Echocardiographic Analysis Of Cardiac Function In Patients With Silicosis Complicated With Chronic Obstructive Pulmonary Disease

Objective:To analyze the cardiac function of patients with silicosis and chronic obstructive pulmonary disease(COPD)by ultrasound,and to further explore its clinical value.Methods:A total of 30 patients with silicosis associated with chronic obstructive pulmonary disease(COPD)were diagnosed by clinical and related auxiliary examinations from January 2016 to January 2018.The the above patients are in accordance with the "Occupational pneumoconiosis Diagnosis"(GBZ 70-2015).30 normal subjects were selected as control group,and both groups were analyzed off-line after collecting images.Under the mode of strain and strain rate,the basal segment,the mid segment,apical segments of the right ventricular free wall and the apical segment,the mid segments,the basal segment of interventricular septum were sampled in turn.And generated the corresponding strain curve or strain rate curve.The following cardiac function indexes were statistically analyzed on the corresponding curves,and the results were compared and analyzed,and compared with the right ventricular positive rate in the conventional two-dimensional echocardiography mode.The measured cardiac function indicators include:Negative systolic peak longitudinal strain(SL PeakS),End systolic longitudinal strain(SL(ES)),Peak systolic longitudinal strain rate(SrL PeakS),Peak A longitudinal strain rate(SrL PeakA),Peak E longitudinal strain rate(SrL PeakE),Global peak Longitudinal strain in midmyocardium(GSmid),Global Peak systolic longitudianl strain rate(GSRs),Global Peak E longitudinal strain rate(GSRe),Global Peak A longitudinal strain rate(GSRa).At the same time,patients with tricuspid regurgitation in the silicosis patients with COPD group carried out a correlation analysis between GSmid,GSRs,GSRe and GSRa of the right ventricular myocardium function indexes and pulmonary artery systolic pressure(PASP).Results:(1)Compared with the control group,the strain curves in the right ventricle of the patients with silicosis combined with chronic obstructive pulmonary disease were not consistent,and the strains in every segment were lower than those in the control group.The strain rate curve was disordered,the shape was different,and its peak value decreased with the control group.(2)The SL PeakS,SL(SE),SrL PeakS,SrL PeakE,GSRs,GSRe,and GSmid values in the six segments of the silicosis combined with COPD group were all lower than those in the normal group,and the differences were statistically significant(p<0.05).However,SrL PeakA and GSRa in silicosis combined with COPD had no significant difference compared with normal group(p>0.05).(3)The difference of SL PeakS,SL(ES)and SrL PeakS between the basal segment and the apex segment of the right ventricular free wall in silicosis patients was statistically significant(p<0.05).Similary,the difference between the middle segment and the apex segment was also statistically significant in three parameters(p<0.05).(4)There was no statistically significant difference between SrL PeakE and SrL PeakA in three segments of the right ventricular free wall in patients with silicosis combined with COPD(p>0.05).(5)With the index of upper heart function,there is no significant difference between the intersegmental segments of the interventricular septum in the patients with silicosis and chronic obstructive pulmonary disease(p>0.05).(6)There was a statistically significant correlation between GSmid,GSRs and PASP in the right heart of patients with silicosis and chronic obstructive pulmonary disease(p>0.05),and there was no significant correlation and statistical significance between GSRe,GSRa and PASP.Conclusion:(1)Ultrasound examination has good evaluation on the cardiac function of patients with chronic obstructive pulmonary disease(COPD)with silicosis.(2)The local and overall cardiac motor function of the right ventricle in patients with silicosis and chronic obstructive pulmonary disease(COPD)is impaired in varying degrees.(3)According to the correlation between GSmid,GSRs of right ventricular and pulmonary hypertension in patients with silicosis and chronic obstructive pulmonary disease,it can play a guiding role in disease prevention and intervention to some extent.(4)Myocardial strain and strain rate imaging can quantify the myocardial movement index,which is more sensitive than two-dimensional echocardiography,and early reflects the reduction of right ventricular systolic function,which has a guiding role in early diagnosis and treatment of pulmonary heart disease in silicosis patients.