Investigation On Left Ventricular Myocardial Strain In Postprandial Hypotension Using 2-dimensional Strain Echocardiography

Objective: Postprandial hypotension(PPH)is a common phenomenon in elderly people.This study aims to observe the early changes in left ventricular myocardial strain of patients with PPH using 2-dimensional speckle tracking imaging(2D-STI),and to provide the clinical evidence of target cardiac change in patients with PPH.Methods:20 patients first diagnosed with PPH(10 cases male,with an average age of 76.1±5.12 years)were recruited in the study as PPH Group.21 cases of gender and age matched patients without PPH(11 cases male,with an average age of 76±5.60 years)were selected as control group(NPPH Group).All patients were measured by global longitudinal strain(GLS)、 global radial strain(GRS)and global circumferential strain(GCS)before and 1.5h after breakfast.Meanwhile,other parameters of cardiac structure and function were measured by normal echocardiography Results: There was no significant difference in heart structure indexes、LV conventional systolic and diastolic indexes between two group detected by normal method.Before meal,GLS of PPH Group was decreased significantly compared with NPPH Group(20.97 ±1.14 vs.21.81±0.98,p= 0.02).There was no significant difference in GCS and GRS between two groups(p=0.11,0.14).1.5h after meal,GLS(p=0.045)decreased in PPH Group,which were not different in NPPH Group.Logistic regression analysis results showed that the GLS before meal(p=0.02,OR= 0.46),GLS(p=0.001,OR= 0.27)、GCS(p=0.008,OR= 0.41)and GRS(p=0.004,OR= 0.33)after meal were independent predictors of PPH respectively.Compare with the area under the ROC,GLS after meal(AUC= 0.86,p= 0.001)was significantly greater than 24 h average SBP(AUC= 0.66,p= 0.08)and LVEF(AUC= 0.44,p= 0.47).Conclusion: Patients with PPH may have occult cardiac function damage.STI does better in detecting the early changes in left ventricular myocardial function than ordinary echocardiography.