Evaluation Of Regional Left Ventricular Function In Patients With Hypothyroidism By Speckle Tracking Imaging (STI)

Objective:By speckle tracking study of hypothyroidism in patients withearly left ventricular regional systolic and diastolic function, and to investigateits clinical value.Methods: Select to confirm the diagnosis in our hospital and39cases ofhypothyroidism in patients with thyroid function and age-matched normalcontrol group of30cases. By Philips the iE33color Doppler ultrasonicdiagnostic apparatus, the apparatus is equipped with the QLAB image analysissoftware. Subjects with left lateral position, quiet breathing, connect thesynchronous ECG. Conventional echocardiography: The standard leftventricular long axis view to measure end-diastolic interventricular septalthickness (IVSd), left ventricular posterior wall thickness (LVPWd), leftventricular ejection fraction (EF) and left ventricular fractional shortening (FS);apical four-chamber view,pulsed Doppler measurement of mitral diastolic flowpeak velocity of E wave, A peak. Strain rate Data Acquisition and Analysis: Inapical four chamber, apical two-chamber apical left ventricular long axis viewand mitral valve level, papillary muscle level, apical level of left ventricularshort axis view, clearly show the endocardium, instruct subjects withend-expiratory breath-hold acquisition rhythmconsistent two-dimensionalgray-scale dynamic Figure2-3cardiac cycles, stored in a CD-ROM for offlineanalysis. The QLAB speckle tracking image analysis software to analyze, Ineach section of the left ventricular long axis, the sampling points were placed ineach left ventricular wall mitral ring and left ventricular endocardial surface tostart TMQA function, the software automatically tracks the two-dimensionalimage of the left ventricular wall, the leftventricular anterior wall, lateral, posterior, inferior wall, anterior septum, after the interval is divided into thebasal segment of the middle segment, and apical segments, a total of18segments, and then start the compute button, the software automaticallycalculates the various segments of the left ventricular walllongitudinal systolic,diastolic early diastolic peak strain rate of late. And then analyze each slice leftventricular short axis, the regions of interest covering the entiretwo-dimensional image to start TMQA functions, the software to automaticallytrack the two-dimensional image of the left ventricular wall, respectively, theleft ventricular basal segments of the middle segment, apical segment is dividedinto wall, lateral, posterior, inferior wall, anterior septum, after the interval, atotal of18segments, start compute button to get the18segments of leftventricular circumferential and radial strain rate curve, and then record eachcurve ring and radial systolic, early diastolic, late diastolic peak strain rate.Results:1.conventional echocardiography measured values:hypothyroidism compared with the control group, EF, FS, end-diastolicinterventricular septum (IVSd), left ventricular end-diastolic wall thickness(LVPWd), mitral diastolic blood flow velocitypeak E peak, A peak, thedifference was not statistically significant (P>0.05).2strain rate parameterscompare:2.1Longitudinal strain rate parameters, the hypothyroid groupcompared with the normal group, most of the segments of the left ventricle,including the inferior, lateral, posterior wall of the basal segment, anterior,inferior, lateral, posterior, anterior septuminterval after the interval after themiddle section, anterior, inferior, lateral, posterior, anterior septum, apicalsegments of longitudinal peak systolic strain rate (SRs-l), the longitudinal peakearly diastolic strain rate (SRe and-l), longitudinal late diastolic strain rate (SRaof the-l) were significantly reduced, the difference was statistically significant(P <0.05);2.2Circumferential compared to the strain rate parameter,hypothyroidism group compared with the normal group, left ventricular inferior wall, lateral wall, posterior wall of the basal segment, anterior, inferior, lateral,posterior wall of the middle segment of the inferior wall, side wallring of theposterior wall of the apical segment, after the interval to the peak systolic strainrate (SRs-c) Circumferential peak early diastolic strain rate (SRe and-c) TheCircumferential peak late diastolic strain rate (SRa of-c) weresignificantlyreduce the difference was statistically significant (P <0.05);2.3radial strain rate parameters, the hypothyroid group compared with the normalgroup, left ventricular inferior wall, lateral wall, posterior wall of the basalsegment, anterior, inferior, lateral, posterior wall of the middle section, underthe wall, the sidewallinterval in the posterior wall, apical segment of the radialpeak systolic strain rate (SRs-r), radial early diastolic strain rate (SRe and-r),radial peak late diastolic strain rate (SRa of-r) were significantlyreduced, thedifference was statistically significant (P <0.05).Conclusions: Speckle tracking imaging technology to fully accuratehypothyroidism in patients with left ventricular regional systolic and diastolicfunction, quantitative assessment of the application of this technique for theanalysis of left ventricular segment wall myocardial strain rate, the objectivefor clinical assessmentprovide new evidence for early change of heart functionin patients with hypothyroidism, is a convenient, noninvasive, comprehensive,accurate regional myocardial systolic and diastolic function, andechocardiography is more sensitive than conventional ultrasound.