| Objective To evaluate the left ventricular diastolic function of hypertensive patients by Speckle Tracking Imaging of Three-Dimensional Echocardiography(3DE-STI),and explore the clinical application value of each strain parameter.Methods 1、 Subjects:40 healthy volunteers were selected as the control group.65 patients with clinically diagnosed hypertension were the case group,and the left ventricular configuration was used as the left ventricular configuration in the normal group of 30 patients(left ventricular normal geometric,LVN group)and the left ventricular remodeling group of 35 patients(left ventricular remodeling,LVR group),including 19 cases of centripetal remodeling and 16 cases of central hypertrophy.2、 Equipments: GE Vivid E9 color Doppler ultrasound system with M5 Sc,4V probe and Echo PAC software workstation(with 3D strain image analysis software).3、 Measurement: All the subjects underwent conventional echocardiography,then Real-time three-dimensional echocardiography was used to measure its left ventricular strain values(expressed in absolute values)of each group,and analyzed the three-dimensional longitudinal strain global longitudinal strain(GLS),global radial strain(GRS),global circumferential strain(GCS),global area strain(GAS),and calculated strain diastolic index longitudinal SI-DI,radial SI-DI,circumferential SI-DI,area SI-DI.Compared the differences of parameters between groups,and analyzed the correlation between strain parameters and traditional diastolic function evaluation indexes E/e’,e’ and left atrial volume index.Results 1、 There were no significant differences in the age,height,weight,and body surface area of the subjects(P>0.05).The plasma levels of NT-pro BNP in the LVN and LVR groups were significantly higher than those in the control group(P<0.05),and the plasma NT-pro BNP concentration in the LVR group was higher than that in the LVR group(P<0.05).2、 Compared with the control group,the left ventricular posterior wall thickness(LVPW),left ventricular end diastolic diameter(LVEDD)and volume(LVEDV)were increased in the LVR group,the E peak was significantly reduced,and the E peak deceleration time(DT)was shortened(p<0.05).There was no significant difference between the above parameters LVN group and the control group.Compared with the control group,the LVN and LVR groups had thicker interventricular septum thickness(IVS),E/A ratio decreased,IVRT prolonged,e’ decreased,E/e’ ratio increased,and left atrial volume index increased(p<0.05).The difference of IVS,E/A,E/e’,e’,left atrial volume index between LVN and LVR group was statistically significant(p < 0.05).There are no significant differences in the remaining indicators.3、 Three groups of three-dimensional strain imaging diastolic index longitudinal SI-DI,circumferential SI-DI,area SI-DI,radial SI-DI and contraction strain parameters GLS,GCS,GAS,GRS had a downward trend,between the LVR group and the control group In particular,the difference was statistically significant(p < 0.05).The longitudinal SI-DI and area SI-DI in the LVR group were significantly lower than those in the LVN group,and the difference was statistically significant(p<0.05).4、 The three-dimensional strain imaging diastolic index longitudinal SI-DI,circumferential SI-DI,area SI-DI,radial SI-DI and E/e’ were negatively correlated(r =-0.34,-0.2,-0.35,and-0.27,P <0.05),positively correlated with e’(r = 0.35,0.19,0.32,0.30,P < 0.05),and negatively correlated with left atrial volume index(r =-0.39,-0.26,-0.38,-0.41,P <0.05).Conclusion 3DE-STI can provide multiple sensitive quantitative indicators to reflect changes in left ventricular diastolic function,providing accurate,non-invasive and efficient detection methods for early detection of heart disease in patients with different left ventricular hypertension.3DE-STI has important clinical guiding significance for early intervention and treatment of patients with essential hypertension. |
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