Evaluate The Left Ventricular Systolic Function In Patients With Pregnancy-induced Hypertension By 3D Speckle Tracking Imaging And Study Left Ventricular Systolic Function Relationship With Ascending Aorta Elasticity

Objective The aim of this study is to evaluate left ventricular systolic function by 3D Speckle Tracking Imaging(3D-STI)in patients with hypertensive disorders of pregnancy(HDP)and measure the ascending aorta elasticity of HDP patients by M-mode echocardiography,and to analyze the correlation between the two.Methods Thirty-six patients with hypertension during pregnancy who were treated in inpatient department of Our hospital from June 2020 to December 2020 were collected as the case group,and 20 healthy pregnant women who came to our hospital during the same period were selected as the control group.And the clinical data required by all subjects were collected.Compare the differences of the general clinical data,biochemical routine,conventional two-dimensional ultrasound parameters,left ventricular three-dimensional global peak strain parameters(GLS,GCS,GRS)and ascending aortic elasticity indexes(Ep,AS%,ASI,ADIS)between the case group and the control group.Pearson’s correlation analysis method was used to analyze the relationship between the three-dimensional global peak strain parameters of the left ventricle and the elastic parameters of the ascending aorta in HDP patients.Results1.There were no significant difference in age and height between the case group and the control group(all P>0.05).Compared with the control group,the heart rate,gestational age,weight,BMI,systolic blood pressure,diastolic blood pressure,and pulse pressure of the patients in the case group all increased,and the differences were statistically significant(all P<0.05).2.There were no statistically significant differences in TC,ALT,AST,UA,UREA,CREA between the case group and the control group(all P>0.05).Compared with the control group,the TG,GGT,ALP of the case group all increased,and the ALB decreased,and the differences were statistically significant(all P<0.05).3.Between the case group and the control group,the differences of the LVEDD,LVEDS,LVEDV,LVESV,LVEF,LVFS,SV,CO,E were not statistically significant(all P>0.05).Compared with the control group,the left atrium anteroposterior diameter,IVSD,LVPWD,A,a were all increased in the case group at the end of systole,and the values of E/A,e/a,and e were all decreased,moreover,the e/a<1,and the differences were statistically significant Academic significance(all P<0.05).4.Compared with the control group,GLS,GRS,and GCS of the case group were all decreased,and SDI increased,and the differences were statistically significant(all P<0.05).5.In the case group and the control group,there were no statistically significant differences between the ASD and ADIS(all P>0.05).Compared with the control group,Ep and ASI in the case group were significantly higher,and AS was significantly lower,the differences were statistically significant(all P<0.05).6.According to the Correlation analysis between three dimensional global peak strain parameters of left ventricle and elastic parameters of ascending aorta,there were no significant correlations between GLS,GRS,GCS and AS,ASI,ADIS,Ep(all P>0.05),there were no significant correlations between SDI,ASI,ASI and ADIS(all P>0.05).There was a significant positive correlation between SDI and Ep(r=1.000,P<0.05).ASI were significantly negatively correlated with AS and ADIS(r=-0.554,-0.468,all P<0.05),and ASI was significantly positively correlated with AS(r=0.969,P<0.05).There were significant positive correlations between GRS and GLS and GCS(r=0.492,0.699,all P<0.05),and a significant positive correlation between GLS and GCS(r=0.396,P<0.05).Conclusion1.The three-dimensional global peak strain of the left ventricle in HDP patients is reduced,and the myocardial asynchrony index is increased.The application of 3D-STI can detect early changes in cardiac subclinical systolic function in HDP patients;2.The AS of the ascending aorta in HDP patients decreases,and the Ep and ASI increase.The application of M-mode echocardiography can detect the elastic changes of the ascending aorta in HDP patients early;3.There is a positive correlation between the increase of the SDI and the decrease of the ascending aorta elasticity in HDP patients,which is in line with the heart-vascular coupling theory.