| Background:Chronic pulmonary heart disease (referred to as pulmonary heart disease) is defined by the thoracic or pulmonary artery of chronic lesions caused by pulmonary circulation resistance increased. Lead to pulmonary hypertension and right ventricular hypertrophy, with or without right heart failure is a kind of disease. From chronic obstructive pulmonary disease development, as the disease progresses. Often complicated with respiratory failure and right heart failure. Most scholars believe that the pulmonary heart disease with right heart though impaired, but in recent years with cardiac examination technology development, a large number of experimental studies show that:pulmonary heart disease is actually involved the left heart disease. Pathological examination revealed pulmonary heart disease patients with myocardial fiber mostly appear in varying degrees of hypertrophy, left ventricular wall thickening in patients with partial. Electron microscopy revealed left myocardial fiber swelling of mitochondria, plasma network expansion, muscle section length of a dissolved or not, glycogen decreased or disappeared. Japanese scholars on pulmonary heart disease autopsy study, according to the ventricular mass、wall thickness. diameter and the percentage of ventricular myocardial fibers four indexes. And without pulmonary heart disease with autopsy controls, found that pulmonary heart disease left ventricular late. Sure to involvement by. Pulmonary heart disease patients with left ventricular diastolic dysfunction is mainly caused by the direct effect of right heart lesions in left heart function, due to a left, right ventricular myocardium in anatomy is continuous side of ventricular pressure, volume changes can be connected to the straight shadow ring contralateral ventricular compliance and geometry, which influences its function. Prolonged hypoxemia and hypercapnia induced myocardial lactate reactor product and energy supply, together with the complex of respiratory tract infections, bacterial toxins or metabolites on myocardial are directly damage, so that the relative myocardial overload.Strain rate imaging is an evaluation of regional myocardial function in the new method, it reflect more directly the local myocardial complex deformation pattern without cardiac motion and entrainment effect (i.e. peripheral tissue stretch) effect, have very high temporal and spatial resolution, accurate and objective measurement of relative value. Research has shown that myocardium by strain rate imaging has the remarkable difference, strain rate imaging for functional evaluation of subendocardial region is most sensitive to strain rate imaging, the advantages are:1strain rate imaging factors affecting small, and it overcomes the shortcomings of the traditional ultrasonic subjectivity and strong empirical shortcomings, so it can be more objective and more accurately reflect the regional myocardial function. The strain rate imaging is based on the quantified based on quantitative analysis, ischemic myocardial function. Strain rate imaging in detection of chronic pulmonary heart disease patients with left ventricular dysfunction is a more sensitive method, for the future study of ventricular function and open a new way.Objective:To investigate the strain rate imaging (SRI) technology assessment in patients with Chronic pulmonary heart disease value of left ventricular function.Methods:64patients with chronic pulmonary heart disease (subdivided into30patients with compensated group and decompensated group,34cases) and normal control group of30patients, application of SRI measured left ventricular wall basal segment, midway through myocardial systolic peak strain rate (SRs), early diastolic peak strain rate (SRe) and late diastolic peak strain rate, computing left ventricular mean peak strain rate (mSR), and with the conventional echocardiographic parameters were compared. Calculation of chronic pulmonary heart disease in decompensated group to systolic function of strain rate index (mSRs) determination of left ventricular systolic dysfunction optimum boundary value and calculation of chronic cor pulmonale decompensation in diastolic function of strain rate index (mSRe/mSRa) in evaluation of left ventricular diastolic dysfunction of the optimum boundary value.Results:1. SRI on the compensation of the left ventricular systolic dysfunction was obviously higher than that conventional echocardiography (P<0.05).2. Compared with the normal control group, chronic pulmonary heart disease group systolic and diastolic function of strain rate indices were significantly different (P <0.01), and were significantly different between groups (P<0.05). 3. Chronic cor pulmonale compensation in group LVEF and mSRs were highly correlated, the values of R-0.75(P<0.01). Chronic cor pulmonale decompensation in group LVEF and mSRs were highly correlated, the values of R-0.82(p<0.01).4. Chronic cor pulmonale decompensation group to systolic function of strain rate index (mSRs) determination of left ventricular systolic dysfunction, the area under the curve=0.850(95%CI=0.707-0.993), has a value of-0.72(s’1), sensitivity and specificity were respectively79%,80%. Chronic cor pulmonale decompensation in diastolic function of strain rate index (mSRe/mSRa) in evaluation of left ventricular diastolic dysfunction, the area under the curve=0.798(95%CI=0.605-0.990), boundary value of0.54, sensitivity and specificity were respectively82%,83%.Conclusion:SRI technology than conventional echocardiography is more sensitive and rapid quantitative evaluation of patients with chronic left ventricular function, and can estimate the changes of early left ventricular systolic function. Chronic pulmonary heart disease in group LVEF and mSRs highly relevant, utilization of patients with chronic pulmonary heart disease in left ventricular regional systolic function in strain rate index (mSRs) in patients with chronic pulmonary heart disease can be reflected by the status of global systolic function of left ventricle. And using mSRs, mSRe/mSRa to check out the chronic pulmonary heart disease patients with left ventricular systolic dysfunction, diastolic abnormality of segmental myocardial is helpful. |
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