Evaluation Of Regional Myocardial Function Of Left Ventricular In Patients With Constrictive Pericarditis By Two-dimensional Speckle-tracking Imaging

BACKGROUND Constrictive pericarditis(CP) is a pericardial chronic inflammation pathological process,which is defined as impedance to diastolic filling by a fibrotic pericardium.CP is not commom in the modern time .At present,Tuberculosis is still the common pathogenesis of CP in our country,meanwhile,cardiac surgery and mediastinal irradiation which are as well major and increasing causes of CP in the developed world.In CP, the pericardium is scarred and inelastic and total cardiac volume cannot change.The long-term outcome of CP is that the myocardium will be damaged ,and occur atrophy.All of these changes will probably impair the regional myocardial properties in the end.The newly developed two dimensional speckle tracking imaging (2D-STI) technique analyzes motion by tracking natural acoustic reflections and interference patterns within an ultrasonic window.The image-processing algorithm tracks user-defined regions of interest which are comprised of blocks of approximately 20 to 40 pixels containing stable patterns that are described as "speckles". STI has presented us with the possibility of enhancing the accuracy of displacement estimation, which was successfully applied to the measurement of myocardial deformation . Specifically, measurement of the myocardial strain and strain rate can evaluate the quantitative indexes of local myocardial function. Therefore, we undertook this study to observe the left ventricular segmental peak systolic strain and peak diastolic strain rate(SRe) by two-dimensional speckle tracking imaging, and to evaluate regional myocardial function of left ventricular in Patients with constrictive pericarditis(CP).This thesis is composed of two parts:Part 1 Evaluation of regional myocardial Systolic Function of left Ventricular in Patients with Constrictive Pericarditis by Two-dimensional Speckle-tracking ImagingThe objective of this part is to evaluate left ventricular strain in Patients with constrictive pericarditis(CP) by Two-dimensional Speckle-tracking Imaging(STI) . 26 patients with CP and 37 normal control subjects were enrolled in this study. The peak systolic longitudinal strain of the left ventricle wall was measured using 2Dstrain software. Results The strain of the left ventricle free wall in patients with CP was significantly decreased, compared with those in the control group (P<0.05).No significant difference in the strain of the septum was found between the control group and CP group.Part2 Evaluation of regional myocardial Diastolic Function of left Ventricular in Patients with Constrictive Pericarditis by Two-dimensional Speckle-tracking ImagingThe objective of this part is to evaluate left ventricular strain rate in Patients with constrictive pericarditis(CP) by Two-dimensional Speckle-tracking Imaging(STI) . The peak diastolic SRe of the left ventricle wall was measured using 2D-strain software.Results The peak diastolic SRe of the left ventricle free wall in patients with CP was significantly decreased, compared with those in the control group (P<0.01).No significant difference in the SRe of the septum was found between the control group and CP group.ConclusionsThe strain of the left ventricle free wall has decreased in patients with CP, which means the regional myocardial systolic properties of left ventricular are impaired in CP patients.The peak diastolic longitudinal strain rate in the left ventricle free wall has decreased in patients with CP, which means the regional myocardial diastolic properties of left ventricular are impaired in CP patients.