Clinical significane of two-dimensional speckle tracking technique in the evaluation of diagnosis and prognosis of heart failure with left ventricular ejection fraction preservation

中国基层医药 Pub Date : 2020-04-01 DOI:10.3760/CMA.J.ISSN.1008-6706.2020.07.011

Jianxiang Yang, Jingbin Yan, Jian-hua Zheng

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Abstract

Objective To observe the clinical effect of two-dimensional speckle tracking technique in diagnosis and prognosis evaluation of heart failure with left ventricular ejection fraction preservation. Methods A total of 64 heart failure patients with reduced left ventricular ejection fraction (HFNEF) and 64 healthy volunteers in the Integrated Traditional Chinese and Western Medicine Hospital of Wenzhou were selected from July 2016 to July 2018.Conventional echocardiography and two-dimensional speckle tracking were performed in all subjects.The hemodynamic parameters and strain parameters of two-dimensional speckle tracking were recorded.The differences of conventional echocardiographic parameters and two-dimensional speckle tracking strain parameters in different subjects were analyzed. Results The E/A (0.79±0.24) and E/E' value (18.93±3.41) in HFNEF patients had statistically significant differences compared with healthy subjects [(1.28±0.35) and (6.84±1.37)] (t=9.507, 23.294; P=0.000, 0.000). There were no statistically significant differences in HR, LAD, LVD, LVSD, LVPWD, LVEF and LVFS between HFNEF patients [(71.37±5.93)times/min, (35.32±4.37)mm, (47.13±5.01)mm, (9.24±1.76)mm, (9.35±1.82)mm, (63.98±5.37)%, (35.49±4.46)%] and healthy subjects [(70.14±5.28)times/min, (37.64±4.69)mm, (49.26±5.54)mm, (9.39±1.82)mm, (9.48±1.90)mm, (66.35±5.41)%, (34.02±4.17)%] (t=0.384-1.628; P=0.102-0.564). In HFNEF patients, the anterior septum, anterior wall, posterior wall, inferior wall and posterior wall of apical segment of left ventricle, the inferior wall and posterior wall of papillary muscle and the posterior wall, inferior wall and posterior wall of basal segment, SRs and ROT of left ventricle were significantly lower than those of healthy subjects, while GLS (-13.52±4.18) and GCS (-10.43±3.85) of left ventricle in HFNEF patients were significantly higher than those of healthy subjects [(-19.89±4.61) and (-15.67±4.24)] (t=8.947~14.063; P=0.000-0.000<0.05). After treatment, the clinical symptoms of HFNEF patients improved significantly in the whole apical segment of left ventricle, inferior and posterior wall of papillary muscle segment, posterior lateral wall, inferior wall, posterior wall SRs and left ventricular GLS, GCS and ROT (t=7.258-13.193; P=0.000-0.000<0.05). Two-dimensional strain GLS and GC values in HFNEF patients were negatively correlated with E/A values and positively correlated with E/E' value (r=-0.817, -0.763; P=0.004, 0.012<0.05), while two-dimensional strain ROT results were positively correlated with E/A values and negatively correlated with E/E' values (r=-0.805, -0.759; P=0.006, 0.014<0.05). Conclusion Left ventricular systolic function damage has occurred in HFNEF patients.Two-dimensional speckle tracking technique is highly sensitive to the changes of myocardial systolic function for HFNEF patients.It has high clinical value in the diagnosis and prognosis evaluation of HFNEF.Relevant clinical workers should pay attention to it. Key words: Two-dimensional speckle tracking technique; Echocardiography; Heart failure with left ventricular ejection fraction preservation; Relevance; Left ventricle; Myocardial dysfunction; Diagnosis; Prognostic evaluation

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二维散斑跟踪技术在左室射血分数保存型心力衰竭诊断及预后评价中的临床意义

目的观察二维散斑跟踪技术在保留左心室射血分数的心力衰竭诊断和预后评估中的临床效果。方法选择2016年7月至2018年7月在温州市中西医结合医院就诊的64例左心室射血分数降低的心力衰竭患者和64名健康志愿者，对所有受试者进行常规超声心动图和二维散斑跟踪。记录二维散斑跟踪的血流动力学参数和应变参数。分析不同受试者常规超声心动图参数和二维散斑追踪应变参数的差异。结果HFNEF患者的E/A（0.79±0.24）和E/E’值（18.93±3.41）与健康对照组相比有统计学意义[（1.28±0.35）和（6.84±1.37）]（t=9.507，23.294；P=0.000，0.000），HFNEF患者[（71.37±5.93）次/分，（35.32±4.37）mm，（47.13±5.01）mm，[（9.24±1.76）mm，/（9.35±1.82）mm，=（63.98±5.37）%，[（35.49±4.46）%]和健康受试者[（70.14±5.28）次/分钟，[（37.64±4.69）mm，]的LVEF和LVFS（t=0.38 4-1.628；P=0.102-0.564），左心室心尖段后壁、下壁和后壁、乳头肌下壁和前壁以及基底段后壁和下壁和后壁、左心室SRs和ROT均显著低于健康受试者，HFNEF患者左心室GLS（-13.52±4.18）和GCS（-10.43±3.85）显著高于健康对照组[（-19.89±4.61）和（-15.67±4.24）]（t=8.947~14.063；P=0.000-0.000<0.05），HFNEF患者的二维应变GLS和GC值与E/A值呈负相关，与E/E’值呈正相关（r=-0.817，-0.763；P=0.004，0.012<0.05），二维应变ROT结果与E/A值呈正相关，与E/E’值呈负相关（r=-0.805，-0.759；P=0.006，0.014<0.05）。二维散斑跟踪技术对HFNEF患者心肌收缩功能的变化高度敏感。它对HFNEF的诊断和预后评估具有较高的临床价值，相关临床工作者应予以重视；超声心动图；保留左心室射血分数的心力衰竭；相关性；左心室；心肌功能障碍；诊断；预后评估

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来源期刊

中国基层医药

CiteScore

0.10

自引率

0.00%

发文量

32251

期刊介绍： Since its inception, the journal "Chinese Primary Medicine" has adhered to the development strategy of "based in China, serving the grassroots, and facing the world" as its publishing concept, reporting a large amount of the latest medical information at home and abroad, prospering the academic field of primary medicine, and is praised by readers as a medical encyclopedia that updates knowledge. It is a core journal in China's medical and health field, and its influence index (CI) ranks Q2 in China's academic journals in 2022. It was included in the American Chemical Abstracts in 2008, the World Health Organization Western Pacific Regional Medical Index (WPRIM) in 2009, and the Japan Science and Technology Agency Database (JST) and Scopus Database in 2018, and was included in the Wanfang Data-China Digital Journal Group and the China Academic Journal Comprehensive Evaluation Database.