The Value Of2-dimension Speckle Tracking Imaging In Diagnosis Of Heart Failure With Normal Left Ventricular Ejection Fraction

Objective: Use two-dimensional speckle imaging（2DSTI） to observeheart failure with normal left ventricular ejection fraction (HFNEF) patients’systole and diastole strain(S) and strain rate (SR) changes. Usetwo-dimensional speckle imaging to assessment these patients’ left ventricularfunction. Through analyzing strain, strain rate and Tissue Doppler Imaging(TDI) parameters’ correlation, to explore the value of two-dimensional speckletracking imaging in the diagnosis of heart failure with normal ejection fraction.Provide a new method and idea to diagnose HFNEF.Materials and methods:29patients were enrolled from July2012toDecember2012in our hospital.ALL patients were consistent with theconsensus statement on the diagnosis of heart failure with normal leftventricular ejection fraction by the Heart Failure and EchocardiographyAssociations of the European Society of Cardiology. And patient with thefollowing diseases was exclude:1)have the symptoms or signs of heart failurebut NT-proBNP<120pg/ml;2)pericardial disease, valvular disease;3)acutemyocarditis, acute myocardial infarction;4)obstructive hypertrophiccardiomyopathy;5)pulmonary hypertension, cor pulmonale;6)hyperthyroidism, hypothyroidism, Cushing’s syndrome and other diseases ofthe endocrine system;7) Severe liver, kidney failure, etc. Gender, age, height,weight, left atrial diameter (LADd), left ventricular internal dimension inend-diastole (LVEDd), left ventricular ejection fraction (LVEF), left ventricularend-diastolic volume (LVEDV), isovolumetric relaxation time(IVRT), indicesof mitral flow velocity and the velocity of mitral annulus were measured andrecorded in21normal controls(NC group) and29patients with HFNEF (HFNEF group). Three cardiac cycles were recorded in apical four-chamber,three-chamber, and two-chamber views. And in each view, a globallongitudinal strain and strain rate curve were obtained, including all LVmyocardial segments by Qlab software. Record the peak longitudinal S and SRduring systolic phase, isovolumic relaxation phase and early diastolic phase, ineach view. All of the statistical data were analyzed by SPSS software.Compared with NC group, observe HFNEF group’s left ventricular longitudinalstrain, strain rate changes. Analyze the global left ventricular longitudinal strain,strain rate and the main indexes of left ventricular diastolic function’scorrelation.Results：1、There was no significant difference between HFNEF groupand NC group regarding of LVEF and FS（p>0.05）.But compared with NCgroup, no matter the global or in each view, HFNEF group’s left ventricularsystolic longitudinal strain and strain rate is reduced (p<0.05);2、HFNEF groupshowed a reduced global longitudinal SR during diastolic phase,andlongitudinal SR in each view also reduced（p<0.05）.3、Either the strain rateindices during isovolumic relaxation phase(GLSRivrt、E/GLSRivrt) and thestrain rate indices during early diastolic phase(GLSRe、E/GLSRe) both have agood correlation with Ea、E/Ea.Conclusions：1、While the LVEF is still normal,2DSE can identifyabnormal Left ventricular contractility. So2DSE is more sensitive than LVEFfor evaluation left ventricular systolic function. As a method to early evaluationthe LV systolic function,2DSE has important diagnostic value;2、2DSTI canaccurately assess the changes of myocardial function during Left ventriculardiastolic in patients with HFNEF. There is a good correlation between2DSEmeasured values and main indices of TDI to diagnosis diastolic dysfunction.2DSTI is a new method to diagnose HFNEF.