Biblioteca Virtual en Salud

Objective:

Evaluation of two-dimensional speckle tracking technique in the diagnosis of apical hypertrophic cardiomyopathy (AHCM) using ROC curve.

Methods:

100 patients with AHCM admitted to Kunshan First People's Hospital from June 1, 2014 to June 30, 2018 were selected as the observation group, and 50 healthy volunteers who underwent physical examination at the same time were selected as the control group. All subjects underwent two-dimensional echocardiography. Circumferential strain (CS) and longitudinal strain (LS) of each segment of the left ventricular wall were obtained. End-rot, epi-rot, bulk-rot, mural-tor and G-tor were measured at mitral and apical levels. To screen effective indicators and evaluate the diagnostic effect of each indicator by receiver operating characteristic (ROC) curve.

Results:

There were significant differences in end-diastolic volume, end-systolic volume, diameter of left atrium in end-systole, the height of the early diastolic flow-velocity peak (E), the height of the late diastolic peak (A), E/A and apical thickness in end-diastole between the two groups ( P<0.05). There were significant differences in CS at mitral valve level, apical level, papillary muscle level, global CS, LS and global LS (GLS) between the observation group and the control group ( P<0.05), the diagnostic value of combined CS and LS at apical level was higher, and the area under curve (AUC) was 0.821(0.791, 0.904); There were significant differences in mitral valve level and apical level of endo-rot, epi-rot, bulk-rot, mural-tor and G-tor between the observation group and the control group ( P<0.05); G-tor has higher diagnostic value among them, and the AUC was 0.844 (0.771, 0.918).

Conclusions:

Two-dimensional speckle tracking technique plays an important role in the diagnosis of apical hypertrophic cardiomyopathy. It can observe the ability of myocardial movement and deformation, as well as the changes of left ventricular myocardial rotation and torsion. The combined detection of CS and LS at apical level and G-tor can better differentiate AHCM.