Strain Rate Imaging Evaluation Research Of Left Atrium Function In Patients With Type2Diabetes

ObjectiveBy Strain Rate Imaging (SRI) technology testing Type2Diabetes Mellitus (DM2)patients’ left atrium wall of myocardial tissue deformability and characteristics of changingcan get a scientific evaluation of left atrium function of the patients. It is a new kind ofdetection methods and theoretical basis for clinical guidance and improves the prognosis.MethodsThe results collected from January2012to December2013in the People’s LiberationArmy NO.88hospital endocrinology department40DM2patients and30health control group(confirmed healthy people).By echocardiography, in2d mode before and after themeasurement of left atrium diameter (LAD), early wave of mitral valve flow (peak E), latewave of mitral valve flow (peak A), the deceleration time of the E wave (DT) and calculate theE/A ratio of the both groups. Then by Pulse Doppler detection measure the velocity of E wave(E), A wave (A), and calculate the E/A ratio. In apical four chamber view Simpson method tomeasure left atrium maximum volume (LAVmax), left atrium volume minimum volumebefore (LAVmin) and left atrium contraction (LAVp), calculate the left atrium ejectionfraction (LAEF), left atrium active ejection fraction (LAAEF), left atrium active ejectionvolume index (LAAEVI), left atrium passive ejection fraction (LAPEF), left atrium passiveejection volume index (LAPEVI) and left atrium stroke volume (LASV). In Pulse Dopplerdetection, SRI technology is applied to all the list apical four chamber view, apical twochamber view, apical three chamber view, respectively on the middle of left atrium intertribalseptum, lateral wall, lower wall, front wall and back wall obtain the strain rate curve, systolicstrain rate, early and late diastolic strain rate (SSR, ESR, ASR), analyzing the left atriumsystolic function of patients with DM2. Results(1) The comparison of left ventricular diastolic and systolic function: DM2group31cases E/A <1,5cases E/A>1but E′/A′<1, the left4cases E/A <1and E′/A′>1. The30casesof control group E/A and E′/A′both>1there is statistical significance; DM2group24casesDT>240ms, all the30cases of control group DT were in the normal range, there is statisticalsignificance; all the DM2group40cases LVEF>50%, all the control group30casesLVEF>50%, there is no statistical significance (P=0.156).(2) The comparison of left atrium structure: DM2group38cases of left atrium diameter(LAD) increased; control group all the30cases of LAD were in the normal range, a verysignificant difference between two groups (P <0.01), there is statistical significance; DM2group40cases the LAVmax were higher than the control group, there is statisticalsignificance (P=0.036); DM2group40cases LAVp were higher than the control group, thereis statistical significance (P=0.018); DM2group40cases LAVmix had the tendency of higherthan the control group but there is no statistical significance(P=0.074).(3) The comparison of left atrium function: DM2group40cases LAEF, LASV, LAAEFand LAAEVI were higher than the control group, there is statistical significance (P<0.01);DM2group40cases LAPEF and LAPEVI were lower than the control group, there isstatistical significance (P<0.01).(4) The comparison of left atrium wall strain rate values:DM2group40cases’ left atriumintertribal septum, lateral wall, front wall, lower wall and back wall ESR value were lowerthan the control group, there is statistical significance (P<0.05); DM2group40cases’ leftatrium intertribal septum, lateral wall, front wall, lower wall and back wall SSR values andASR values were higher than the control group, there is statistical significance (P<0.01).(5) The comparison of left atrium wall average strain rate values:The mESR averagevalue of DM240patients were lower than control group, there is statistical significance(P<0.01); the mSSR average value and mASR value of DM240patients were higher thancontrol group, there is statistical significance (P<0.01).ConclusionDM2patients have cardiac structural and functional abnormalities in the early time. Themost obvious appearance is left atrium enlargement, left ventricular filling restricted,abnormalities of left atrium storage function, pipeline function, and booster pump function.Strain Rate Imaging technology have a better analysis the change of left atriumfunction of DM2patients and reflect the change of left ventricular diastolic and systolicfunction. This technology gives an accurate basis for clinical evaluation of cardiac functiondamage of DM2patients.