Evaluation Of Myocardial Function Of Left Ventricular In Primary Hypertension Patients By Omni-directional M-mode Echocardiograph And Wave Intensity Technique

Objective:1.To evaluate the myocardial motion and function of left ventricular short-axis inprimary hypertension patients by Omni-directional M-mode Echocardiograph (OME)with different function parameters.2.To analyse the movement function of left ventricular in hypertension patients bywave intensity technique (WI). To explore the application of assessing myocardialmotion and function between Omni-directional M-mode echocardiography and waveintensity technique.Methods:Object:30normal subjects (group A);70primary hypertension patients were enrolled inthe study,19with normal septal (group B) and21with hypertrophy septal (group C).Equipment: Using LEJ-2omni-directional M-mode echocardiography which was developed byBiomedical Engineering Institute of Fuzhou University in China, GE Vivid Seven Demisionultrasound system with Echo PAC work station and ALOKAα10ultrasonic diagnosis systemwith WI analysis software. Measurement:1. LV functions were analyzed with conventionalechocardiography and LEJ-2OME. Besides the routine parameters (LV,,EDV,EF,Vp,Ea,Aa,etc.),papillary level of left ventricle short-axis six segmental peak systolic and diastolic endocardialmotion velocity (Vepi), acceleration (Aendo), relative force (F). Mean value of three cardiaccycle were recorded of each parameter.Then compared the indicators in differentsubgroups.2. Assess WI indices including transient acceleration wave intensity (W1), transientdeceleration wave intensity (W2), negative area of transient wave intensity (NA). Then compareall WI indices among the groups.3. Investigated the relationship between the WI indices andOME parameters, to explore the application of assessing myocardial motion and function inpatients with hypertension. Results:1. The diastolic endocardial motion velocity (Vepi) and acceleration (Aendo) in groupB and group C were lower than those in group A in the papilla muscle plane of LVshort-axis regions (P <0.05). The diastolic endocardial motion velocity in group Bwere higher than group C on inferior, posterior, anterior septum and posteriorseptum(P <0.05). The diastolic endocardial motion acceleration in group B werehigher than group C on six short-axis regions. The diastolic endocardial relative force(F) in group B were lower than group A on inferior, posterior, anterior septum andposterior septum(P <0.05), however,in group C those were lower than group A oninferior, anterior septum and posterior septum(P <0.05). The segmental diastolicendocardial motion acceleration correlated well with the propagation velocity of mitralflow (Vp)(r=0.484~0.614).2. The systolic endocardial motion velocity and acceleration between the three groupshad no statistical differences (p>0.05). The systolic endocardial relative force (F) ingroup B and group C were little higher than those in group A, but the differences hadno statistical significance(p>0.05) except anterior(p<0.05).The sum of six systolicendocardial relative forces in the papilla muscle plane of LV short-axis regions(sum-F)in group B and group C were significant higher than group A(p<0.05),and sum-F ingroup C was higher than group B (p<0.05).3. Compared with group A, the transient acceleration wave intensity (W1) andnegative area of transient wave intensity (NA) in group B and group C had significantincreased (P <0.01). W1in group C was higher than group B (p<0.05),but NA has nodifferences between group B and group C (p>0.05).While, the transient decelerationwave intensity (W2) in the three groups had no statistical differences (p>0.05).4. Analysed all the cases together, WI and sum-F had correlation（r=0.239，P<0.05）,but they lost the relation when analysed by there groups.Conclusion:1. OME had accuracy in evaluating the regional myocardial diastolic function of LVin hypertension patients, and acceleration could be more sensitive than velocity and relatively force.2. The sum of six systolic endocardial relative forces in the papilla muscle plane ofLV short-axis regions(sum-F) can reflect the integral myocardial systolic function ofhypertension patients, may become a new index to evaluate LV myocardial systolicfunction.3. As a novel hemodynamic index which could evaluating the integral behavior ofcardiovascular system, WI provides a potential exploration in conveniently andeffectively assessing the LV systolic function of hypertension patients.