The Study On Application Of The Velocity Vector Imaging To Evaluate Left Ventricular Diastolic Function In Patients With Hypertension

Objective Using velocity vector imaging measured the maximum velocity and strainrate of early diastolic phase of patients with hypertension. Compare the differences ofthree groups that are normal diastolic function、impaired relaxation pattern and pseudonormal filling. To investigate the clinical application value of VVI in evaluate leftventricular diastolic function of patients with hypertension.Methods Choosing the patients were diagnosed hypertension with60cases in hebeiunited university affiliated hospital in August2013to December2013by “2010Chinahypertension prevention and treatment guidelines”, Age from40to60years old.According to the clinical commonly used echocardiography standards to evaluate leftventricular diastolic function, they were divided into three groups that are normal group(normal diastolic function)、 LVDDⅠgroup (impaired relaxation pattern) and LVDDⅡgroup (pseudo normal filling). Choosing SIEMENS ACUSON color Doppler ultrasonicdiagnostic instrument, application of4v1-c cardiac probe, connection body surfaceelectrocardiogram, then tell the patients to take the left lateral position and takeconventional echocardiography examination. Storage the dynamic image clip of apical2-chamber、3-chamber4-chamber view. Application of VVI software analysis andmeasuring the maximum velocity (Ve) and strain rate (SRe) of early diastolic phase ofmitral annular level of left ventricular wall of long axis.Results1. Compare with Normal group, Ve and SRe of every parts in LVDDⅠandLVDD Ⅱ group were decrease, the difference was statistically significant (P <0.05),but the difference between LVDD Ⅰ and LVDD Ⅱ group was not statisticallysignificant (P>0.05), Ve and SRe can identify left ventricular diastolic dysfunction, butcan not judge the degree of left ventricular diastolic dysfunction; The difference of E/Veamong LVDD Ⅰ、LVDD Ⅱ and Normal group were statistically significant (P <0.05), the ratio of LVDD Ⅰ group was lowest, LVDD Ⅱ group was lower, Normalgroup was between two group, E/Ve can identify left ventricular diastolic dysfunctionand judge the degree of left ventricular diastolic dysfunction.2. Ve of interventricularseptal evaluate left ventricular diastolic dysfunction of ROC curve area is0.916, itsaccuracy is high, and Ve <4.27as the critical point (sensitivity0.846, specificity,0.905);SRe of interventricular septal evaluate left ventricular diastolic dysfunction of ROC curvearea is0.812, its accuracy is medium, and SRe <1.44as the critical point (sensitivity0.692, specificity,0.762); E/Ve evaluate the degree of left ventricular diastolicdysfunction of ROC curve area is0.963, its accuracy is high, and E/Ve>19.27as thecritical point (sensitivity0.983, specificity0.911).3. The consistency of two methods(velocity vector imaging technology and ASE “Recommendations for the Evaluation ofLeftVentricular Diastolic Function by Echocardiography”) to juge the left ventriculardiastolic function: The consistency of Ve and SRe was good (Ve Kappa0.784，E/VeKappa0.837). The consistency of SRe is general (Kappa0.450). Conclusions1. Application of the VVI to measurement Ve and SRe of early diastolicphase of mitral annular level of left ventricular wall of long axis can reflect leftventricular diastolic function, estimate normal left ventricular diastolic function anddysfunction in patients with hypertension.2. E/Ve not only estimate normal leftventricular diastolic function and dysfunction in patients with hypertension, but alsoestimate impaired relaxation pattern and pseudo normal filling.3. VVI can quantitativeassessment left ventricular diastolic function in patients with hypertension, provides areliable method for clinical to evaluate left ventricular diastolic function.