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Objective:To evaluate the left ventricular myocardial strain in patients with light chain cardiac amyloidosis (AL-CA) with normal left ventricular ejection fraction (LVEF) by three-dimensional speckle tracking imaging(3D-STI), and to explore the clinical value of 3D-STI in predicting the prognosis of AL-CA patients with normal LVEF.Methods:A total of 80 patients with AL-CA and LVEF≥50% were retrospectively analyzed in the Xijing Hospital of Air Force Military Medical University from October 2014 to May 2020.According to whether the patients had endpoint events, they were divided into endpoint event group and non-endpoint event group. The clinical data, conventional echocardiographic parameters, 3D-STI related parameters and follow-up results were collected. Cox regression proportional hazards model was used to analyze the survival status of AL-CA patients with univariate and multivariate regression analyses, in order to find the relevant indicators of conventional echocardiography and 3D-STI to predict adverse events.Results:All patients were followed up for 20(7.3, 40.8) months. At the end of follow-up, 25 patients had all-cause deaths. Compared with the non-endpoint group, the endpoint event group had significantly increased left ventricular end diastolic maximum wall thickness (MLVWT), peak early diastolic flow velocity/peak early diastolic velocity at mitral annulus(E/e′) (all P<0.05), and decreased LVEF, left ventricular global longitudinal strain (GLS) and basal segment longitudinal strain (LS) (all P<0.05). Multivariate cox regression analysis after adjusting for age and gender showed that basal segment LS ( HR=0.812, 95% CI=0.675-0.976, P=0.026) was an independent predictor of end-point events in patients with AL-CA. Kaplan-Meier survival curve showed that AL-CA patients with basal segment LS≤13.07% were more likely to have endpoint events. Conclusions:Basal segment LS can be used as a predictor of endpoint events in patients with AL-CA.
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OBJECTIVES@#To study the application of three-dimensional speckle-tracking imaging in evaluating left ventricular systolic function and its correlation with peripheral arterial elasticity in children with simple obesity.@*METHODS@#Random sampling combined with convenience sampling was used to obtain research samples, and then the samples were divided into an obesity group (23 cases), an overweight group (21 cases), and a normal group (24 cases). Three-dimensional speckle-tracking imaging was used to measure the global longitudinal strain (GLS), global radial strain (GRS), and global circumferential strain (GCS) of the left ventricle. An automatic arteriosclerosis tester was used to measure ankle-brachial index (ABI) and brachial-ankle pulse wave velocity (baPWV). These parameters were compared among the three groups. The correlation of three-dimensional speckle-tracking parameters with ABI and baPWV was evaluated.@*RESULTS@#There were no significant differences in GLS, GRS, and GCS between the obesity and normal groups (P>0.05). The overweight group had a significantly higher GLS than the normal group [(-24±7) vs (-19±12), P<0.05]. The obesity and overweight groups had a significantly lower ABI than the normal group [(1.00±0.09)/(1.09±0.13) vs (2.25±0.13), P<0.05). The obesity group had a significantly higher baPWV than the normal group [(978±109) vs (905±22), P<0.05]. In the children with obesity, GLS was positively correlated with baPWV (r=0.516, P<0.05) , but not correlated with ABI (P>0.05), and GCS and GRS had no significant correlation with ABI or baPWV (P>0.05).@*CONCLUSIONS@#There are varying degrees of changes in left ventricular systolic function and peripheral arterial elasticity in children with simple obesity, and there is a certain correlation between them.
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Child , Humans , Ankle Brachial Index , Echocardiography, Three-Dimensional/methods , Elasticity , Obesity , Overweight , Prospective Studies , Pulse Wave AnalysisABSTRACT
Objective:To assess the left ventricular(LV) structure and systolic function in amateur marathon runners using real-time three-dimensional speckle tracking echocardiography(3D-STE) and analyze its correlation with the running volume.Methods:A total of 84 amateur marathon runners were recruited between January 2019 and October 2021 in Hangzhou and were divided into short-term (ST) group(≤6 months) and more extended-term(MET) group(>6 months–2 years) based on their time of participating in the marathon. Thirty-nine healthy volunteers were enrolled from the Affiliated Hospital of Hangzhou Normal University during the same period as a control group. The running volume of ST and MET runners were recorded, LV end-diastolic volume(EDV), end-systolic volume(ESV), LV mass(LVM), LV ejection fraction(LVEF), LV global longitudinal strain(GLS), global circumferential strain(GCS), global radial strain(GRS), global area strain (GAS), twist, and torsion were measured by conventional echocardiography and 3D-STE. The differences of those parameters among the three groups were compared. The correlation between 3D-STE parameters and the running volume was further analyzed.Results:In ST amateur marathon runners, LV EDV was higher compared with controls( P<0.05). Compared with ST and control groups, LV EDV, ESV, and LVM of MET runners were increased(all P<0.05). In addition, compared with control group, GLS of MET runners was increased( P<0.05). The LVEF, GCS, GRS, GAS, twist, and torsion showed no statistically significant differences among the three groups(all P>0.05). In amateur marathon runners LV EDV, ESV, LVM had statistically significant positive correlations with an average weekly running volume and total running volume (all P<0.01). Multivariate linear regression analysis showed that the total running volume was an independent correlation factor in LV EDV of amateur marathon runners (β=0.618, P<0.01). Conclusions:Amateur marathon runners participating in a short term marathon mainly show an increase in LV EDV, the longitudinal systolic function of the LV can be enhanced in the early stage of the marathon.
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Objective To evaluate the application value of three-dimensional speckle tracking imaging (3D-STI) in quantitatively evaluating the left ventricular global strain in recipients within 3 months after renal transplantation. Methods Clinical data including blood pressure, serum creatinine and tacrolimus blood concentration of 34 renal transplant recipients were collected before operation, 7 d, 1 month and 3 months after operation, respectively. Meanwhile, conventional echocardiography and 3D-STI examination were performed. Echocardiographic parameters [left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV) and left ventricular ejection fraction (LVEF)] and 3D-STI parameters [left ventricular global peak longitudinal strain (GPLS), global peak circumferential strain (GPCS), global peak radial strain (GPRS) and global peak area strain (GPAS)] of recipients were collected. The changes of these parameters before operation, 7 d, 1 month and 3 months after operation were statistically compared. The changing characteristic and application value of 3D-STI in quantitatively evaluating the left ventricular global strain in recipients within 3 months after renal transplantation were evaluated. Results LVEF and GPCS did not significantly differ at different time points (all P > 0.05), whereas LVEDV, LVESV, GPLS, GPAS and GPRS significantly differed at different time points from preoperative to within postoperative 3 months (all P < 0.001). GPLS, GPAS and GPRS trended to decline within postoperative 1 month, and slightly increased at 3 months after operation, which was still lower than the preoperative levels. Conclusions Application of 3D-STI may sensitively detect the changes of left ventricular global strain in recipients after renal transplantation when no significant variations are observed in postoperative LVEF. Compared with conventional echocardiography, 3D-STI may more accurately evaluate the changes of left ventricular global strain in recipients after renal transplantation.
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OBJECTIVES@#To compare the left ventricular systolic function between the 1eft bundle branch pacing (LBBP) and right ventricular septum pacing (RVSP) in patients with pacemaker dependence by three-dimensional speckle tracking imaging (3D-STI).@*METHODS@#A total of 65 patients with atrioventricular block (AVB) (Mobitz type II second-degree AVB, high-degree AVB, or third-degree AVB), who underwent permanent cardiac pacing implantation including 32 patients receiving LBBP (LBBP group) and 33 patients receiving RVSP (RVSP group) from June 2018 to June 2019,were enrolled in this study. These patients met the following inclusion criterion: pre-operative left ventricular ejection fraction (LVEF)>50% and ventricular pacing rate>40% at 6-month programming follow-up; and the patients underwent echocardiography at pre-operation and 6 months after operation. The 3D-STI was used to obtain global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS), and global area strain (GAS).@*RESULTS@#All the patients in the LBBP group and the RVSP group had normal LVEF, there was no significant difference between the 2 group (@*CONCLUSIONS@#For patients with pacemaker dependence and normal LVEF at pre-operation, the cardiac function in the LBBP group is not significantly better than that in the RVSP group in short term follow-up. But in terms of physiologic pacing and long-term cardiac function protection, the 1eft bundle branch pacing is an optimal pacing mode.
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Humans , Bundle of His , Cardiac Pacing, Artificial , Pacemaker, Artificial , Stroke Volume , Ventricular Function, Left , Ventricular Septum/diagnostic imagingABSTRACT
Objective:To investigate the clinical value of real-time three-dimensional speckle tracking echocardiography in the evaluation of early cardiac function damage in patients with pregnancy induced hypertension.Methods:Sixty-five pregnant women with pregnancy induced hypertension (patient group) and 65 healthy pregnant women (healthy group) who received prenatal examination and delivered between January 2018 and June 2020 in Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine were included in this study. The patient and healthy groups were subjected to routine echocardiography and real-time three-dimensional speckle tracking echocardiography at 24-36 and 32-34 weeks of gestation. The imaging parameters of routine echocardiography and real-time three-dimensional speckle tracking echocardiography measured at different periods of gestation were compared between the two groups.Results:At 24-36 weeks of gestation, there were no significant difference in routine echocardiography parameters of the left ventricle between patient and healthy groups ( t = 0.793-1.748; P = 0.129-0.458). Left ventricular diameter (LVD), intra-ventricular septum diastole (IVSD) and left ventricular posterior wall diameter (LVPWD) in the patient group at 32-34 weeks of gestation were (34.97 ± 2.66) mm, (11.96 ± 1.85) mm, (12.07 ± 1.73) mm, respectively, which were significantly greater than those in the healthy group at the same time [(31.56 ± 2.58) mm, (9.17 ± 1.70) mm, (9.23 ± 1.62) mm] and those in the patient group at 24-36 weeks of gestation [(32.36 ± 2.61) mm, (10.15 ± 1.79) mm, (10.19 ± 1.64) mm, t = 5.437, 6.274, 6.319, 3.621, 4.017, 5.241, all P < 0.001]. Left ventricular ejection fraction (LVEF) in the patient group at 32-34 weeks of gestation was (54.36 ± 4.71)%, which was significantly lower than (63.27 ± 5.04)% in the healthy group at the same time and (59.65 ± 4.62) % in the healthy group at 24-36 weeks of gestation ( t = 7.682, 5.483, both P < 0.001). At 24-36 and 32-34 weeks of gestation, the absolute values of real-time three-dimensional speckle tracking echocardiography parameters left ventricular global longitudinal strain, left ventricular global circumferential strain, left ventricular global radial strain and left ventricular global area strain in the patient group were (23.45 ± 2.58)%, (34.09 ± 3.28)%, (22.03 ± 2.31)%, (34.73 ± 3.58)%, (18.63 ± 2.42)%, (30.74 ± 3.07)%, (19.56 ± 2.28)%, (25.85 ± 3.37)%, respectively, which were significantly lower than those in the healthy group [(26.27 ± 2.74)%, (37.62 ± 3.61)%, (24.67 ± 2.59)%, (39.41 ± 3.96)%, (26.10 ± 2.81)%, (37.56 ± 3.64)%, (24.82 ± 2.59)%, (40.16 ± 3.96)%, t = 4.415, 5.013, 4.724, 6.253, 10.736, 8.592, 7.627, 14.319, all P < 0.001]. In patient group, the absolute values of left ventricular global longitudinal strain, left ventricular global circumferential strain, left ventricular global radial strain and left ventricular global area strain at 32-34 weeks of gestation were (18.63 ± 2.42)%, (30.74 ± 3.07)%, (19.56 ± 2.28)%, (25.85 ± 3.37)%], respectively, which were significantly lower than those at 24-36 weeks of gestation [(23.45 ± 2.58)%, (34.09 ± 3.28)%, (22.03 ± 2.31)% (34.73 ± 3.58)%, t = 7.529, 4.785, 5.194, 8.413, all P < 0.001]. Conclusion:Real-time three-dimensional speckle tracking echocardiography is advantageous in identifying the damage to cardiac function over routine echocardiography. Findings from this study provides a great clinical guiding value for protecting the cardiac function of patients with pregnancy induced hypertension.
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Objective@#To evaluate the left ventricular global systolic function and myocardial fibrosis in adult hypertrophic cardiomyopathy (HCM) patients by three-dimensional speckle tracking echocardiography(3D-STE) combined with cardiac magnetic resonance imaging-late gadolinium enchancemet (CMRI-LGE) sequence, and to explore the association between left ventricular global systolic function and myocardial fibrosis.@*Methods@#Thirty patients with HCM(HCM group) and 33 healthy controls(control group) were enrolled in the study. All patients underwent conventional two-dimensional echocardiography (2DE), tissue Doppler imaging (TDI), and 3D-STE. The following parameters were acquired and compared between the groups: interventricular septal end-diastolic thickness (IVSD), left ventricular posterior wall end-diastolic thickness (LVPWD), left ventricular mass(LVM), left ventricular mass index (LVMI), left atrial volume (LAV), and left ventricular end-systolic volume(LVESV), left ventricular end-diastolic volume (LVEDV), left ventricular outflow tract pressure gradient (LVOT-PG), left ventricular outflow tract velocity time integral (LVOT-VTI), isovolumic relaxation time (IVRT), global strain (GS), global longitudinal strain (GLS), global radial strain (GRS), global circumferential strain (GCS). And 28 patients who met the CMRI indications underwent CMRI-LGE to obtain the LVM, and the correlation and consistency of LVM results obtained from CMRI and 3D-STE were performed.According to LGE results, HCM patients were divided into LGE(+ ) group and LGE (-) group, the differences of GLS, GRS and GCS between the two groups were analyzed.@*Results@#①Compared with the control group, IVSD, LVPWD, LVMI, LAV, LVOT-PG, LVOT-VTI and IVRT were significantly increased in the HCM group (all P<0.05); ②There was no significant difference in GS between the two groups(P>0.05), while GLS and GRS decreased and GCS increased significantly in HCM group (P<0.05); ③The correlation between 3D-STE and CMRI in measuring measured LVM in HCM patients was good, and the results showed good concordance(r=0.807, P<0.01). ④GLS in LGE(+ ) group was lower than in LGE(-) group(P=0.004), but there was no significant difference in GCS and GRS between the two groups(P=0.597, 0.534).@*Conclusions@#①3D-STE can detect the early damage of left ventricular global systolic function in patients with HCM; ②3D-STE combined with CMRI-LGE technology can provide an important imaging reference for the evaluation of the relationship between left ventricular global systolic function and myocardial fibrosis in patients with HCM.
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Objective: To evaluate the cardiac functional changes in hypertrophic cardiomyopathy(HCM) patients with β-myosin heavy chain gene (MYH7) mutations by three-dimensional (3D) speckle tracking imaging(3D-STI) and conventional echocardiography modalities, and then to explore the potential predictors of adverse cardiovascular events in these patients. Methods: A consecutive series of 192 HCM patients admitted in our center from October 2014 to October 2016 were genetically screened to identify MYH7 mutations in this retrospective study. A total of 43 HCM patients with MYH7 mutations were enrolled. The patients were divided into events group(n=13) and no event group(n=30) according to the presence or absence of adverse cardiovascular events(primary and secondary endpoints). All patients were followed up to January 2019 after comprehensive evaluation of 3D-STI, two-dimensional and Doppler echocardiography. The adverse cardiovascular events were recorded. Results: The median follow up time was 1 012 (812, 1 330) days. During follow-up, 13 patients (30.2%) reached endpoints: 6 cases of the primary endpoints(2 cases of sudden cardiac death(SCD), 3 cases of survival after defibrillation, and 1 case of appropriate implantable cardioverter-defibrillator(ICD) discharge); 7 cases of the second endpoints(5 cases of heart failure hospitalization, 1 case of syncope and cardioversion due to supraventricular tachycardia, and 1 case of end-stage HCM). Patients with adverse cardiovascular events had higher prevalence of syncope and risk of SCD, enlarged left atrial volume index(LAVI) and reduced 3D left ventricular global longitudinal train (3D-GLS), as compared to those without adverse events(all P<0.05). The multivariate Cox regression analysis showed that reduced 3D-GLS(HR=0.814, 95%CI 0.663-0.999, P=0.049) was an independent predictor for adverse cardiovascular events. The cutoff value of 3D-GLS≤13.67% was linked with significantly increased risk of adverse cardiovascular events in this patient cohort(AUC=0.753, 95%CI 0.558-0.948, sensitivity 86%, specificity 69%, P<0.05). The Kaplan-Meier analysis indicated that the patients with the 3D-GLS≤ 13.67% faced higher risk of death than those with 3D-GLS>13.67%. Conclusion: 3D-GLS is useful on predicting adverse cardiovascular events in HCM patients with MYH7 mutations.
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Humans , Cardiac Myosins/genetics , Cardiomyopathy, Hypertrophic/genetics , Echocardiography , Mutation , Myosin Heavy Chains/genetics , Predictive Value of Tests , Retrospective Studies , Risk FactorsABSTRACT
Objective: To evaluate the impact of acute carbon monoxide poisoning on left ventricular systolic function with three-dimensional speckle tracking imaging (3D-STI). Methods: Totally 109 patients with acute carbon monoxide poisoning (study group) were enrolled and divided into mild (n=36), moderate (n=40) and severe (n=33) subgroups. And 105 healthy volunteers were selected as control group. 3D-STI was performed 1 hour and 1 week after poisoning, respectively. The levels of carboxyhemoglobin (HbCO) and serum cardiac troponin I (cTnI) were measured. The difference and correlation of the indexes were analyzed between the study group and the control group. Results: One hour after acute carbon monoxide poisoning, no significant difference of global longitudinal strain (GLS), global area strain (GAS), global circumferential strain (GCS), global radial strain (GRS) nor left ventricular ejection fraction (LVEF) was found between mild subgroup and control group (all P>0.05), while HbCO and cTnI in mild subgroup were higher than those in control group (both P0.05); GAS in severe subgroup was lower than that in control group (P<0.05), cTnI was higher than that in control group (P<0.05). One hour after acute carbon monoxide poisoning, serum cTnI was negatively correlated with GLS and GAS in the study group (r=-0.626, -0.640, both P<0.05). Conclusion: 3D-STI can early diagnose damage of left ventricular systolic dysfunction caused by acute carbon monoxide poisoning. GAS decreases with the increase of serum cTnI content, which is a good indicator of left ventricular dysfunction in patients with acute carbon monoxide poisoning.
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Objective To evaluate left ventricular (LV) systolic function in patients with paroxysmal atrial fibrillation (PAF) after catheter ablation by three-dimensional speckle tracking imaging (3 D-STI). Methods A total of 35 patients with PAF who underwent catheter ablation were enrolled in this study. The participants underwent standard echocardiography and 3 D-STI three to six months before and after the operation. 30 healthy volunteers were enrolled as controls. 3 D-STI was used to obtain global longitudinal strain (GLS) , global circumferential strain (GCS) , global radial strain (GRS) , and global area strain (GAS). Results The LA and E/e' ratio in PAF group showed no significant difference before and after the operation, but were increased compared with controls.There were no significant differences between PAF group and control group in LV, left ventricular end-diastolic volume (LVEDV) , left ventricular end-systolic volume (LVESV) and left ventricular ejection fraction (LVEF) before and after the operation. Compared with control group, GLS and GAS in PAF group were significantly decreased.GAS in PAF group three to six months after catheter ablation was significantly increased. Conclusions Although with normal LVEF, LV systolic function is impaired in patients with PAF. 3 D-STI technique could sensitively reflet the decline in LV myocardial deformation and systolic function.
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Objective To investigate whether three-dimensional speckle tracking imaging ( 3D-STI) combined with conventional echocardiography can identify cardiac functional characteristics and predict adverse cardiovascular events in patients with hypertrophic cardiomyopathy ( HCM ) . Methods One hundred and eighty HCM patients were involved in the study . All patients were followed up to March 2017 after comprehensive evaluation of 3D-STI and conventional echocardiography for endpoint events . The endpoint events were divided into the primary and secondary endpoints . The primary endpoints included sudden cardiac death ( SCD ) , survival after cardioversion and appropriate implantable cardioverter-defibrillator( ICD) discharge ;the secondary endpoints included acute myocardial infarction ,heart failure hospitalization ,thromboembolism and endstage HCM . The composite endpoints contained primary or secondary endpoints . Results ①Totally 175 HCM patients completed the follow-up [ ( 435 ± 204) days] . During follow-up ,25 patients ( 14 .3% ) reached composite endpoints :8 cases of the primary endpoints ( 3 cases of sudden cardiac death ,3 cases of survival after defibrillation ,and 2 cases of appropriate implantable cardioverter-defibrillator discharge ) ; 17 cases of the second endpoints ( 14 cases of heart failure hospitalization ,2 cases of thromboembolism ,and 1 case of end-stage HCM ) . ② Patients with primary endpoints had higher NYHA class ,reduced systolic and early diastolic mitral annular velocities (MV s′and MV e′) ,decreased systolic tricuspid annular velocity ( TV s′) ,and impaired 3D left ventricular global longitudinal strain ( GLS ) ,as compared to those without primary endpoints ( n ＝ 167 ) ( P ＜ 0 .05 ) . Impaired 3D GLS ( hazard ratio was 0 .72 ,95% CI was 0 .53 －0 .98 , P ＝ 0 .035) and decreased TV s′( hazard ratio was 0 .70 ,95% CI was 0 .54－0 .91 , P ＝0 .007) were independent predictor factor for primary endpoints . 3D GLS≤11 .7% or TV s′≤12 .7 cm/s raised the risk of primary endpoints . ③Similarly ,HCM patients with composite endpoints ( n ＝25) had higher NYHA class ,enlarged left atrial diameter ( LAD) , reduced MV s′,MV e′ and TV s′,as well as impaired 3D GLS ( P ＜ 0 .05) ,when compared to those without composite endpoints ( n＝150) . Moreover ,impaired 3D GLS ( hazard ratio was 0 .68 ,95% CI was 0 .56－0 .81 , P ＝0 .000) was independent predictor for composite endpoints ;and patients with 3D GLS≤12 .9% was more susceptible to composite endpoints . Conclusions 3D GLS combined with TV s′ are of value in predicting adverse cardiovascular events .
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Objective To evaluate the change of right ventricular function before and after single hemodialysis by 3-dimensional speckle tracking imaging( 3D-STI) . Methods Seventy-six patients with end-stage renal disease ( ESRD ) and 35 controls were included .ESRD patients were divided into normal left ventricular ejection fraction group( LVEF ≥ 50％ ,46 cases ,group A ) and decreased LVEF group( LVEF <50％ ,30 cases ,group B) .Conventional echocardiography and 3D-STI parameters including right ventricular end diastolic volume( RVEDV ) ,right ventricular end systolic volume ( RVESV ) ,right ventricular ejection fraction( RVEF) ,right ventricular septal longitudinal strain [ RVLS ( Septum ) ] ,right ventricular free wall longitudinal strain [ RVLS( Freewall ) ] ,basal segment of right ventricular diameter[ RVDd( base ) ] ,right ventricular middle diameter [ RVDd ( mid ) ] ,right ventricular long diameter ( RVLD ) and the upper and lower right ventricular fractional area change ( FAC) were performed in patients and controls before and after a single hemodialysis . Results ① RVEDV ,RVESV ,RVDd( base) ,RVDd( mid) ,RVLD before a single hemodialysis in group A and B were significantly higher than those in control group ( all P < 0 .05) . RVEF , RVLS Freewall ,RVLS( Septum) and FAC in group A and B were significantly lower than those in control group ( all P < 0 .05) . ② RVEDV ,RVESV ,RVEF ,RVLD ,RVLS ( Freewall) were significantly lower in group A after a single hemodialysis ( all P < 0 .05 ) ;RVEDV ,RVESV ,RVEF ,RVLS ( Freewall) ,RVLS ( Septum) were significantly lower in group B after a single hemodialysis( all P < 0 .05) ;RVEDV ,RVESV , RVEF ,RVLS( Septum) and RVLS( Freewall) in group B before a single hemodialysis were lower than those in group A ( all P < 0 .05) . The difference of RVLS Septum decrease in group B after a single hemodialysis was higher than that in group A( P < 0 .05) ;The linear correlations analysis showed that the difference of body weight before and after a single hemodialysis was negatively related with the difference of RVLS ( Freewall) before and after a single hemodialysis( group A : r = 0 .351 , P = 0 .017 ;group B : r = 0 .696 ,P =0 .000) . Conclusions A single hemodialysis may have injurious effects on right ventricular systolic function and reduce strain value ,which is more significant in group B( LVEF < 50％ ) . Cardiac dysfunction of patients may be remitted by reasonable control of water intake .
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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 detect the changes of systolic function of left ventricle in patients with lymphoma receiving anthracycline by three dimensional speckle tracking imaging(3D-STI).@*Methods@#Thirty patients with newly diagnosed diffused large B-cell lymphoma who had received R-CHOP chemotherapy were enrolled. Left ventricular global longitudinal strain (GLS), global circumferential strain(GCS) and longitudinal strain(LS) on different left ventricular segments were measured by 3D-STI at baseline, after the completion of 2 cycles and 4 cycles of the regimen respectively.@*Results@#Compared with baseline, GLS reduced significantly after four cycles of anthracycline chemotherapy(P=0.002). Analysis of LS on different segments of the left ventricle shows: after 2 cycles of anthracycline chemotherapy, LS only on apical septum was significantly decreased(P=0.019). After 4 cycles of treatment, LS on mid anterior, mid anteroseptal, mid inferoseptal, mid anterolateral, apical anterior, apical septal walls and apex worsened (t=3.321, P=0.002; t=2.497, P=0.018; t=2.387, P=0.024; t=2.096, P=0.045; t=4.015, P=0.000; t=4.064, P=0.000; t=3.370, P=0.002, respectively).@*Conclusions@#LS deterioration emerges on some left ventricular walls in patients with lymphma underwent chemotheapy based on anthracycline in early stage of the remedy, especially on apex and mid segments. LS on apical septum manifests firstly. The segmental LS index maybe expected to be valuable for monitoring of early cardiotoxicity of antharcycline.
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Objective To assess the left ventricular systolic function in young strength male athletes by three-dimensional speckle tracking echocardiography (3D-STE).Methods A total of 45 young strength male athletes (athlete group) and 30 healthy young men (control group)were enrolled.Traditional echocardiography combined with 3D-STE were applied for all the subjects to obtain heart rate (HR),left ventricular end-diastolic diameter (LVEDD),the thickness of interventricular septum (IVS) and posterior wall thickness (PWT),relative wall thickness (RWT),left ventricular end-diastolic volume (EDV),endsystolic volume (ESV),left ventricular ejection fraction(LVEF),stroke volume (SV),left ventricular mass (LVM),left ventricular global longitudinal strain (GLS),global circumferential strain (GCS),global area strain (GAS),global radial strain (GRS).Results There were a significant increase inLVEDD,IVS,PWT,RWT,EDV,ESV,SV,LVM and significant decrease in HR,GLS,GCS,GAS and GRS in athlete group compared with the control group (P ＜ 0.05).However,there was no significant difference in LVEF between two groups (P ＞0.05).Conclusions There are subclinical changes of left ventricular systolic functionin of young strength male athletes.3D-STE can accurately assess the changes,and provide reliable information for clinical assessment of athletes' heart function.
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Objective To obtain the normal reference ranges of global longitudinal strain (GLS),global circumferential strain (GCS),global area strain (GAS) and global radial strain (GRS) of left ventricular in normal adults by three-dimensional speckle tracking imaging (3D-STI) using Meta analysis.Methods Eligible trials which detected global strain of left ventricular in normal subject through 3D-STI were searched in Embase,Pubmed,Cochrane Library database.According to the heterogeneity,parameters of contained studies were analyzed the weighted mean difference (WMD) and 95％ confidence interval (CI).The statistical software was STATA 12.0.Results Totally 1 552 healthy adults from 27 articles were included.Based on the Meta-analysis,theWMDand 95％CIofGLSwere 17.80 and (16.27,19.33),of GCS were 24.73 and (22.50,26.95),of GRS were 47.86 and (39.52,56.19),of GAS were 36.17 and (34.08,38.26).Conclusion The Meta analysis defines reference range of strains obtained by 3D-STI in healthy adults.Using these parameters of 3D globe strains,a guidance of reference for patienfs management and therapy selection may be provided.
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Objective:To evaluate the left ventricular segmental strains,global strains and systolic function in the patients with acute myocardial infarction (AMI) after percutaneous coronary intervention(PCI)with three-dimensional speckle tracking echocardiography(3D-STI),and to clarify the characteristics of early myocardial strain changes after PCI and their clinical values.Methods:Thirty patients received PCI for left anterior descending branch disease were enrolled as case group;at the same period, 30 healthy middleaged and elderly people were selected as control group.After two-dimensional ultrasound data were obtained regularly, the myocardial motion and systolic functions of the patients in two groups were detected with 3D-STI, and all segmental strain, global longitudinal strain(GLS), global radial strain(GRS), global circumferential strain (GCS)and global area strain(GAS) values of left ventricle and left ventricular ejection fraction (LVEF) values were collected.Results:Compared with control group, the global strain values of the patients in case group were lower than those in control group;9/16 longitudimal strain(LS), 8/16 circumferential strain(CS), 5/16 radial strain(RS) and 11/16 area strain(AS) were significantly lower than those in control group(P<0.05).The decrease of strain value was mainly concentrated in the anterior segment of the anterior wall, the anterior segment of the anterior wall, anterior apical segment, anterior septal basal segment, anterior septal segment, posterior septal basal segment, posterior septal segment, and posterior septal segment.The GLS,GAS and GCS in case group were negatively correlated with LVEF(r=-0.819,r=-0.897,r=-0.807,P<0.0001);the GRS was postively correlated with LVEF(r=0.862,P<0.0001).Conclusion:3D-STI can quantitatively analyze the segmental wall motion of left ventricle and could apply the parameters to evaluate the therapeutic efficacy after PCI.
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Objective To assess the improvements of left ventricular systolic function by three‐dimensional speckle tracking imaging ( 3D‐STI) in type 2 diabetes mellitus ( T2DM ) patients after short‐term insulin pump intensive therapy . Methods Thirty‐five T2DM patients complicated with microangiopathy and thirty‐two healthy volunteers were studied ,underwent the dynamic image of the four‐chamber view ,three‐dimensional images of left ventricle were obtained for all the individuals . The left ventricular global longitudinal strain ( LVGLS) ,left ventricular global circumferential strain ( LVGCS) ,left ventricular ejection fraction (LVEF) ,peak basal and apical rotation (LV‐ProtB ,LV‐ProtA) ,peak LV twist ( LV‐tw ) were calculated using TomTec software .After insulin pump intensive therapy for two weeks ,all the indexes were reexamined in T2DM patients . Results Compared with control group ,the LVGLS , LVGCS ,LV‐tw and LV‐ProtA were significantly decreased in diabetes mellitus group before and after treatment ( P < 0 .01 or P < 0 .05) . Compared with diabetes mellitus patients before treatment ,the LVGLS ,LVGCS had significant higher level after treatment( P <0 .05) . The LVGLS ,LVGCS ,LV‐tw and LV‐ProtA were significantly correlated with LVEF in type 2 diabetes mellitus patients and normal controls . Conclusions Insulin pump intensive treatment could improve left ventricular systolic function in type 2 diabetes patients complicated with microangiopathy . 3D‐STI can be sensitive to accurately assess the therapeutic effect and has the important clinical value .
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Objective To assess the value of the myocardial segment number of color change in the bull's eyes of three-dimensional speckle tracking echocardiography (3D-STE)in the detection of multi-vessel coronary stenosis at the resting state.Methods A total of 125 consecutive patients were enrolled and divided into the following three groups according to the coronary angiography(CAG):multi-vessel coronary stenosis group (n=48),single-vessel stenosis group(n =34)and control group (n =43).All patients underwent two-dimensional (2D)and three-dimensional echocardiography (3D)and three-dimensional speckle tracking echocardiography (STE).The bull's eyes of left ventricular 17 myocardial segments including longitudinal strain(LS),circumferential strain (CS),area strain(AS)and radial strain(RS)were acquired by 3D-STE.The homogeneous colors were regarded as normal wall motion myocardial segment (LS,CS,AS is a uniform red,RS for uniform blue ),the colors were uneven or shallower,or changes were regarded as abnormal wall motion myocardial segment.The myocardial segment number of color change in the bull's eyes can be calculated.Receiver operating characteristic (ROC ) curves were computed to determine optimal strain cutoff values to predict multi-vessel coronary stenosis.Results The myocardial segments of abnormal wall motion in the bull's eyes (LS,CS,AS,and RS)were significantly increased compared with the control group(P <0.001).In particular,the multi-vessel coronary stenosis group were dramatically increased than the single-vessel coronary stenosis group.Meanwhile,these parameters were higher in patients with multi-vessel coronary stenosis than in those with single-vessel coronary stenosis (P <0.05).ROC analysis demonstrated areas under the curve of 0.84 for 3D GLS,0.89 for 3D GCS,0.95 for 3D GAS,and 0.89 for 3D GRS.An optimal cutoff value of magnitude,sensitivity and specificity were LS,12,89.6%,76.7%;CS,11,89.6%,74.4%;AS,12,91.7%,88.4%;RS,13,81.2%,86.0%,respectively. Conclusions The myocardial segment number of color change in the bull's eyes by 3D-STE is useful to detect multi-vessel coronary stenosis,where in GAS are more valuable indicators with higher sensitivity and specificity.
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Objective To explore the accuracy of three dimensional speckle tracking imaging (3D-STI) in quantitative coronary evaluation of (CHD) patients' left ventricular global systolic function.Methods Sixty-eight CHD patients were divided into three groups according to the coronary artery angiography (CAG) results:32 cases in severe stenosis group,23 cases in moderate stenosis group,and 13 cases in mild stenosis group.Thirty gender-age-matched healthy subjects(control group) were enrolled in this study.All patients underwent 2D-echocardiography and real-time three-dimensional echocardiography (3DE).The global longitudinal strain(GLS),global radial strain(GRS),global circumferential strain(GCS),global area strain (GAS),global area strain rate (GASrate) and 3D global LV strain (3D-Strain) were analyzed using 3D-STI.Correlation between strain measurements and left ventricular ejection fraction (LVEF) by simpson method,3D-LVEF by 3DE were assessed using linear regression analysis.Results All 3D-STI parameters in the severe stenosis group were significant decreased compared with the other groups.GLS,GRS,GCS,GAS,3D-Strain of moderate stenosis group shown more significant decrease than both mild stenosis group and control group (P ＜ 0.05).Strong correlations were demonstrated in all 3D-STI parameters between 3D-LVEF and LVEF.The strongest correlation was observed between GAS with 3D-LVEF in severe stenosis group(r =-0.910,P ＜0.05).Intraobserver and interobserver reliability of GAS was better than other parameters.Conclusions Global strain of 3D-STI can quantitatively evaluate the global LV function in CHD patients,and GAS is more sensitive and reproducible than other parameters.