Evaluation Of Global Left Ventricular Systolic Function In Type 2 Diabetic Nephropathy Patients By Tissue Velocity Imaging

Objective with the study in the field of ventricular walls motion deepely in recent years, people have realized that the ventricular walls motion in the longitudinal axis has the more important value in the evaluating the ventricular systolic and diastolic functions. Tissue velocity imaging(TVI) is a kind of ultrasonic imaging technique based on doppler principle, by which we can detect the myocardium moving with high amplitude of vibration and low speed, and evaluate the heart accurately in quantity and non-invasion of its whole and local systolic and diastolic function. It has been used more and more widely in the evaluation of heart function. TVI has the technology of Quantitial Tissue Velocity Imaging(QTVI) and Tissue Tracking(TT) and Strain Rate Imaging(SRI) and Myocardial Velocity Gradient(MVG) and so on .SRI and MVG have some shortages in the repeat and measurement. So we evaluated the global left ventricular systolic function in type 2 diabetic nephropathy(T2DN) patients in various stages by QTVI and TT. This purposes of the study were: 1. we studied the varial regulation of the mitral annular systolic peaking velocity(Vs) and peaking displacement(D) in the normal controls and patients ,assessing the early advantage of QTVI and TT comparing with the left ventricular ejection fraction(LVEF); 2. we studied the correlation between the mitral annular average systolic peaking velocity(AVs) and the average peaking displacement(AD) and the LVEF,assessing the AVs and AD were the new quantization indices in evaluating the grobal left ventricular systolic function independently.Materials and Metheds30 normal controls(NC) and 90 type 2 diabetes mellitus(T2DM) patients were included. On the basis of urinary albumin excretion rate(UAER), patients were classified into:no albuminuria(NAU) ,microalbuminuria (MAU)and clinic albuminuria(CAU) .We obtained the LVEF by Simpson's method . A total 120 subjects underwent QTVI and TT study. We obtained the mitral annular Vs,AVs and D, AD of the anteroseptal, lateral, anterior, inferior, posteroseptal and posterior walls.Results1. There was no statistically sidnificant difference of LVEF between MAU group and NC group, NAU group;There was statistically sidnificant difference between CAU group and other groups.2. The mitral annular Vs, AVs and D, AD in MAU group were lower than the NC group(P<0.05或P<0.01); The mitral annular Vs, AVs and D, AD in CAU group were lower than the others group(P<0.01).3. There was signigicant correlation between AVs and LVEF, also between VD and LVEF in T2DM patients.Conclusions1. the mitral annular Vs and D of lateral site were highest than other sites. There was no statistically sidnificant difference of LVEF between MAU group and NC group, But There was statistically sidnificant difference of the mitral annular Vs, AVs ,D, AD between MAU group and NC group. The QTVI and TT had the advantage of easy, early and sensitive performance in evaluating The global left ventricular systolic function in T2DN in early stage.2. There was signigicant correlation between AVs and LVEF, also between VD and LVEF in T2DM patients. So AVs and AD were the new quantization indices in evaluating the grobal left ventricular systolic function independently. It has a high clinical value.