Assessment of right ventricular function by two-dimensional speckle tracking echocardiography in heart failure patients with different left ventricular diastolic dysfunction grade
10.3760/cma.j.cn131148-20200105-00011
- VernacularTitle:二维斑点追踪技术评价不同等级左心室舒张功能不全心力衰竭患者的右心室功能
- Author:
Xiuying LIU
1
;
Yang SUN
;
Haitao RAN
;
Zhigang WANG
Author Information
1. 重庆医科大学附属第二医院超声科 超声分子影像重庆市重点实验室 400010
- From:
Chinese Journal of Ultrasonography
2020;29(7):564-570
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the right ventricular(RV) function by two-dimensional speckle tracking echocardiography(2D-STE) in heart failure patients with different left ventricle diastolic dysfunction grade.Methods:Twenty-nine healthy volunteers(control group), sixteen heart failure patients with reduced ejection fraction(HFrEF group) and eighty-six heart failure patients with preserved ejection fraction(HFpEF group) were enrolled in the Second Affiliated Hospital of Chongqing Medical University from October 2018 to September 2019. HFpEF patients were further divided into four subgroups according to recommendations of the American Society of Echocardiography in 2016: normal left ventricular diastolic function group and left ventricular diastolic dysfunction groups with grade 1, 2, 3 (LVDD1, LVDD2, LVDD3). Conventional ultrasonic parameters were obtained in apical four-chamber images, including RV basal diameter(RVD1), RV middle diameter(RVD2) and RV longitudinal diameter(RVD3), RV end diastolic area(EDA), end systolic area(ESA) and fractional area change(FAC), peak systolic velocity(S′), myocardial performance index(MPI), tricuspid annular plane systolic excursion(TAPSE). 2D-STE was performed to observe strain parameters, including basal, middle, apical and the whole longitudinal peak systolic strain of RV free wall respectively (RVLSbas, RVLSmid, RVLSapi and RVLSfw). Then 2D strain parameters were compared among these groups, and the correlation between 2D strain parameters and conventional ultrasonic parameters were analyzed.Results:①TAPSE and S′ gradually decreased in normal group, HFpEF group and HFrEF group(all P<0.05). For the four subgroups of HFpEF, compared to LVDD3, TAPSE、S′ increased significantly in normal group, LVDD1 and LVDD2(all P<0.05). ②RVLSbas, RVLSmid, RVLSfw gradually increased in control group, HFpEF group and HFrEF group(all P<0.05). The same trend appeared in group LVDD1, LVDD2 and LVDD3(all P<0.05). ③In control group, HFpEF group and HFrEF group, RVLSfw showed strong correlation with LVEF( r=0.77, P<0.01) and middle correlation with age, TAPSE, and S′( r=0.41, -0.48, -0.40, P<0.01). In the subgroups of HFpEF, RVLSfw had middle correlation with LV diastolic function( r=0.59, P<0.01), and weak correlation with age( r=0.21, P<0.01), and the same correlations with B-type natriuretic peptide(BNP), FAC, TAPSE( r=0.28, -0.29, -0.29; all P<0.01). Conclusions:2D-STE can detect the early subtle impairment of RV systolic function in HFpEF patients.
