Myocardial Longitudinal Systolic Function Assessment Of Left Ventricle And Its Synchrony In Newly Diagnosed Hyperthyroidism Using Two-dimensional Ultrasonic Speckle Tracking Imaging

Objective: The myocardial longitudinal systolic function of left ventricle and its synchronism in newly diagnosed hyperthyroidism patients were evaluated using two dimensional ultrasound speckle tracing imaging to reveal the potential impairment of left ventricular systolic function in newly diagnosed hyperthyroidism patients.Methods : A total of 47 patients with hyperthyroidism were enrolled from Wenjiang District People’s Hospital of Chengdu,Sichuan Province from March 2018 to August 2018,who were diagnosed newly as hyperthyroidism at the department of endocrinology out-patient and the physical examination center from March 2018 to August 2018,including 8 males and 39 females,the average age was(40.1 ±12.4).Patients were employed as the hyperthyroidism group.The age and sex matched 39 healthy cases,including 8males and 28 females,with an average age of(38.7 ±12.5)were randomly selectedas control group at the same period..The dynamic standard views of apical four-chamber,apical three-chamber and apical two-chamber of the heart were acquired from the two groups,and the left ventricular ejection fraction(LVEF)was calculated with biplane Simpson’s method.Offline analysis of the standard views with a dedicated EchoPAC ultrasonic workstation was performed,the myocardial longitudinal peak systolic strain and time to peak of strain at 17 segments of left ventricular wall were derived in two-dimensional strain mode,and were compared for the differences between the two groups.Results: 1.LVEF: There was no statistically significant difference of LVEF measured by conventional ultrasonography between hyperthyroidism group and control group(p > 0.05).2.Parameters related to Two-Dimensional Ultrasonic Speckle tracing Imaging:(1)Longitudinal peak strain of left ventricular wall: the peak longitudinal strain values of apical anterior septal,middle and apical posterior septal segments in the hyperthyroidism group were lower than those in the control group(p < 0.05).There was no significant difference in the longitudinal strain values of the apical,middle and basal segments of the left ventricular anterior wall between hyperthyroidism group and control group(p > 0.05).(2)Time to peak of left ventricular wall strain: the longitudinal strain peak time of all segments of left ventricle in the hyperthyroidism group was earlier than that in the control group,except the longitudinal strain time to peak of anterior septal basal segment between hyperthyroidism group and the control group.There was significant difference of time to peak of left ventricular wall longitudinal strain of all the other segments between the hyperthyroidism group and the control group except the anterior septal basal segment(p < 0.05).Conclusion: Before the diagnosis of hyperthyroidism heart disease clinically,the left ventricular segmental myocardial mechanical systolic function might be damaged with desynchronism.