Early Diagnosis Of Adult HCM By Three-dimensional Speckle Tracking Echocardiography Combined With Cardiac Magnetic Resonance Imaging In Ningxia

Objective To assess the left ventricular global systolic function in early stage of adult Hypertrophic Cardiomyopathy in Ningxia by Three-dimensional Speckle Tracking Echocardiography,and to explore the correlation betwween three-dimensional strain parameters and conventional two-dimensional parameters.Methods 30 consecutive patients with HCM were enrolled,and another 33 healthy subjects were recruited as a control group.An Ultrasound diagnostic equipment(i E33)(Philips Medical Systems,Bothell)was used to acquire conventional two-dimensional images and parameters,and tissue Doppler related parameters.X5-1matrix probe was used to obtain three-dimensional full-volume images.Three-dimensional parameters such as three-dimensional global peak strain(3DS),longitudinal peak strain(LS),circumferential peak strain(CS)and radial peak strain(RS)of the 16 segments were acquired by off line Tom Tec software.GS,GCS,GLS and GRS were averaged over the 16 segments in a certain direction.The differences of the parameters between the two groups were compared.Results 1.Compared with the control group,there were significant increases in conventional two-dimensional ultrasound indexes IVSD,LVPWD,LVMI,,LAV,LVOT-PG,LVOT-VTI and IVRT in the HCM group(p<0.05);2.There was no significant difference in GS between the two groups.(p>0.05),GLS and GRS were significantly decreased in HCM group,the difference was statistically significant(p<0.05),GCS showed a significant increase trend,but the difference was notstatistically significant(p>0.05);3.Correlation analysis between the three-dimensional global strain parameters and some conventional two-dimensional ultrasonic indexes is as follows:GLS was negatively correlated with IVSD,LVMI and LVOT-PG;GRS was negatively correlated with IVSD,while GCS and GS were not correlated with the above parameters;There was a linear correlation between LVEF and GRS,GCS and GS,but no correlation with GLS;LAVI had no correlation with each strain parameter.Conclusions: 3D-STE can detect the impairment of left ventricular systolic function in early early stage of HCM,which is characterized by decreased GLS and GRS,increased GCS,and GLS was negatively correlated with IVSD,LVMI,and LVOT-PG,that is,GLS decreases as the above parameters increase.Thus 3D-STE can provide important reference for early diagnosis of HCM patients.Objective Three-dimensional Speckle Tracking Echocardiography combined with cardiac magnetic resonance imaging(CMRI)was used to evaluate hypertrophic cardiomyopathy(HCM).The concordance of parameter(LVM)obtained by 3D-STE and CMRI was discussed.According to the results of CMRI-LGE,the difference of GLS between LGE positive and LGE negative patients was compaired.Methods 26 consecutive patients with HCM were enrolled,an Ultrasound diagnostic equipment(i E33)(Philips Medical Systems,Bothell)was used to acquire conventional two-dimensional images and parameters.X5-1 matrix probe was used to obtain three-dimensional full-volume images.Three-dimensional parameters such as three-dimensional longitudinal peak strain(LS),circumferential peak strain(CS)and radial peak strain(RS)of the 16 segments were acquired by off line Tom Tec software.GCS,GLS and GRS were averaged over the 16 segments in a certain direction.All subjects were examined by CMRI-LGE to obtain left ventricular mass(LVM).The concordance of LVM obtained by CMRI-LGE and 3D-STE was tested.In addition,HCM patients were divided into LGE(+)group and LGE(-)group according to LGE results.The difference of GLS between the two groups was observed.Results The correlation between 3D-STE and CMRI in measuring LVM in HCM patients was good,and the results showed good concordance.Compared with LGE(-)group,GLS in LGE(+)group was significantly lower.Conclusions: 3D-STE has good concordance with gold standard CMRI in evaluating left ventricular mass in HCM patients,and can be used as a more convenient method for LVM quantification.The GLS of LGE-positive patients is significantly lower than that of LGE-negative patients,indicating that LGE-positive HCM patients have more serious left ventricular global systolic dysfunction.Thus3D-STE combined with CMRI-LGE technology can provide an important imaging basis for early evaluation of left ventricular global systolic function and myocardial fibrosis in patients with HCM.