Quantitative evaluation of early left ventricular function in patients with severe arterial pulmonary hypertension using non-invasive pressure strain loops
10.3760/cma.j.cn431274-20230320-00364
- VernacularTitle:应用无创性压力-应变环定量评价重度动脉性肺动脉高压患者早期左心室功能
- Author:
Linlin HE
1
;
Dexi FENG
Author Information
1. 内蒙古自治区人民医院超声医学科，呼和浩特 010000
- Keywords:
Echocardiography;
Pulmonary arterial hypertension;
Noninvasive pressure-strain loop;
Ventricular function
- From:
Journal of Chinese Physician
2023;25(12):1824-1828
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the feasibility of using left ventricular pressure-strain loop (PSL) to evaluate left ventricular myocardial work in patients with severe arterial pulmonary hypertension (sPAH) and to elucidate the interaction between left and right ventricles.Methods:A total of 30 sPAH patients (case group) and 30 healthy individuals (control group) who received medical examination at Inner Mongolia Autonomous Region People′s Hospital from November 2020 to April 2022 were selected. Routine echocardiography data were collected and left ventricular myocardial work analysis was performed. The parameters obtained included overall work index (GWI), overall useful work (GCW), overall useless work (GWW), and overall work efficiency (GWE). The differences in myocardial work parameters between the two groups were compared, and the correlation analysis between ventricular strain parameters and other conventional echocardiography parameters was performed.Results:(1) Compared with the control group, there was no statistically significant difference in general clinical data between the sPAH group except for pulmonary artery systolic pressure (PASP) (all P>0.05). (2) The parameters of right ventricular diameter (Rv-d)/left ventricular diameter (Lv-d), right ventricular wall thickness, right ventricular area change fraction (RVFAC), tricuspid annular displacement (TAPSE) in the sPAH group showed statistically significant differences compared to the control group ( t=21.305, 12.485, 12.359, 8.095, all P<0.05). The parameters of left ventricular conventional echocardiography, left ventricular end diastolic volume (LVEDV) The cardiac output (CO) was smaller than that of the control group ( t=4.443, 2.458, all P<0.05). (3) The overall left ventricular longitudinal strain (LVGLS) and right ventricular longitudinal strain (RVGLS) in the sPAH group were lower than those in the control group ( t=2.927, 22.350, all P<0.05). (4) The GWI, GCW, and GWE of the sPAH group were lower than those of the control group, while GWW was higher than that of the control group, with statistical significance ( t=8.297, 5.520, 15.251, 11.389, all P<0.05). (5) The left ventricular GWI, GCW, and GWE in the sPAH group were negatively correlated with LVGLS, RVGLS, and PASP (all P<0.01), and positively correlated with TASPE and RVFAC (all P<0.01); GWW was positively correlated with PASP, RVGLS, and LVGLS (all P<0.01), and negatively correlated with RVFAC and TAPSE (all P<0.01). Conclusions:PSL can accurately and sensitively reflect the relationship between early left ventricular function changes and left and right ventricular function in sPAH patients, providing a new reference for clinical evaluation of cardiac function.
