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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 .
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Objective@#To investigate the value of longitudinal strain and peak strain dispersion in the evaluation of left ventricular longitudinal strain and longitudinal strain synchrony in essential hypertensive patients with preserved ejection fraction.@*Methods@#A total of 50 essential hypertensive patients with preserved ejection fraction were collected as hypertensive group, they were divided into left ventricular hypertrophy( LVH) group (n=29) and non left ventricular hypertrophy(NLVH) group(n=21), and 26 healthy volunteers were collected as control group, two-dimensional echocardiography was performed. Peak systolic longitudinal strain(LPS), global LPS (GLPS), time to LPS (TTPLS) and longitudinal peak strain dispersion (PSD) were determined by the offline EchoPAC 201.54 software. It can automatically obtaine the bull′s-eye map of the corresponding 18-segmental LPS and TTPLS.@*Results@#Left atrial diameter (LAD) was higher in NLVH group than that in control group(P<0.05). LAD, left ventricle end-systolic diameter(LVESD), left ventricular end diastolic diameter(LVEDD), interventricular septal thickness (IVST), left ventricular mass index (LVMI) and left ventricular posterior wall thickness (LVPWT) were higher in the LVH group than those in the control group and NLVH group (all P<0.05), there was no significant differences in left ventricular ejection fraction(LVEF) among the three groups (all P>0.05). LPS and TTPLS: LPS of basal, middle, apical left ventricular segments were significantly lower and TTPLS of middle left ventricular segments were significantly longer in the LVH group than those in the control group and NLVH group (all P<0.05). LPS of middle left ventricular segments was significantly lower in the NLVH group and TTPLS of basal left ventricular segments was obviously greater in the LVH group than those in the control group (all P<0.05). PSD increased and absolute value of GLPS decreased gradually in the control group, NLVH group and LVH group(all P<0.05). There was a negative correlation between absolute value of GLPS and PSD in the hypertensive group (r=-0.61, P<0.01). Measurement of PSD had well repeatability and stability.@*Conclusions@#Longitudinal strain and PSD are promising approach to evaluate left ventricular longitudinal systolic function earlier in hypertensive patients with preserved ejection fraction. It has well repeatability and stability and it provides help for clinical diagnosis and efficacy assessment.
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Objective To evaluate the value of longitudinal peak strain ( GLS ) and peak strain dispersion ( PSD) in left ventricular myocardial synchrony and systolic function in patients with obstructive sleep apnea syndrome ( OSAS ) . Methods Seventy male patients with OSAS diagnosed by polysomnography and 26 healthy volunteers were enrolled in this study . According to AHI ,the OSAS patients were divided into three groups :mild group ,moderate group and severe group . Echocardiography was performed on the next day . The Left ventricular ejection fraction ( LVEF) ,diastolic blood pressure , systolic blood pressure ,left ventricular end-diastolic diameter ( LVDd) ,left ventricular end-systolic diameter ( LVDs) ,left atrial diameter ( LAD) ,interventricular septum thickness ( IVST ) ,left ventricular posterior wall thickness ( LVPW) ,global systolic longitudinal strain( GLS) and peak strain dispersion ( PSD) were compared among four groups . The correlation between GLS ,PSD and AHI were analyzed . Results ① Age , height ,weight ,body mass index ( BMI) ,LVEF ,diastolic blood pressure ,systolic blood pressure ,LVDd , LVDs ,LAD and LVPW were not statistically different among the OSAS mild ,moderate ,severe group and control group ( P > 0 .05) . IVST in severe groups was increased than that in control group ( P < 0 .05) . ②Compared with the control group and the mild group ,the PSD increased and the GLS decreased significantly in the moderate and severe groups ( P < 0 .05) ,and there was a statistically significant decrease in the GLS between the severe group and the moderate group ( P < 0 .05) . There was no statistical difference in other parameters among 4 groups ( P > 0 .05) . ③ Pearson correlation analysis showed that AHI was associated with GLS( r 2 = 0 .5026) and PSD( r 2 = 0 .6845) ( P < 0 .05) . Conclusions GLS and PSD can early evaluate the left ventricular myocardial synchrony and systolic function changes in patients with OSAS .
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Objective To investigate the value of peak strain dispersion (PSD) in evaluation of synchronicity of left ventricle in maintenance hemodialysis (MHD) patients.Methods Totally 38 MHD patients (MHD group) and 45 healthy volunteers (control group) were enrolled.Two-dimensional dynamic images,including standard apical two-chamber,longaxis and four-chamber views in 3 consecutive cardiac cycles were acquired,and the standard deviation of time-to-peak longitudinal strain,i.e.PSD,in 18 segments of left ventricle were calculated.The difference of PSD between the two groups and the correlation between PSD and other parameters were assessed.Results PSD of MHD group ([54.21 ± 11.55] ms) was larger than that of control group ([35.58±14.37]ms;t=4.653,P＜0.001).In MHD group,PSD had positive correlation with left ventricular mass index (LVMI),interventricular septum thickness at end-systolic (IVSd),left ventricular posterior wall thickness at end-diastolic (LVPWd),left ventricular end-diastolic diameter (LVDd),left ventricular end-systolic volume (LVESV) and left ventricular end diastolic volume (LVEDV;r=0.461,0.466,0.498,0.472,0.414,0.498,respectively,all P＜0.05).Conclusion Left ventricular systolic synchronicity in MHD patients might be impaired in early stage,which can be quantitatively evaluated with PSD.