| BackgroundIt is estimated that there are 290 million patients of cardiovascular disease in China.Heart failure(HF)is the terminal stage of various cardiovascular diseases which the cardiac output cannot meet the metabolic needs of organs and tissues,and HF is a complex group of clinical syndromes.According to left ventricular ejection fraction(LVEF),heart failure can be divided into heart failure with reduced ejection fraction(HFrEF)and heart failure with preserved ejection fraction(HFpEF).HFpEF patients accounts for about 50%of all heart failure patients.With progressing of the aging population,HFpEF is increasing rapidly now.Patients with HFpEF have poor quality of life,frequent hospitalization,and high mortality.However,the pathogenesis,diagnostic criteria,and the early symptoms and signs of HFpEF in the elderly are insidious.There is no effective means of early diagnosis,as well as effective treatment.Echocardiography is the most commonly examination method in cardiac diseases.However,the left ventricular fraction(LVEF)in HFpEF patients is normal,so it cannot reflect the early changes of the patient’s heart.Recently,speckle tracking echocardiography,as a new technique,can better reflect the myocardial motor function.Especially,left ventricular longitudinal peak systolic strain(GLS)and peak strain dispersion(PSD),play a great role in the evaluation of myocardial systolic function.ObjectiveUsing non-invasive and convenient echocardiographic spot-tracking technique to evaluate the left ventricular myocardial function characteristics of HFpEF patients.To explore their contractility and further potential pathogenesis,so as to provide a potential means for the diagnosis of HFpEF.Methods42 cases with heart failure were enrolled in the Department of Cardiology of Zhengzhou University People’s Hospital between September 2018 and September 2019,and 42cases were divided into two groups:21 patients with HFpEF,21 patients with heart failure with reduced ejection fraction(HFrEF)and 20 patients with reduced left ventricular diastolic function,with similar age and risk factors,were selected as the control group.The clinical data:age,gender,body mass index,mean 24-hour systolic blood pressure,mean 24-hour diastolic blood pressure,mean 24-hour heart rate,N-terminal pro-B-type natriuretic peptide(NT-proBNP),etc.,and the left ventricular fraction(LVEF),left atrium diameter(LAD),end diastolic volume(EDV),E/A value,E/e’value,left ventricular longitudinal peak strain(GLS)and peak strain dispersion(PSD)were measured by speckle tracking technique.Then,All the data of the above three groups are statistically analyzed and compared pairwise.Results(1)Comparison in pairs between the three groups have shown that there was significant difference in NT-proBNP and E/e’(P<0.05).Compared with the control group and HFpEF group,the LVEF was significantly reduced and the E/A was significantly higher in the HFrEF group,and they were significant difference(P<0.05).(2)The comparison in pairs of both GLS and PSD in the three group were significant difference(P<0.05).Both the value of GLS and PSD,control group<HFpEF<HFrEF.In particular,in the control group,GLS was-20.0±2.8%((?)±s),PSD was 34.5±12.3ms;in the HFpEF group,GLS was-15.0±2.2%,PSD was 56.1±16.8 ms;in the HFrEF group,GLS was-11.1±3.2%,PSD was 72.8±17.7ms.(3)Pearson correlation analysis in the HFpEF group showed that both GLS and PSD were linearly correlated with N-terminal pro-brain natriuretic peptide(NT-proBNP),GLS was positively correlated with NT-proBNP,r=0.634,P<0.05;PSD was positively correlated with NT-proBNP,r=0.556,P<0.05.Conclusions1.Patients with HFpEF have impaired left ventricular longitudinal systolic function and diastolic function;2.Patients with HFpEF have decreased left ventricular systolic coordination and synchronization;3.The severity of HFpEF disease is correlated with left ventricular longitudinal systolic and systolic synchronization,and the worse the left ventricular longitudinal systolic function and systolic synchrony,the more severe the disease progression;4.Speckle echocardiography is a novel imaging that can be applied to assess left ventricular systolic function in patients with HFpEF,and GLS and PSD are used as important parameters to evaluate left ventricular systolic function in HFpEF.STE can provide a basis for early diagnosis and assessment of disease progression in patients with HFpEF. |
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