Methods Thirty BAV patients were divided into normal function (NF) group (10 cases) and non-normal function (N-NF) group (20 cases) based on aortic valvular lesion types ,and 20 healthy volunteers were taken as control group . Longitudinal strain( LS) and circumferential strain (CS) of three-layer myocardium and full thickness myocardium were assessed using layer-specific speckletracking imaging ,available by GE Vivid E9 and EchoPac workstation . Results There was no significant difference in left ventricular ejection fraction( LVEF) among the N-NF group ,NF group and control group ( P > 0 .05) ,all of them within the normal range[(63 .3 ± 7 .1)％ ,(64 .6 ± 6 .2)％ , ( 65 .3 ± 3 .9)％ ] . It showed a gradient decrease from the endocardium to the epicardium in both control and BAV group . LS of endocardium ( LSendo) and LS of epicardium ( LSepi) in N-NF group and NF group were significantly reduced compared with those in control group ( P <0 .05) [ LSendo :( -21 .19 ± 3 .12)％vs ( -23 .06 ± 2 .07 )％ vs ( -25 .53 ± 2 .51 )％ ;LSepi:( -16 .08 ± 2 .68 )％ vs ( -18 .85 ± 2 .12 )％ vs ( -20 .72 ± 2 .28)％ ] . Compared with control group ,there was no significant difference in NF group in CS of the three-layer myocardial and full-thickness myocardium as well as the LS of the whole medial myocardial layers and full-thickness ( P > 0 .05 ) . Compared with NF group [ CS :( -19 .57 ± 2 .9 )％ vs ( -13 .43 ± 2 .19)％ vs ( -20 .03 ± 3 .04)％ ;LS :( -21 .38 ± 2 .05)％ vs ( -18 .85 ± 2 .12)％ vs ( -21 .09 ± 2 .03)％ ] and control group[CS :( -21 .63 ± 3 .01)％ vs ( -14 .34 ± 2 .55)％ vs ( -21 .48 ± 2 .16)％ ;LS :( -22 .18 ± 2 .30 )％ vs ( -20 .72 ± 2 .28 )％ vs ( -22 .89 ± 2 .30 )％ ] , CS [ ( -16 .78 ± 3 .65 )％ vs ( -11 .40 ± 3 .78 )％ vs ( -15 .83 ± 2 .61 )％ ] and LS [ ( -18 .34 ± 2 .85 )％ vs ( -16 .08 ± 2 .68 )％ vs ( -18 .51 ± 2 .86)％ ] of middle myocardium ,epicardial myocardium and full-thickness myocardium in N-NF group were decreased significantly ( P < 0 .05) . Conclusions It is essential to maintain normal valvular function to prevent the progress of myocardial deterioration . LSendo and LSepi can be used to sensitively identify early left ventricular systolic dysfunction in BAV patients with normal LVEF .
ABSTRACT
Objective To investigate the value of layer-specific strain in evaluating the changes of left ventricular three layers and segmental myocardial function in patients with different degree of aortic stenosis (AS).Methods Ninety-eight AS patients were selected as AS group from December 2017 to June 2019 in Henan Provincial People's Hospital,they were divided into mild AS group(30 cases),moderate AS group (33 cases),severe AS group(35 cases);30 healthy subjects were enrolled as control group.Longitudinal strain (LS),circumferential strain (CS) of endocardium,mid-myocardium,epicardium,global full thickness and each segment of left ventricular myocardium were measured by layer-specific strain and then compared.Results Compared with the control group,Vmax,PPG,interventricular septal thickness in diastole(IVSD),left ventricular posterior wall thickness in diastole(LVPWD),left ventricular mass index(LVMI),and E/e increased in all three AS groups(all P ＜0.05).There were stepwise decreases of global full-thickness LS,CS with the increases of AS degree(all P ＜0.05).LS of endocardial,mid-myocardial,epicardial and global full-thickness myocardium layers in basal and middle left ventricular(LV) segments of different AS groups were decreased compared with the control group (all P ＜0.05).LS of three myocardium layers in apical LV segment were decreased in severe AS group compared with control group (all P ＜0.05).Compared with the mild AS group,the endocardial myocardium LS in moderate AS group decreased,and the difference was statistically significant (P ＜ 0.05),and LS and CS of mid-myocardial,epicardial myocardium decreased,but the difference was statistically insignificant (all P ＞ 0.05).There were no significant difference in CS of endocardial,mid-myocardial,epicardial and global full-thickness myocardium layers in basal,middle and apical LV segments between mild AS group and control group (all P ＞ 0.05).CS of endocardial,mid-myocardial,epicardial and global full-thickness myocardium layers were decreased in moderate AS and severe AS groups compared with control group (all P ＜0.05).CS of endocardial,mid-myocardial myocardium layers in basal and middle LV segments were decreased in moderate AS group compared with control group(all P ＜0.05).CS of three myocardium layers in basal,middle and apical LV segments were decreased in severe AS group compared with control group (all P ＜ 0.05).Conclusions Layer-specific strain can quantitatively evaluate left ventricular three layers and segmental myocardial function in patients with aortic stenosis,and has certain clinical application value.
ABSTRACT
Objective To reveal the early elastic dysfunction of common carotid artery may have occurred in systemic lupus erythematosus( SLE) patients ,the circumferential strain parameters of common carotid artery intima in SLE patients at different serum complement levels were quantitatively evaluated by layer-specific strain imaging . Methods Seventy-two patients suffered from SLE without evidence of atherosclerosis were enrolled ,and the results of laboratory examination of serum complement C 3 in patients with SLE were recorded in detail ,49 cases of SLE patients whose serum C3 was lower than the normal reference range(SLE C3+ group) ,23 cases of SLE patients whose serum C3 was in the range of normal reference value(SLE C3 - group) . And a matched healthy control group ( n =38) were selected . Carotid ultrasound were performed in all three groups ,and the common carotid artery conventional parameters ,such as common carotid artery intima-media thickness ( CCA-IM T ) ,peak systolic velocity ( PSV ) ,end-diastolic velocity(EDV) ,resistance index(RI) and circumferential strain related parameters ,such as circumferential strain of common carotid artery intima(CSendo) and circumferential strain rate(CSr) were measured and derived.Therelatedparametersamongthosegroupswerecomparedfordifference.Results ①Therewas no significant difference in RI among the three groups(all P >0 .05) . The values of CCA-IMT in the SLE C3+ group and SLE C3- group were larger than that in the control group( all P <0 .05) . ②The values of CSendo and CSr in the SLE C3+ group and SLE C3 - group were lower than those in the control group ,the values of SLE C3+ group were significantly lower than those in the control group ( P <0 .001) ,and there was no significant difference between the SLE C3- group and control group( P >0 .05) . ③The CSendo and CSr in the SLE C3+ group were lower than those in the SLE C3- group(all P < 0 .05) . Conclusions CSendo which is provided by new ultrasonic technology of layer-specific strain combined with recent changes in serum complement C3 may provide visual evidence for assessing early elastic disfunction of carotid intima in SLE patients .
ABSTRACT
Objective To explore the systolic function and synchronicity of left ventricle ( LV ) in patients with maintenance hemodialysis( MHD) by layer-specific strain. Methods Forty-three patients with MHD and 48 healthy controls were studied. Three consecutive cardiac cycles two-dimensional dynamic images including standard LV apical two-chamber,long-axis and four-chamber views and LV short-axis views at the levels of basal,middle and apical were acquired. A quantitative software called EchoPAC was used to analyze longitudinal strain(LS) and circumferential strain(CS) of these six dynamic images and peak strain dispersion ( PSD) was automatic computed by the software. The difference of these parameters between the two groups and the correlation between PSD and other parameters were studied. Results Parameters of global layer-specific strain: compared with the control group, global LS and CS of subendocardial,midmyocardial,epicardial and full-thickness myocardium layers were decreased in the MHD group ( P ＜0.01). Parameters of segmental layer-specific strain:LS of 3 layers and full-thickness in basal, middle,apical segments were lower in MHD group than those in control group ( P ＜0.001). CS of 3 layers and full-thickness in middle,apical segments were lower in MHD group than those in control group ( P ＜0.05). There was no significant difference in CS of 3 layers and full-thickness in basal segment between two groups( P ＞0.05). Parameters of synchronicity:PSD of MHD group was larger than that of control group ( t ＝6.094, P ＜0.001). PSD was positively correlated with longitudinal strain of full-thickness (GLS) in MHD group ( rs＝0.478, P ＝0.039). Conclusions Layer-specific strain can noninvasively and accurately quantitate left ventricular systolic function and synchronicity in patients with MHD.