Evaluation of Left Ventricular Function in Patients with Different-stage Pulmonary Hypertension Using Three-dimensional Speckle Tracking Imaging Combined with Two-dimensional Ultrasound / 中国医学影像学杂志

ABSTRACT

Purpose To evaluate the left ventricular systolic and diastolic function in patients with pulmonary hypertension (PH) using three-dimensional speckle tracking imaging (3D-STI) combined with two-dimensional ultrasound (2D ultrasound),and to investigate the effects of different-degree PH on left ventricular function.Materials and Methods Fifty-two patients who were diagnosed as PHin the First Hospital of Jilin University from September 2011 to November 2015 were retrospectively analyzed,and based on pulmonary artery systolic pressure (PASP),they were assigned into mild group (PASP 36-49 mmHg,n=20),moderate group (PASP 50-70 mmHg,n=18) and severe group (PASP＞70 mmHg,n=14).Besides,healthy volunteers were selected as control group (n=30).All the subjects accepted 2D and 3D imaging,their left ventricular diastolic diameter (LVDd),left ventricular ejection fraction (LVEF),left atrial maximum volume index (LAVI),PASP,e',E/e',etc.,were obtained by 2D ultrasound,and their left ventricular global longitudinal strain (GLS),left ventricular global radial strain (GRS),left ventricular global circumferential strain (GCS),left ventricular global area strain (GAS),etc.,were obtained by 3D-STI.The data of different groups were compared,and the correlation between PASP with left ventricular systolic and diastolic function was analyzed.Results E/e'and LAVI in moderate group and severe group were significantly higher than those in control group,and the differences were statistically significant (P＜0.05);the absolute values of GLS and GAS in moderate group were lower than those in control group (P＜0.05);the absolute values of GLS,GRS,GCS and GAS in severe group were all lower than those in control group,and the differences were statistically significant (P＜0.05).The correlation analysis showed that among 2D parameters,the correlation between LAVI and PASP was better (r=0.56,P＜0.01);among 3D strain values,the correlation between GLS absolute value and PASP was better (r=0.60,P＜0.01).Conclusion 3D-STI combined with 2D ultrasound can effectively assess the left ventricular systolic and diastolic dysfunction in patients with PH,which provides theoretical support for early clinical intervention.