Assessment Of Left Ventricular Rotation And Twist With3-dimensionat Speckle Tracking Echocardiography In Patients With Essential Hypetrension

Essential hypertension (EH) is a common genetic tendency disease, heartis affected target organ directly. Patients with essential hypertension, leftventricurar (LV) pressure overload because of peripheral vascular resistanceincreasing, through a series of complex mechanism lead to structure and formto change, namely left ventricular remodeling, produces left ventricular systolicdysfunction. And is a very important independent cardiovascular risk factor. LVrotation and twist play a major role in cardiac systolic function，and is asensitive index in assessment of cardiac systolic function, offer moresubclinical systolic abnormalities informations. Currently,2-dimensionalspeckle tracking echocardiography(2DSTE)is most frequently used for theassessment of LV rotation and twist. because2DSTE can only track motionoccurring within the2D imaging plane, and motion in and out of the plane canonly detectef as features appearing and disappearing from the imaging plane.Because LV wall motion is complex3D patterns, so2DSTE affect the accuracyof tracking. The new development of3-dimensional speckle trackingechocardiography(3DSTE) tracking LV motion in real-time3D Echocardio-graphic dataset in one cardiac cycle, and reduce the shortcomings of2DSTE.Objective: To assess the clinical value and early change of left ventricularrotation and twist in EH patients with normal left ventricular ejectionfraction(LVEF) using3-dimension speckle tracking echocardiography (3DSTE).Aim to detect early changes of LV systolic function that begin before LVremodeling, decrease the incidence of congestive heart failure.Methods:30EH patients with left ventricular normal geometry (LVN)and30healthy control subjects were included.3-dimensional real-time fullvolume were attained from apical four chamber views using the PST-25SX probe (Toshiba Medical Systems, ARTIDA, equipped with the3D wall motiontracking software). Multiplanar reformation of the3D real-time full volumedatasets were displayed in5different cross-sections: apical4-chamber view,apical2-chamber view, and the3standard short-axis views. Peak rotation onbasal plane (Prot-base), peak rotation on middle plane (Prot-mid), peak rotationon apical plane (Prot-ap), peak twist angle (Ptw) were measured.Results: In the patients with essential hypertention,the trend of the rotationand twist curves remain unchanged, the value of Prot-ap, Prot-mid and Ptwsignificantly increased (all P<0.05) in EH patients, There was no significantdifference in Prot-base (P>0.05).Conclusion:3DSTE can effectively assess the left ventricular rotation andtwist in patients with essential hypertension, and3DSTE is an new tool toevaluate the early change of left ventricular function.