Evaluation Of Left Ventricular Strain And Synchronism Of Left Ventricle In Patients With Liver Cirrhosis Of Different Levels By Two-dimensional Speckle Tracking Imaging Technology

Objective:To evaluate the myocardial strain and synchrony of left ventricular segments in patients with different degrees of cirrhosis by two-dimensional speckle tracking（2 D-STI）technique.Methods:two-dimensional speckle tracking technique（2 D-STI）was used to analyze the myocardial strain and synchronism of left ventricle in patients with different liver function grade cirrhosis and normal healthy control group.From December 2019 to December 2020,80 patients with liver cirrhosis diagnosed in our hospital’s infectious liver disease ward and the second digestive department ward were selected as experimental groups,Grading by Child-Pugh,Divided into A groups of 30 people,Group B 26,C grade group 24 people.In addition,25 healthy volunteers were selected as the control group.Conventional three-dimensional echocardiography and two-dimensional speckle tracking imaging were performed in the experimental group and the control group（2 D-STI）,segments of the left ventricle,The peak longitudinal strain（SLS）,circumferential strain（SCS）and radial strain（SRS）and the peak time(SLS-T_max,SRS-T_max))of longitudinal and radial systolic strain were measured,and the longitudinal and radial peak strain dispersion（L-PSD and R-PSD）of the left ventricular myocardium to evaluate the effects of different degrees of cirrhosis on left ventricular myocardial strain and synchrony in different segments.Results:1.Compared with the control group,enlargement of the left atrium（LAD）and thickening of the wall of the ventricle,E peak deceleration time（EDT）extended,The ratio of E peak to A peak decreased（P<0.05）;There was no significant difference in LVEF between groups（P>0.05）.2.SLS、SCS、SRS results:compared with the control group,The left ventricular myocardial SLS、SRS、SCS in the A、B、C group decreased gradually,（P<0.05）,The difference was statistically significant,C group had the most significant reduction,B group followed.3.SLS-T_max、SRS-T_maxResults:Left ventricular SLS-T_maxand SRS-T_maxin A、B、C group compared with control group successively Reduce,peak ahead.Synchronization was inconsistent,P<0.05,C group was significant,followed by B group.4.L-PSD and R-PSD results:compared with the control group,the L-PSD and R-PSD of longitudinal and radial peak strain dispersion of left ventricular myocardium in A、B、C group increased,P<0.05,and C group was significant,followed by B group.Conclusion:The higher the Child-Pugh grade score,the more the myocardial segments with reduced strain,the more the myocardial segments with early peak reach and asynchronous contraction,and the greater the peak strain dispersion（PSD）degree.Peak strain（SLS、SRS、SCS）,peak time(SLS-T_maxand SRS-T_max)and peak strain dispersion（PSD）of left ventricular myocardial SLS/SRS can be used as monitoring indexes to evaluate left ventricular systolic function changes in patients with cirrhosis.