Evaluation Of Left Ventricular Function In Alcohol-induced Myocardial Damage During The Subclinical Stage By New Techniques Of Ultrasound

Objective: By quantitative tissue velocity imaging(QTVI)and two- dimensional strain imaging(2DSI)evaluation of alcohol-induced myocardial damage in left ventricular function,especially abnormal left ventricular function of subclinical stage alcohol-induced myocardial damage.Methods: Eighty-six chronic alcohol abusers were divided into 3 groups:group B(n=31):consumed≥90 g ethanol or 2 to 3 bottles(1100～1650 ml)beer daily for 5 to 8 years, 3 to 5 days per week; group C(n= 34):consumed≥90 g ethanol or 2 to 3 bottles(1100～1650 ml)beer daily for 9 to 20 years,3 to 5 days per week;group D(n=21): consumed≥150 g ethanol or≥4 bottles(≥2200 ml)beer daily for more than 10 years, 6 to 7 days per week, consistent with diagnostic criteria of alcoholic cardiomyopathy. Group A(n= 40):the control group.The parameters of the conventional echocardiographic, 2DSI and QTVI were respectively measured.These parameters were as follows:(1)the conventional echocardiographic parameters,including:left ventricular end diastolic diameter(LVDd),left ventricular end systolic diameter (LVDs),interventricular septum thickness diastolic(IVSTd),left ventricular pesterior thickness diastolic(PWTd),left ventricular ejection fraction (LVEF),E velocity(E),A velocity(A) and E/A.(2)QTVI parameters, including:systolic peak velocity(Vs),early diastolilc peak velocity(Ve),atrial contraction(Va),Ve/Va.(3)Tei index parameters,including:the isovolumic relaxation time(IRT),the isovolumic contraction time(ICT)and ejection time(ET)of LV were obtained using QTVI,and examed Tei index.(4)2DSI parameters,including:①The longitudinal two-dimensional peak systolic strain and radial two-dimensional peak systolic strain of left ventricular short-axis.②Circumferential two-dimensional peak systolic strain of left ventricular short-axis.③The left ventricular short-axis views at the levels of mitral annulus and apex peak systolic rotation two-dimensional strain of left ventricular short-axis,and the peaks systolic torsion of left ventricular.Results:1. Conventional echocardiography The conventional echocardiographic parameters showed no significant difference between groups A and B(P>0.05).The conventional echocardiographic parameters showed no significant difference between groups C,A and B(P>0.05), but E/A showed significant difference between groups A and B (P<0.01). The conventional echocardiographic parameters showed signifycant difference between group D and groups A,B,C (P<0.01).2. QTVIQTVI parameters showed no significantly difference between groups B and A(P>0.05).No significant change of parameters Vs were found between groups C and A,C and B(P>0.05),Va in group C enlarged diginficantly compared with those in groups A and B(P<0.01),Ve,Ve/Va in group C enlarged significantly compared with those in groups A and B(P<0.01).Va in group D reduced significantly compared with those in groups A and B(P<0.05),Vs,Ve and Ve/Va in group D reduced significantly compared with those in groups A and B(P<0.01).Vs,Va in group D reduced significan- tly compared with those in group C(P<0.01),Ve in group C enlarged significantly compared with those in group D(P<0.05).but Ve/Va showed no change significantly (P>0.05).3. Tei indexNo statistical difference was found in groups B and A(P>0.05).Tei index showed significant difference between groups B and C(P<0.05),groups A and C(P<0.05).Tei index showed significant difference between group D and groups A,B(P<0.01), groups D and C(P<0.05).4. 2DSI(1)Comparison of the longitudinal two-dimensional peak systolic strain and radial two-dimensional peak systolic strain of left ventricular short-axis:Comparison between groups B and A has no significantly difference (all P>0.05).Compared with groups A and B,parameters in all section of group C lowered down remarkably (all P<0.05). Comparison between groups D and C has significantly difference (all P<0.05). Compared with groups A and B, parameters in all section of group D lowered down remarkably (all P<0.01). (2)Comparison of the circumferential two-dimensional peak systolic strain of left ventricular short-axis:Comparison between groups B and A has no significantly difference (P>0.05).Compared with groups A and B,parameters in all section of group C lowered down remarkably (P<0.05).Compared with groups A and B,parameters in all section of group D lowered down remarkably (P<0.01).Comparison between groups D and C has significantly difference (P<0.05).(3)Comparison of the left ventricular short-axis views at the levels of mitral annulus and apex peak systolic rotation two-dimensional strain of left ventricular short-axis,and the peaks systolic torsion of left ventricular: Comparison between groups B and A has no significantly difference(all P>0.05).Comparison between groups C and A,B has no significantly difference(all P>0.05).Compared with groups A,B and C,parameters in all section of group D lowered down remarkably(all P<0.01).Conclusions:1. Conventional echocardiography can evaluate alcohol-induced myocardial damage during the clinical stage,but it was not able to assess alcohol-induced myocardial damage during the subclinical stage.2. QTVI can effectively assess the left ventricular function of alcohol-induced myocardial damage during the subclinical stage.3. Tei index by QTVI is valuable in assessing the left ventricular function of alcohol-induced myocardial damage during the subclinical stage.4. 2DSI can effectively assess the change of left ventricular systolic function of alcohol-induced myocardial damage during the subclinical stage, especially during the subclinical stage.5. 2DSI can effectively assess the change of left ventricular peak systolic rotation and torsion of alcohol-induced myocardial damage.