Evaluation On Relationship Between Torsion And Remodeling Of Left Ventricular In Patients With Dilated Cardiomyopathy By STI

Object:Evaluation on the relationship between twist and remodling of left ventricular in patients with dilated cardiomyopathy by twodimensional speckle tracking imaging can provide effective and accurate basis for clinical treatment.Mothord:As study group, forty-one patients with Dilated Cardiomyopathy(DCM)were divided into two groups called DCM1 group(clockwise rotation at apical level) and DCM2 group(counterclockwise rotation at apical level).As contral group, thirty cases of healthy wolunteers were selected. We checked the left lateral position when the patients in quiet breathing, and simultaneously recorded three lead ECG. We Used S5-1 ultrosound probe on standard left ventricular long axis to measure parameters: inter ventricular septal end-diastolic thickness(IVSTd) 、 left ventricular posterior wall end-diastolic thickness(LVPWTd) and left ventricular end diastolic diameter(LVEDd). Sampling for sternum left ventricular short axis basal level and apical level two-dimensional gray-scale dynamic images when the subjects were in expiration and stable heart rate. And then we collected ful-volume images of four carvity heart standard sections by using real-time three-dimensional echocardiography(RT-3DE). Finally, all the images were pulled into Qlab software to analysis. After running TMQ Advanced software,we could get the rotation angle-time curved line of left ventricular short axis basal level and apical level. Next, we measured the peak of left ventricular basal rotation(B-Prot), the peak of left ventricular apical rotation(A-Prot), and calculated the peak of left ventricular global twist(G-Ptwi). We measured end diastolic velocity(EDV), end systolic velocity(ESV) by 3DQ Advanced software, automatically it could come up with left ventricular ejection fraction(LVEF). Then calculated left ventricular spherical index(LVSI). Average value of measuing date were three times.Results:1.The conventional parameters IVSTd、LVPWTd、LVEF:N、DCM1 、 DCM2 three groups gradually decrease, comparative differences between these three groups are statistically significant(P<0.05); LVEDd、LVEDV:N、DCM1、DCM2 three groups gradually increase, comparative differences between these three groups are statistically significant(P<0.01).2.In N 、 DCM1 、 DCM2 groups, the rotation-angle of basal level is negative, and clockwise rotate at systole. It is consistent that the peak of rotation angle in the four curves in N group, but in DCM1 and DCM2 group are not. In N 、 DCM1 groups, the rotation-angle of apical level is positive,and counterclockwise rotate at systole. In DCM2 group the rotation-angle of apical level is negative, clockwise rotate at systole. Compared with N group,the LVSI is increas in DCM1 and DCM2 but the A-Prot、B-Prot、GPtwi in DCM1 and DCM2 are decreas, meanwhile, comparative differences between three groups were statistically significant(P <0.05).3.DCM1 group:B-Prot、A-Prot、G-Ptwi is correlated positively with LVEF( r=0.920 、 r=0,954 、 r=0.948, P<0.01), B-Prot 、 AProt、G-Ptwi is negatively with LVSI(r=-0.950、r=-0.938、r=-0.947, P<0.01), LVEF is negatively with LVSI( r=-0.918,P<0.01).4.DCM2 group : B-Prot is correlated positively with LVEF(r=0.764,P<0.01),B-Prot is negatively with LVSI(r=-0.857,P<0.01).Conclusions:1.This study confirms that using 2D-STI technology to measure the changes of rotation angle and global twisting angle of left ventricular in patients with dilated cardiomyopathy may assess their condition of remodeling and function.2.Compared with the control, the twisting motion and the ejection fractions in patients with dilated cardiomyopathy is weaker.3.As the twisting motion weak in patients with dilated cardiomyopathy,the fuction of them would become weaker. At the same time, the geometry form of left ventricular approach to a sphere.When the direction of apical level from anticlockwise to clockwise,the rotation angle and global twisting angle of left ventricular would decease, as well as the ejection fractions.And then the geometry form of left ventricular would have a tendency to be a sphere.