Value of three-dimensional speckle tracking echocardiography in evaluation of left ventricular diastolic function in elderly patients with heart failure / 中国医师杂志

ABSTRACT

Objective:To analyze the value of three-dimensional speckle tracking echocardiography (3D-STE) in evaluation of left ventricular diastolic function in elderly patients with heart failure (HF).Methods:130 elderly patients with heart failure (HF pEF) with preserved left ventricular ejection fraction in Gulou Hospital Affiliated to Medical College of Nanjing University from January 2018 to October 2019 were studied. All of them were examined by conventional ultrasound, 3D-STE and left-heart catheterization. Their cardiac three-dimensional full-volume dynamic images were collected and then analyzed with three-dimensional speckle tracking technique. The global longitudinal strain (GLS), global radial strain (GRS), global circumferential strain (GCS), and global area strain (GAS) were measured. According to the detected left ventricular end diastolic pressure (LVEDP), the patients were divided into the normal left ventricular diastolic function group (LVEDP≤15 mmHg) and the left ventricular diastolic dysfunction group (LVEDP>15 mmHg). The GLS, GRS, GCS and GAS of the two groups were compared. Pearson correlation analysis was performed to analyze the correlation between GLS, GRS, GCS, GAS and LVEDP, and ROC curves were used to analyze efficiencies of GLS, GRS, GCS and GAS in prediction of left ventricular diastolic dysfunction.Results:The absolute values of GLS, GRS, GCS and GAS of the left ventricular diastolic dysfunction group were lower than those of the normal left ventricular diastolic function group ( P<0.05). The GLS, GCS and GAS were positively correlated with LVEDP ( P<0.05), while GRS was negatively correlated with LVEDP ( P<0.05). The AUC values of GLS, GRS, GCS and GAS for predicting left ventricular diastolic dysfunction were 0.667, 0.775, 0.762 and 0.840, respectively. The sensitivities were 79.17%, 72.22%, 69.44% and 80.56%, specificities were 48.28%, 70.69%, 82.76% and 77.59%, accuracy rates were 65.38%, 71.54%, 75.38% and 79.23%, respectively. Conclusions:The 3D-STE-related strain parameters GLS, GRS, GCS and GAS can be used as ultrasound indexes for assessment of left ventricular diastolic function in elderly patients with HF pEF, which is helpful for early detection of changes in left ventricular diastolic function in elderly patients with HF.