Assessment of left ventricular systolic asynchrony by two dimensional speckle-tracking imaging and its relationship with ejection fraction in patients with chronic heart failure / 中华超声影像学杂志

ABSTRACT

Objective To assess the characteristics of left ventricular(LV) systolic dyssynchrony in patients with chronic heart failure (CHF) using two dimensional speckle-tracking imaging(2D-STI) and validate the correlation between LV systolic dyssynchrony and its ejection fraction (EF) measured by traditional two dimensional echocardiography. Methods Forty-two patients with CHF, which were divided into group CHF1 with 35% ＜EF≤50% and group CHF2 with EF≤35%, and 35 healthy subjects as control group were enrolled in this study. Two-dimensional echocardiography Simpson's method was used to measure EF of LV. The time from the onset of QRS complexes to systole peak strain rate from the longitudinal, radial and circumferential vectors(Tsrsl, Tsrsr, Tsrsc)was recorded and measured using 2D-STI, respectively. The standard deviation and the maximal temporal difference of Tsrsl, Tsrsr, Tsrsc (Tsrsl-SD,Tsrsr-SD,Tsrsc-SD,Tsrsl-diff,Tsrsr-diff, Tsrsc-diff)of 18 segments were calculated as indicator of LV systolic dyssynchrony. Results The indices of LV systolic dyssynchrony Tsrsl-SD,Tsrsl-diff, Tsrsr-SD, Tsrsr-diff,Tsrsc-SD,Tsrsc-diff in group CHF1 and CHF2 were significantly higher than those in the control group (P<0.05). Compared with group CHF1, those indices in CHF2 were significantly longer (P<0.05). Meanwhile, Tsrsl-SD, Tsrsr-SD, Tsrsc-SD(r = - 0.904～0.912, all P<0.05) and Tsrsl-diff, Tsrsr-diff, Tsrsc-diff(r = - 0.916～0.967, all P<0.01) had singnificantly negative correlations with LVEF, and the correlation coefficients between radial and circumferential 2D-STI dyssynchrony parameters and LVEF were higher than those between the longitudinal parameters and LVEF. Conclusions 2D-STI is a useful modality to evaluate the LV systolic asynchrony of the CHF and there is a good correlation between LVEF and the LV systolic dyssynchrony indices derived from 2D-STI.