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Objective To explore the changes of left ventricular torsion function in patients with latent obstructive hypertrophic cardiomyopathy ( HCM ) ,and provide quantitative informations for clinical evaluation of cardiac function . Methods A total of 49 consecutive patients with HCM without left ventricular outflow tract obstruction at rest were enrolled . All subjects underwent exercise stress echocardiography . After exercise left ventricular outflow tract pressure gradient ( LVO T‐PG ) ≥30 mm Hg was positive for exercise stress test ( latent obstruction) ,w hile LVO T‐PG＜ 30 mm Hg was negative for exercise stress test ( non‐obstruction) . An ultrasound system obtained two‐dimensional ultrasound images of resting and moving peaks . The global longitudinal strain ( GLS ) ,global circumferential strain ( GCS ) , global radial strain ( GRS) of the left ventricle 16 segments and left ventricular rotation ,twist were analysis using off‐line EchoPAC software . T he differences of the above parameters were compared between the two groups . Results T here were no significant differences in GLS ,GRS ,GCS and Rotation‐B between the two groups in resting and peak period of exercise ( all P ＞ 0 .05 ) ,GRS in both groups were significantly increased compared with that before exercise ( all P ＜ 0 .05 ) . Compared with the negative exercise stress group ,the left ventricular twist and Rotation‐A were significantly increased in resting and peak period of exercise in the positive exercise stress test group( all P ＜0 .05) . Compared with before exercise ,Rotation‐A and left ventricular twist were significantly decreased in the positive exercise stress test group ( all P ＜0 .05) ,while no significantly difference was found in the negative exercise stress group ( all P ＞ 0 .05 ) . Conclusions Left ventricular torsion function is significantly changed in rest and after exercise in latent obstructive HCM patients ,providing valuable quantitative information for clinical comprehensive evaluation of cardiac function .
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Objective To investigate the relationship between arterial elasticity and left ventricular twist in patients with essential hypertension (EH).Methods Sixty patients with EH who were treated in the First Affiliated Hospital of the Medical College of Shihezi University from October 2014 to June 2015 as the EH group,and 60 healthy persons in the same period as the control group.The systolic blood pressure (SBP),diastolic blood pressure (DBP),pulse pressure (PP) were measured.Ascending aortic systolic diameter,diastolic diameter were detected by ultrasonic technology.Aortic strain (AS),aortic stiffness (β) and aortic distensibility (AD) were calculated.Left ventricular basal peak rotation(PBR) and apical peak rotation(PAR) were detected by speckle tracking imaging(STI),and the left ventricular peak twist(Ptw) was calculateby.Results The β,PP and Ptw in EH group were 3.99±0.47,(74.2±10.4) mmHg and (21.73±2.30) °respectively,in the control group were 2.75 ± 0.27,(45.9 ± 5.1) mmHg and (14.04 ± 2.90) ° respectively,and the differences were significant(P=0.000).AS and AD in Eh group were 0.034±0.012,1.00±0.47 respectively,in the control group were 0.106 ± 0.028,4.69 ± 1.37 respectively,and the differences were significant (P =0.000).Pearson correlation analysis showed there were opsitive correlation between β with PBR,PAR and Ptw (correlation coefficient =0.361,0.719,0.730;P＜0.01 or P＜0.05),and negative correlation between AD with PBR,PAR and Ptw(correlation coefficient =-0.279,-0.625,-0.610;P＜0.01 or P＜0.05).Conclusion β,PP and Ptw are high,while AS,AD are poor in patient with EH,and there are associations between β,AD with PBR,PAR and Ptw.
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Objective To assess segmental ventricular wall motion abnormalities in patients with coronary artery heart disease by velocity vector imaging (VVI).Methods Eight-six patients of chest pain having underwent coronary angiography were selected,and were divided into myocardial ischemia group (31 cases),myocardial infarction group(25 cases) and normal group (30 cases) according to test results.All the patients were checked with ultrasonic cardiogram in specified time.Systolic rotation angle and speed,diastolic rotation speed in the bottom and apex heart of each segment (anterior,anterior septum,posterior,lateral,inferior wall,interval) was analyzed by VVI.Results Rotary motion of the left ventricle was not consistent in different segment in myocardial infarction group,and the extent and form was different compared with that in normal group.Compared with that in normal group,bottom and apex heart angle of rotation of each segment in myocardial infarction group showed significant difference (P ＜ 0.01 or ＜ 0.05).The rotation angle of each segment in apex and bottom heart between myocardial ischemia group and normal group had no statistical significance (P ＞0.05).In bottom heart:the systolic rotation speed on anterior wall,anterior septum,posterior wall and lateral wall in myocardial infarction group was statistically lower than that in normal group (P ＜ 0.01 or ＜ 0.05),and the diastolic rotation speed on anterior wall,anterior septum,posterior wall,lateral wall,inferior wall was statistically lower than that in normal group (P ＜ 0.01 or ＜ 0.05).The systolic rotation angle between two groups was not statistically significant (P ＞ 0.05).The diastoic rotation speed on anterior interval septum in myocardial ischemia group was statistically lower than that in normal group (P ＜ 0.05),the systolic rotation angle and speed,diastolic rotation speed in other segment was not statistically significant compared with that in normal group (P ＞ 0.05).In apex heart,the systolic rotation speed in anterior wall,anterior septum,posterior wall in myocardial infarction group was statistically lower than that in normal group (P ＜ 0.01 or ＜ 0.05),and the diastolic rotation speed in anterior wall,posterior wall,lateral wall,inferior wall was statistically lower than that in normal group (P ＜ 0.01 or ＜ 0.05).The diastolic rotation speed on anterior and inferior wall in myocardial ischemia group was statistically lower than that in normal group (P ＜ 0.05),and the systolic rotation angle and speed,diastolic rotation speed in other segment was not statistically significant (P ＞ 0.05) compared with that in normal group.Conclusion VVI technique in ultrasonic cardiogram can check out difference between myocardial ischemia and myocardial infarction incipiently.
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Speckle tracking imaging (STI) was employed to investigate the effect of right ventricular (RV) volume and pressure overload on left ventricular (LV) rotation and twist in 35 patients with atrial septal defect (ASD), 18 of which with pulmonary hypertension, and 21 healthy subjects serving as controls. The peak rotations of 6 segments at the basal and apical short-axises and the average peak rotation and interval time of the 6 segments in the opposite direction during early systolic phase were measured respectively. LV twist versus time profile was drawn and the peak twist and time to peak twist were calculated. LV ejection fraction (EF) was measured by Biplane Simpson. Compared to ASD patients without pulmonary hypertension and healthy subjects, the peak rotations of posterior, inferior and postsept walls at the basal level were lower (P<0.05), and the average counterclockwise peak rotation of 6 segments at the basal level during early systolic phase was higher (P<0.05), and the average interval time was delayed (P<0.05). LV peak twist was also lower (P<0.05), and had a significant negative correlation with pulmonary arterial systolic pressure (r=-0.57, P=0.001). No significant differences were found in LVEF among the three groups. It was suggested that although RV volume overload due to ASD has no significant effects on LV rotation and twist, LV peak twist is lower in ASD patients with pulmonary hypertension. Thus LV twist may serve as a new indicator of the presence of pulmonary hypertension in ASD patients.