Analysis Of Ultrasonic Parameters Of Left Ventricular Diastolic Function In 2146 Cases

Objective:To study the intrinsic relationship between the parameters of left ventricular diastolic function and the isotropy between parameters,and to find the best parameter combination to comprehensively evaluate left ventricular diastolic function.Methods:We retrospectively analyzed the data of 2146 general patients with complete clinical data and echocardiography at the echocardiography laboratory of Union Hospital Affiliated to Fujian Medical University from January to December 2016.During this period,2146 general patients were divided by age.There were three groups:119 in group A（20-40 years old）,538 in group B（41-60 years old）,and 1489 in group C（≥60 years old）.Based on the specific purpose of this study,statistical analysis of three groups of echocardiographic measurements and clinical parameters:two-dimensional echocardiography:left ventricular end-diastolic diameter（LVEDD）,left ventricular end-systolic diameter（LVESD）,right ventricular end diastolic diameter（RVEDD）,left anterior（LA）,interventricular septum（IVS）,and Posterior wall thickness（PWT）;pulsed wave Doppler imaging:early mitral cusp tip diastole（E wave,left ventricular relaxation）,Late diastolic（A wave,left atrial contraction）peak velocity,calculated E/A ratio;Tissue Doppler imaging:Early Diastolic Myocardial Peak Velocity（E’Wave）in the Mitral Annulus,calculated E/E’ratio;continuous wave Doppler imaging:tricuspid regurgitation flow velocity(V_TR),pulmonary artery systolic pressure（PASP）=Right ventricular systolic pressure=tricuspid valve transvalvular pressure+right atrial mean pressure=4V²_TR（tricuspid regurgitation flow rate squared）+right atrial average pressure.Clinical parameters:age,sex,height,weight,body surface area（BSA）.Left ventricular mass（LVM）=0.8 x 1.04 x[（IVS+LVEDD+PWT）-LVEDD]+0.6 g.The selected clinical parameters were divided into measurement data and count data,and one-way ANOVA and Chi-square test or rank sum test were performed one by one.The parameters obtained by conventional standard echocardiography were compared between groups to evaluate the differences in the parameters of the three groups;the Pearson correlation coefficient was used to detect the intrinsic correlation between the left ventricular diastolic function parameters;Meta-Logistic regression analysis was used to examine the effects of multiple parameters on left ventricular diastolic function.Results:With age,left atrium size,E/E’ratio gradually increased,E,E/A ratio,mitral annular space E’gradually decreased,the difference was statistically significant（p<0.05）;The proportion of LVDDI and LVDDII patients gradually increased,and the proportion of normal diastolic function and LVDD III patients gradually decreased,and the difference was statistically significant（p<0.05）.There was a very low-to-low correlation between PASP and mitral annular space E’and E/E’ratio;there was a moderate-to-high correlation between LAAP and LVM,and a moderate correlation between LAAP and mitral annular space E’,and the difference was statistically significant.（p<0.05）.The LV diastolic function was related to the patient’s age,gender,left ventricular mass,and pulmonary artery systolic pressure.The difference was statistically significant（p<0.05）.Conclusions:Left ventricular diastolic function is related to left atrium size,left ventricular mass,mitral annulus E’,and pulmonary artery systolic pressure.Because of the age-dependent diastolic function of the left ventricle,diastolic function assessment is performed by selecting different key parameters at different ages.When there are inconsistencies between traditional parameters for evaluating left ventricular diastolic function（E,mitral annulus E’,E/A ratio,E/E’ratio,LV mass,LA volume,etc.）,the above parameters and age,pulmonary artery systolic pressure can better evaluate left ventricular diastolic function.