Study Of Left Ventricular Systolic Function In Patients With Chronic Heart Failure Using Speckle Tracking Imaging

Objective Two-dimension and three-dimension speckle tracking imaging was applied to analyze left ventricular systolic function in patients with chronic heart failure, then which provide more guiding information for diagnosis and treatment.Method64inpatients with clinical symptoms were enrolled during September2012to February2013who was diagnosed chronic heart failure. According to the New York Heart Association (NYHA) classification method, They were divided into three subgroups:II level group (n=20), â…¢ level group (n=21), IV level group (n=23). Control group was selected volunteers who ruled out heart failure (n=24). All objects were detected N terminal serum brain natriuretic peptide precursor. Analyze left ventricular systolic strain and synchronism by two-dimensional and three-dimension speckle tracking echocardiography.Result1. Compared with control group, N terminal brain natriuretic peptide precursor levels increased significantly in heart failure groups (P <0.01). The higher level of cardiac function grade, the more N terminal brain natriuretic peptide precursor.2. Compared with control group, left ventricular ejection fraction gradually declined with the more serious level of cardiac function grading (P<0.01). But there was no statistically significant difference between â…¢ level group and IV level group (P>0.05).3. Compared with control group, left ventricular two-dimensional global strain, strain rate and three-dimensional global strain gradually declined with aggravating of heart function classification in heart failure group. But there was no statistically significant difference with radial strain and strain rate between â…¡ level group andâ…¢ level group (P>0.05). Synchronicity indexes of two-dimension and three-dimension increased with the increase of heart function classification (P<0.01), and there was good correlation between two-dimensional and three-dimensional synchronicity indexes. The parameters of strain and synchronicity had a good correlation with N terminal brain natriuretic peptide precursor.4. The interclass and intraclass correlation coefficient of two-dimensional global longitudinal, radial, and circumferential strain and strain rate respectively were0.81/0.83,0.77/0.74,0.80/0.78and0.85/0.87,0.83/0.86,0.82/0.80. The interclass and intraclass correlation coefficient of synchronization parameters (Tls-maxD, Tls-SD and Trs-maxD, Trs-SD) were0.78/0.73,0.81/0.79,0.82/0.80,0.81/0.80. The interclass and intraclass correlation coefficient of three-dimensional global longitudinal, radial, circumferential and three-dimension strain respectively were0.80/0.82,0.62/0.64,0.73/0.79and0.79/0.80. And correlation coefficient of three-dimensional synchronicity parameter was0.82/0.83.Conclusion1. The value of speckle tracking echocardiography is better than left ventricular ejection fraction in the assessment of cardiac function in patients with heart failure.2. Left ventricular myocardial strain ability and synchronicity disorders in patients with heart failure closely associates with the severity of cardiac function decline.3. The analysis results of two and three dimension methods have a good correlation.