Comparison Of Mitral Annular Displacement And Twodimensional Longitudinal Strain In Evaluating Of Left Ventricular Systolic Dysfunction Function In Hypertension

Backgrounds and Objectives Left ventricular systolic function is an indicator commonly used for evaluation of cardiac function in clinical environment.The Indicators for evaluation of left ventricular systolic function include left ventricular ejection fraction,left ventricular longitudinal strain,tissue Doppler peak velocity,mitral annulus displacement,etc.GLS is considered to be the most accurate and sensitive indicator for evaluation of early left ventricular systolic dysfunction,while LVEF has obvious limitations as an early evaluation of left ventricular systolic dysfunction.Finding a noninvasive evaluation method with good repeatability,simple operation and sensitivity is of great significance for early detection of cardiac dysfunction and early clinical intervention.In this study,M-mode ultrasound,tissue Doppler imaging(TDI)and two-dimensional speckle tracking technology are respectively applied to measure the left ventricular longitudinal systolic function of hypertensive patients with different levels of LVEF,and the value of different methods in evaluating left ventricular systolic function is discussed.Methods 105 patients(male 82,female 23,average age 56.80±12.35 years)with primary hypertension were enrolled as the HT group.25 age-and gender-matched healthy volunteers(male 16,female 9,average age 52.72±9.51)as the normal control group(NC).HT patients were divided into three groups based on LVEF: group A(LVEF?55%,n=64),group B(45%?LVEF<55%,n=18),group C(LVEF?45%,n=23),Echocardiographic examination was performed to acquire conventional parameters including LV diameter,ventricular wall thickness,LA diameter,trans-mitral diastolic inflow velocities(E,A),mitral annuluar early and late diastolic velocities(e,a),and to acquire parameters for evaluation of Left ventricular systolic function,including LVEF(by simpson method),mitral annulus displacement(by Mmode ultrasound and Tissue Doppler imaging),mitral annuluar systolic velocities(s),and GLS.Results 1.Mitral annular displacement and displacement index(DM-l,DM-s,DIM-l,DIM-s,DTDI-l,DTDI-s,DITDI-l,DITDI-s)obtained by M-type and TDI in groups A,B and C were decreased significantly than those in NC group(P<0.05),and showed a decreasing trend among groups A,B and C(P<0.05).and the annulus velocities(Sl,Ss)decreased significantly in group B and C(p <0.05),while group A has no obvious change.2.All mitral annular motion indexes(DM-l,DIM-l,DM-DIM-s,DTDI-l,DITDI-l,DTDI-s,DITDI-s,Sl,Ss)in HT group were negatively correlated with SL,with DIM-s having the highest correlation with SL(r=0.80).3.All mitral annular motion indexes(DM-l,DIM-l,DM-s,DIM-s,DTDI-l,DITDI-l,DTDIs,DITDI-s,Sl,Ss)in HT group were correlated with LVEF,with DIM-s having the highest correlation with LVEF(r=0.68).4.Mean differences were close to zero and had narrower ranges when measuring MA displacement by M-mode ultrasound and tissue Doppler imaging(TDI).The 95% confidence interval is narrow(0.08±0.39,-0.05±0.28).Conclusions: 1.M-mode ultrasound,tissue Doppler and two-dimensional strain methods can detect early left ventricular longitudinal systolic dysfunction in hypertensive patients,and the correlation between annular displacement correlated with global Longitudinal strain is better than that between peak velocity.2.In clinical application,the displacement obtained by M-mode would be more convenient in operation than two-dimensional because ECG acquisition is not required.