Assessing Left Ventricular Systolic Function in Patients with Pregnancy-Induced Hypertension Using Three-Dimensional Speckle Tracking Technology.

Objective: This study investigates the clinical utility of three-dimensional speckle tracking technology in assessing left ventricular systolic function in pregnancy-induced hypertension syndrome (PIH). Methods: We retrospectively enrolled 70 patients with diagnosed PIH treated at our institution between July 2019 and August 2021 as the study group. A total of 70 healthy pregnant women undergoing routine antenatal examinations at the same institution during the same period were included in the control group. Two-dimensional conventional echocardiography measured left ventricular parameters in both groups. Three-dimensional speckle tracking technology analyzed Left Ventricular Global Longitudinal Peak Strain (LVGLS), Left Ventricular Global Radial Peak Strain (LVGRS), and Left Ventricular Global Circumferential Peak Strain (LVGCS). Differences in left ventricular systolic function and pregnancy outcomes were compared. Results: In the study group, LVEDD, LVPWTd, and IVSTd (47.67±4.88, 10.68±1.21, 11.24±1.03) exceeded those in the control group (45.21±5.65, 8.17±0.98, 8.91±0.37). LVEF (62.12±5.63) was lower than the control group (65.25±5.17) (all P < .05). LVGLS, LVGCS, and LVGAS in the study group (-15.66±1.07, -20.17±2.89, -23.17±3.43) were higher than the control group (-20.14±1.27, -25.17±1.36, -37.68±3.29), while LVGRS (30.29±3.61) was lower than the control group (34.18±4.08) (all P < .05). The study group had 72.86% natural deliveries and 27.14% cesarean sections; the control group had 31.43% natural deliveries and 68.57% cesarean sections (all P < .05). Weeks of delivery and birth weight in the study group (36.87±1.23, 2.71±0.41) were lower than the control group (38.96±1.54, 3.41±0.78) (both P < .05). Conclusions: Compared to traditional methods, three-dimensional speckle tracking technology more sensitively detects left ventricular strain and rotation in PIH patients. It holds clinical relevance in early left ventricular dysfunction detection, effectively mitigating adverse pregnancy outcomes and warranting clinical adoption and application.

Assessment of Myocardial Work of the Left Ventricle before and after PCI in Patients with Non-ST-Segment Elevation Acute Coronary Syndrome by Pressure-Strain Loop Technology.

Objectives: Noninvasive left ventricular pressure-strain loop (PSL) is a new method for quantitative evaluation of myocardial work, which is developed on the basis of speckle tracking echocardiography. It is necessary to fit the noninvasive left ventricular pressure and the strain by speckle tracking echocardiography to construct a pressure-strain loop. Compared with traditional left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS), it has potential application value and is a useful supplement for clinical evaluation of left ventricular systolic function. We perform this study to evaluate the changes of myocardial function in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) before and after percutaneous coronary intervention (PCI) with noninvasive left ventricular pressure-strain loop (PSL). Methods: 33 NSTE-ACS patients admitted to the Department of Cardiovascular Medicine of the Affiliated Lianyungang Hospital of Xuzhou Medical University who successfully underwent early PCI were included as the PCI group. At the same time, 30 healthy patients matched in age and sex were selected as the control group. All patients received routine echocardiography. The parameters such as GWI, GCW, GWW, and GWE were obtained by EchoPAC 203 software. The differences in the general clinical data and echocardiographic parameters between the two groups, including controls and patients 1 day before surgery and 1 month after surgery, were compared. Results: Compared with the control group, GWI, GCW, and GWI in the PCI group were decreased 1 day before surgery and 1 month after surgery, while GWW was increased, with statistical significance (P < 0.05). In the PCI group, compared with 1 day before surgery, GWI and GCW were all increased 1 month after surgery (P < 0.05), and GWW and GWE were not significantly different between the two groups (P > 0.05). Conclusion: The noninvasive left ventricular PSL technology can early and accurately evaluate the myocardial function impairment in NSTE-ACS patients and the recovery of myocardial function after PCI, providing a new noninvasive method for clinical postoperative myocardial function evaluation.

Detection of coronary artery disease in diabetic hypertensive patients using conventional transthoratic echocardiography at rest.

To investigate the usefulness of conventional transthoratic echocardiography in identifying coronary artery disease (CAD) in diabetic hypertensive patients, transthoratic echocardiography and coronary angiography were performed in 122 diabetic hypertensive patients with suspected CAD. Correlation analysis, multivariate analysis and receiver operating characteristic curve (ROC) analysis were done. Diabetic hypertensive patients with CAD had significantly smaller coronary sinus diameter (Dcs), less velocity time integral (VTI), less coronary sinus flow (Flow) and less Flow divided by left ventricular mass (Flow/LVM) at rest versus normal participants (P < 0.01) and diabetic hypertensive patients without CAD (P < 0.05). The VTI, Dcs, Flow, LVM and Flow/LVM all showed significant correlations with the maximal percent stenosis of the coronary artery lesions (P < 0.05). However, only Flow showed statistically significant correlations with the maximal percent stenosis of the coronary artery lesions (P < 0.01) when multiple stepwise regression analysis was performed. For predicting CAD (angiographically proven, >50%) in diabetic hypertensive patients, the area under the ROC (AUC) was 0.92 for Flow, and a cut-off of <220 ml/min had a 93.2% sensitivity, 87.9% specificity and 91.3% accuracy. For predicting a >70% coronary artery stenosis, the AUC was 0.88 for Flow, and a cut-off of <147 ml/min had an 89.5% sensitivity, 87.4% specificity and 88.5% accuracy. Conventional transthoratic echocardiography can effectively and sensitively detect the CAD in diabetic hypertensive patients at rest. The reduced coronary sinus flow is a sensitive and specific predictor of CAD in diabetic hypertensive patients.