| Background and Objective:Quantitative estimation of cardiac function has been a hot topic in the field of clinical cardiology.A number of techniques can evaluate cardiac function. Echocardiography is now recognized as a main non-invasive method of clinical evaluation of cardiac function.Strain rate imaging(SRI) technology is a new method to evaluate regional myocardial function evolved from Doppler imaging(TDI).In this study,strain(S) and strain rate(SR) technology is used to analyse ventricular longitudinal myocardium deformability in patients with right ventricular tention or valume overload.Aim at: 1)To investigate the features of ventricular longitudinal myocardium deformability in patients with exsessive preload or afterload in right ventricular.2)To investigate the effect on regional myocardial function caused by rjght ventricular tention or valume overload.3)To search parameters of strain and strain rate for judging right ventricular load swing.Methods:Philips iE33 equipped S5-I probe was used to detect 60 patients in 3 groups. Group 1:20 patients with right ventricular pressure overload;Group 2:20 patients with right ventricular volume overload;Group 3:control.All patients were examined in the left lateral position by two-dimensional and tissure doppler echocardography.A one-lead electrocardiogram was recorded continuously.The standard apical four-chamber view were acquired by two-dimensional and then switched to tissue Doppler mode,recording 3-5 cycles.Sample volume were placed over three points(basal,middle,and apical) of The left ventricular free wall,right ventricular free wall and interventricular septum.The peak strain in systole(Ss),the peak strain rate in systole(SRs),early diostolic strain rate(SRe),and late diostolic strain rate(SRa) were measured.The parameters measured in patients with right ventricular overload were compared with those of control.All statistical analyses were performed by SPSS 15.0 for Windows.The results were expressed as mean±standard deviation,inter-group comparison was tested by t-test.Compared with the control group,the parameters with significant differences were tested through work characteristic curve(ROC curve) to determine its diagnostic value sector,the correlative results were tested by correlation analysis(P＜0.05:significant ).Results:(1) Most of the strain(S) parameters in patients with right ventricular tention overload were significantly lower than those of controls(P＜0.05),and the basel segment of left ventricular,middle segment of right ventricular is the most significant.Most of the strain(S) parameters in patients with right ventricular volume overload were significantly larger than those of controls(P＜0.05),and the basel segment of left ventricular and right ventricular were the most significant.(2) About half of the strain rate(SR) parameters in patients with right ventricular tention overload were significantly lower than those of controls(P＜0.05),and the basel segment of left ventricular,middle segment of right ventricular is the most significant. Half of the strain rate(SR)parameters in patients with right ventricular volume overload were significantly larger than those of controls(P＜0.05),and the basel segment and middle segment of right ventricular were the most significant.(3) The absolute value of Ss and SRs in middle segment of RV in patients with RHD were negative correlated with LA diameter,the coefficient were -0.886,-0.879, -0.638(P＜0.01 ).The absolute value of Ss and SRs in basel segment of RV in patients with ASD were positive correlated with RV diameter,the coefficient were 0.697,0.822, (p＜0.05).(4) As Ss in middle segments of RV was represented to judge the right ventricular tention overload,the sensitivity,specificity and accuracy were 75%,85%,80%,when Ss was -11%.As SRs in middle segments of RV was represented to judge the right ventricular tention overload,the sensitivity,specificity and accuracy were 70%,85%, 77.5%,when SRs was -0.8(1/s).As Ss in basel segments of RV was represented to judge the right ventricular valume overload,the sensitivity,specificity and accuracy were 70%,85%,77.5%,when Ss was -14%.As SRs in basel segments of RV was represented to judge the right ventricular volume overload,the sensitivity,specificity and accuracy were 85%,50%,67.5%,when SRs was -1.4(1/s).Conclutions:This study shows that:(1)The features of ventricular longitudinal myocardium deformability in normal adult was:strain of basel segment was larger than middle than apicel in left ventricular(p＜0.05),strain rate of basel segment is the largest of LV.Strain of middle segment is the largest of right ventricular,but strain rate of RV were not significently different.(2) Most of the strain(S) parameters in patients with right ventricular tention overload were significantly lower than those of controls(P＜0.05),and the basel segment of left ventricular,middle segment of right ventricular is the most significant.Most of the strain(S) parameters in patients with right ventricular volume overload were significantly larger than those of controls(P＜0.05),and the basel segment of left ventricular and right ventricular were the most significant.(3) About half of the strain rate(SR) parameters in patients with right ventricular tention overload were significantly lower than those of controls(P＜0.05),and the basel segment of left ventricular,middle segment of right ventricular is the most significant. Half of the strain rate(SR)parameters in patients with right ventricular volume overload were significantly larger than those of controls(P＜0.05),and the basel segment and middle segment of right ventricular were the most significant.(4) The absolute value of Ss and SRs in middle segment of RV in patients with RHD were negative correlated with LA diameter,the coefficient were -0.886,-0.879, -0.638(P＜0.01).The absolute value of Ss and SRs in basel segment of RV in patients with ASD were positive correlated with RV diameter,the coefficient were 0.697,0.822, (p＜0.05).(5) As Ss in middle segments of RV was represented to judge the right ventricular tention overload,the sensitivity,specificity and accuracy were 75%,85%,80%,when Ss was -11%.As SRs in middle segments of RV was represented to judge the right ventricular tention overload,the sensitivity,specificity and accuracy were 70%,85%, 77.5%,when SRs was -0.8(1/s).As Ss in basel segments of RV was represented to judge the right ventricular valume overload,the sensitivity,specificity and accuracy were 70%,85%,77.5%,when Ss was -14%.As SRs in basel segments of RV was represented to judge the right ventricular volume overload,the sensitivity,specificity and accuracy were 85%,50%,67.5%,when SRs was -1.4(1/s).
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