Evaluation Of Left Ventricular Systolic Function And Left Ventricular Contraction Synchrony In Patients With Left Ventricular Noncompaction By Two-dimensional Speckle Tracking Imaging

Part 1 The preliminary study of quantitative evaluating left ventricular systolic function by speckle tracking technique detecting in patients with left ventricular noncompactionThis study sought to evaluate the clinic value of left ventricular systolic function by automated motion tracking of mitral annular displacement in patients with left ventricular noncompaction(LVNC). Forty-three patients with LVNC and thirty-nine healthy subjects were enrolled in this study. Left ventricular end-diastolic dimension (LVDd) measured with two-dimensional echocardiography, left ventricular end-systolic volume (ESV), left ventricular end-diastolic volume (EDV) and left ventricular ejection fraction (LVEF) were measured by biplane Simpson's method with two-dimensional echocardiography. The maximal displacement of the four points of mitral annulus (MAD), the displacement of midpoints of mitral annulus and percentages (MADmid,MADmid%)were measured with tissue motion tracking of mitral annular displacement (TMAD). Compared these targets with healthy subjects, and analyzed the correlation between LVEF and the TMAD parameter. Results①Compared with healthy subjects, LVEF decreased significantly in patients with LVNC (P<0.01), the EDV, ESV and LVDd increased significantly in patients with LVNC (P<0.01).②Compared with healthy subjects, the four points and midpoints MAD, percentages decreased significantly in patients with LVNC (P<0.01).③There was significant correlation between LVEF and the four points MAD and MADmid, MADmid% in patients with LVNC (P<0.01). And the ratio of midpoints of mitral annulus displacement correlated best with LVEF among all the date of MAD(r=0.753,0.794).Part 2 Speckle tracking technique detecting left ventricular asynchrony in patients with left ventricular noncompactionTo evaluate the occurrence of left ventricular systolic asynchrony in patients with left ventricular noncompaction (LVNC). Forty-eight patients with LVNC, including left ventricular ejection fraction (LVEF)≥50% 14 cases and LVEF <50% 34 cases, thirty healthy subjects were enrolled in this study. Left ventricular segments in accordance with the 18-segment model, by using two-dimensional speckle tracking imaging to obtain each segment time to peak myocardial systolic longitudinal strain (Tsl), time to peak systolic radial strain (Tsr) and time to peak circumferential strain (Tsc). Then calculated the standard deviation of Tsl , Tsr , Tsc (Tsl-SD, Tsr-SD, Tsc-SD), and any two the largest segment of the peak time difference (Tsl-diff, Tsr-diff, Tsc-diff). Results①Among three groups, the values of Tsr-diff, Tsc-diff and Tsr-SD, Tsc-SD were significantly increased in the left ventricular systolic dysfunction group with LVNC those in the normal group with LVNC and control group (P<0.01). Compared with control group, the values of Tsl-SD and Tsl-diff significantly increased in the left ventricular systolic dysfunction group than those in the control group (P<0.01). Compared with control group, the values of Tsl-SD and Tsl-diff significantly increased in the normal left ventricular systolic function group with LVNC than those in the control group (P<0.05), but the values of Tsr-diff, Tsc-diff, Tsr-SD, Tsc-SD were no statistical difference significance between the two groups(P>0.05).②Compared with the uninvolved left ventricular myocardial segments, the values of Tsl were significantiy higher in the affected segments with LVNC (P< 0.05).Conclude①There was good correlation between left ventricular systolic function with TMAD and two-dimensional echocardiography. TMAD was a new technology to evaluate left ventricular systolic function with LVNC exactly and objectively.②The longitudinal, radial and circumferential contraction dyssynchrony of the left ventricular was commonly existed in patients with LVNC with left systolic dysfunction, and the longitudinal contraction dyssynchrony was existed in patients with LVNC with normal LVEF.③The longitudinal contraction dyssynchrony was existed in the non-compaction myocardial segments and densification myocardial segments of left ventricular in patients with LVNC.