Echocardiographic: a comparison of chronic Keshan disease between patients in plateau and plain areas / 中华地方病学杂志

ABSTRACT

Objective The echocardiography of patients with chronic Keshan disease (CKD) in the plateau and plain areas was compared,to analyze the specific manifestations of echocardiography in patients with high altitude CKD,to provide a reference for imaging diagnosis.Methods From October 2014 to December 2016,34 patients with CKD were selected in the Tibet Autonomous Region [18 males,16 females,aged (44.5 ± 5.6) years old] as plateau group;45 patients with CKD were selected in Shandong Province [21 males,24 females,age (47.3 ± 6.9) years old] as a plain group.Echocardiography was performed on the observed subjects,and cardiac morphology,hemodynamics and cardiac function were analyzed.Results The left atrial diameter (LAD),left ventricular end diastolic diameter (LVEDD),and left ventricular mass (LVM) of the plateau group were (39.2 ± 4.8),(56.5 ± 6.3) mm and (232.4 ± 40.2) g,respectively,which were lower than those of the plain group [(48.3 ± 5.7),(65.2 ± 7.8) mm,(283.7 ± 38.3) g,t =-7.52,-5.30,-5.74,P ＜ 0.01].The right atrial transverse diameter (RATD),right ventricular transverse diameter (RVTD) and right ventricular lateral wall thickness (RVWT) of the plateau group were (47.6 ± 8.5),(50.4 ± 7.3) and (4.8 ± 1.1) mm,respectively,which were higher than those of the plain group [(42.3 ± 7.2),(42.7 ± 6.8),(3.3 ± 0.7) mm,t =2.99,4.81,7.36,P ＜ 0.01].The early diastolic filling velocity (E),the early diastolic peak velocity of the mitral annular (Em) of the plateau group were lower than those of the plain group,E/Em of the plateau group was higher than that of the plain group (t =-2.64,-2.35,2.07,P ＜ 0.05).The fractional area change (FAC) of right ventricular,tricuspid annular plane systolic excursion (TAPSE) and tricuspid annular systolic velocity (S') of the plateau group [(24.9 ± 2.8)％,(13.2 ± 1.2) mm,(6.8 ± 1.0) cm/s] were lower than those of the plain group [(26.3 ± 3.2)％,(14.5 ± 1.3) rmm,(7.5 ± 1.2) cm/s,t =-2.02,-4.53,-2.74,P ＜ 0.05 or ＜ 0.01].The tricuspid annular diastolic velocity (e') of the plateau group was lower than that of the plain group,and tricuspid annular blood flow early diastolic filling velocity maximum (e)/e'was higher than that of the plain group (t =-2.07,2.09,P ＜ 0.05).The systolic pulmonary artery pressure (SPAP) of the plateau group [(48.5 ± 12.3) mmHg,1 mmHg =0.133 kPa] was higher than that of the plain group [(41.6 ± 13.3) mmHg,t =2.34,P ＜ 0.05].Conclusion Compared with CKD patients in plain area,CKD patients in plateau area have showed more obvious right heart enlargement and right ventricular failure,and combined with higher SPAP.