Evaluation Of Ventricle Function By Tissue Doppler Imaging In Patients With Acute Organophosphate Poisoni

Objective To evaluate global ventricular function in patients with acute organophosphate poisoni (AOPP) by Color-Tissue Doppler Imaging (C-TDI).Methods 78 patients with acute organophosphate poisoni (AOPP) were divided into mild and moderate AOPP group(AOPP-A group, n=42),sever AOPP group(AOPP-B group,n=36) based on plasma Cholinesterase (CHE) and Clinical manifestation.32 health adults were selected as contral group. Left ventricular eject faction(EF) was assessed by improved Simpson formular. Conventional left and right ventricular diastolic function parameters were acquired by pulsed Doppler. The mitral and the tricuspid flow velocity, deceleration time of early diastolic mitral flow and early diastolic tricuspid flow, isovolumic relaxation time were measured by the pulse Doppler,and the E/A was calculated. The mitral annular and the tricuspid annular peak systolic (Sm) and early diastolic (Em) and peak late (Am) velocities were determined by Color TDI in the apical views (4-and 2-chamber, and long-axis),and mean Sm(M-Sm), mean Em (M-Em) mean Am (M-Am), the M-Em/M-Am, the Em/Am, lateral-Em, the E/lateral-Em and Tei index were calculated. Plasma CHE, Creatine kinase (CK), Creatine kinase-MB isoenzyme (CK-MB), Lactate dehydrogenase (LDH) levels were measured by automatic biochemical analyzer.Then the function parameters of the AOPP-A,AOPP-B were compared with the control, and the correlation between the parameters were analyzed.Results 1.M-Sm, M-Em, M-Em/M-Am, Right Ventricular Sm, Em, Em/Am, Plasma CHE were reduced in AOPP-B subjects compared with contral group and AOPP-A group (p<0.05) 2.Am,E/M-Em, Tei Index,Plasma CK,CK-MB,LDH concentration were increased in AOPP-A,B subjects compared with contral group and in AOPP-B subjects compared with AOPP-A group (p<0.001). M-Sm correlated positively with M-Em in AOPP-B group (p<0.001).3. E/M-Em correlated positively with LVIDd and correlated negatively with M-Sm,M-Am/M-Em and M-Em(p<0.001). Right Ventricular E/Em correlated positively with Tei Index.and correlated negatively with Em,Em/Am (p<0.01).4. Plasma CK-MB correlated positively with E/M-Em,Left Ventricular Tei Index. and correlated negatively with M-Sm,M-Em and M-Em/M-Am (p<0.001) Plasma CK-MB correlated positively with right ventricular Tei Index, Am, E/Em. and correlated negatively with Sm,Em,Em/Am. (p<0.001).5. Pulmonary arterial pressure(PAP) correlated positively with right Ventricular Am,E/Em,Tei Index,Plasma CK-MB (p<0.001). and correlated negatively with right Ventricular Sm,Em,Em/Am (p<0.001) 6. Left ventricular E/A correlated positively with M-Em/Am.and right Ventricular E/A correlated positively with Em/Am. (p< 0.001). right Ventricular Em/Am correlated positively with Left ventricular Em/Am.M-Em correlated positively with M-Em/Am (p<0.001).7. The AUC for Plasma CK-MB concentration to detect diastolic dysfunction in patients with AOPP was 0.849.Conclusions:1.Tere are diastolic dysfunction in patients with acute severe organophosphate poisoni;2.Systolic function is impaired in acute severe organophosphate poisoni subjects with normal ejection fraction.3.TDI provid effective methods to quantitatively assess the cardiac function in patients with AOPP.4.Left and right ventricular Tei indexes in patients with sever AOPP are bigger than them in normal and mild and moderate AOPP;5.Plasma CK-MB concentration can be used to detect diastolic dysfunction in patients with severe AOPP.