Assessment Of Left Ventricular Systolic Function In Early Stage Of HCM By Two-dimensional And Three-dimensional Speckle Tracking Imaging

Objective: To explore the left ventricular longitudinal contractibility in early stage in patients with hypertrophic cardiomyopathy by 2D-STI.Methods: Forty patients with HCM were selected,including 22 patients with non-obstructive hypertrophic myocardium(NHCM),18 patients with obstructive hypertrophic cardiomyopathy(OHCM),In addition,thirty cases of healthy physical examination volunteers were selected as normal control group(NOR).The LV global longitudinal strain(GLS),the global longitudinal strain rate(GLSR),and the regional longitudinal strain(LS)among the three groups were respectively measured by off-line QLAB 9.0 software,then we compared the differences among the three groups.At last separately explore the correlation between left ventricular ejection fraction(LVEF),Interventricular septal end-diastolic dimension(IVSD),Left ventricular outflow tract pressure gradient(LVOT-PG),Left ventricular mass index(LVMI)with GLS.Results: Compared with the NOR group,the levels of IVSD,LVPW,LVOT-PG and LVMI in two HCM groups were significantly higher(P <0.05).Compared with NHCM group,the levels of LVOT-PG and LVMI in OHCM group were significantly increased(P <0.05).2.Compared with the NOR group,the levels of the segment LS in two HCM groups were significantly decreased(P <0.05).Compared with the NHCM group,the levels of LS in Interventricular septum of the OHCM group were significantly decreased(P <0.05).3.Compared with the NOR group,the GLS and GLSR of the two HCM groups were significantly decreased(P <0.001).4.There was no correlation between GLS and LVEF(P> 0.05),and positively correlated with IVSD,LVOT-PG and LVMI(P<0.05).Conclusions: 1.The LS of 16 segment in Left ventricular can effectively reflect the LV regional systolic function with HCM patients at the early stage.2.GLS and GLSR of LV can accurately evaluate the changes of left ventricular systolic function in early stage with HCM patients,and there were negative correlation between absolute value of GLS and IVSD,LVOT-PG and LVMI of LV,.2D-STI which can provide important reference information for early diagnosis and prevention.Objective: To explore the left ventricular systolic function in early stage in patients with hypertrophic cardiomyopathy by 3D-STI.Methods: Forty patients with HCM were selected,including 22 patients with non-obstructive hypertrophic myocardium(NHCM),18 patients with obstructive hypertrophic cardiomyopathy(OHCM),In addition,thirty cases of healthy physical examination volunteers were selected as normal control group(NOR).The LV regional longitudinal strain(LS),regional radial strain(RS),regional circumference strain(CS),global longitudinal strain(LS),global radial strain(RS),global circumference strain(CS)were measured by 3D-STI,the differences among three groups were compared.To explore the correlation between left ventricular ejection fraction(LVEF),Interventricular septal end-diastolic dimension(IVSD),Left ventricular outflow tract pressure gradient(LVOT-PG),Left ventricular mass index(LVMI)with GLS,GRS and GCS.Results: Compared with the NOR group,the levels of IVSD,LVPW,LVOT-PG and LVMI in the two HCM groups were significantly higher(P <0.05).Compared with NHCM group,the levels of LVOT-PG and LVMI in OHCM group were significantly increased(P <0.05).2.Compared with the NOR group,the levels of the segment LS in the two HCM groups were significantly decreased(P <0.05).Compared with the NHCM group,the levels of LS in IVS of the OHCM group were significantly decreased(P <0.05).Compared with the NOR group,the RS of the basal IVS and apex IVS in the two HCM groups were significantly decreased(P <0.05).3.Compared with the NOR group,the CS of the basal IVS in the two HCM groups were significantly decreased(P <0.05),the basal LVLW was significantly increased(P <0.05).Compared with the NOR group,the GLS and GRS of the two HCM groups were significantly decreased(P <0.05).Compared with the NHCM group,the decrease trend of GLS and GRS in the OHCM group was more obvious,but the difference was not statistically significant(P >0.05).Compared with the NOR group,the increase trend of GCS in the two HCM groups was more obvious(P >0.05).4.There was no correlation between the absolute value of GLS and LVEF(P> 0.05),but there was positively correlation between absolute value of GRS,absolute value of GCS and LVEF(P <0.05).There was negative correlation between absolute value of GLS and IVSD,LVOT-PG,LVMI(P <0.05).There was negative correlation between absolute value of GRS and IVSD,LVMI(P <0.05).5.There was no significant difference in the GLS of the 3D-NHCM group compared with the 2D-HNCM group(P> 0.05).Compared with the 2D-OHCM group,the GLS of the 3D-OHCM group was significantly decreased,The difference was statistically significant(P <0.05).Conclusions: 1.The LS of 16 segment in Left ventricular can accurately evaluate the LV regional systolic function patients with HCM at the early stage.GLS and GLSR of LV can accurately and sensitively reflect the changes of left ventricular systolic function in early stage in patients with HCM.2.There was negative correlation between absolute value of GLS and IVSD,LVOT-PG,LVMI;There was negative correlation between absolute value of GRS and IVSD,LVMI.3.Compared with 2D-STI,3D-STI can be more sensitive and effective in assessing the left ventricular systolic function of HCM patients in the early stage,and provids important reference value for clinical early diagnosis and early intervention.