Two-dimensional Speckle Tracking Imaging Assessment Of Left Ventricular Longitudinal Stain In Patients With Aortic Insufficiency

ObjectiveTo evaluate the left ventricular longitudinal strain in patients with aortic insufficiency using longitudinal peak and peak time of two-dimensional speckle tracking imaging before and after valve replacement surgery.1. To assess changes of left ventricular structure and left ventricular ejection fraction in patients before and after valve replacement surgery using conventional echocardiography.2. To evaluate the left ventricular regional myocardial deformation capacity of each level segment in patients with aortic insufficiency before and after valve replacement surgery using two-dimensional speckle tracking imaging.Method30 patients with routine medical examination and Color Doppler ultrasound of the heart and another 30 patients with Simple Aortic Valve Insufficiency which were ready for Aortic valve replacement (AVR) were included. All subjects were divided into 3 groups (A, B and C). A-Control group, B - preoperative AVR and C - postoperative 3-6 months AVR.1. A, B and C groups were measured by routine echocardiography combined with two-dimensional speckle tracking imaging. We measure the left ventricular end-diastolic diameter (LVDd), left ventricular end-systolic diameter (LVDs) and left ventricular ejection fraction (LVEF) using Simpson’s method. All subjects of LVEF were>50% and all the results were compared with each other.2. Seventeen section of each group were divided into three segments, which were respectively basal, middle and apical segment. Then we measured the longitudinal peak and peak time of each segment of every group. All results were compared with each other.Results1. Each group (control, preoperative of AVR, and postoperative of AVR) between gender, age and heart rate has no statistical differences (p>0.05).2. LVDd, LVDs and LVEF between of A, B and C group were compared with each other. (Form 1)(1). Compared with A group, LVDd and LVDs of B group increased, the LVEF of B group decrease (p<0.05),C group between of LVDd, LVDs and LVEF has no differences (p>0.05).(2). Compared with B group, LVDd and LVDs of C group decrease, LVEF of C group increased (p<0.05). 3. The longitudinal strain peak and peak time between each segment of A, B and C group compared with each other (Form 2 and 3).(1). Compared with A group, between each segment (basal, middle, apical) in patients of B group, the longitudinal strain peak appears to decrease. And the peak time appear to increase, there was a statistically significant difference (p<0.05),but between each segment (basal, middle, apical) of C group, the longitudinal strain peak reduced and peak time still increase (p<0.05).(2). Compared with B group, between each segment (basal, middle, apical) of C group, the longitudinal strain peak increase (p<0.05) and peak time is shortened which shows statistics difference (p<0.05).4. The longitudinal strain peak and peak time between each segment of A internal group compared with each other (Form 4).(1). To each segment (basal, middle, apical), there was significant differences between longitudinal peak, basal> apical> middle segment (p<0.05).(2). To each segment (basal, middle, apical), there was a significant difference between of peak time, basal> middle> apical (p<0.05).5. The longitudinal strain peak and peak time between each segment of B and C internal group compared with each other (Form 5 and 6).(1). To each segment (basal, middle, apical), the longitudinal strain peak all shows that the basal> middle, basal> apical, but there was no difference between middle and apical (P>0.05).(2). To each segment (basal, middle, apical), the peak time all shows that the basal> middle, basal> apical, but there was no difference between middle and apical (P>0.05).Conclusions1. After AVR of 3-6 months, the left ventricular structure and left ventricular ejection fraction recovered to normal person range.2. Using two-dimensional speckle tracking imaging could assess the left ventricular regional myocardial deformation capacity of each level segment with AI before and after 3-6 of AVR.3. Using two-dimensional speckle tracking imaging shows that left ventricular regional myocardial capacity was closely related with left ventricular structure with AI before and after 3-6 ofAVR.