The Clinical Value of Three-dimensional Speckle Tracking Imaging and Pressure-strain Loop in Quantitative Evaluation of Left Ventricular Function in Patients with Hypertensive Disorder Complicating Pregnancy
Author:
Affiliation:
Beijing Tian Tan Hospital, Capital Medical University
Objective To investigate the clinical value of three-dimensional speckle tracking imaging(3D-STI)and pressure-strain loop(PSL) in quantitative evaluation of left ventricular myocardial function in patients with hypertensive disorder complicating pregnancy(HDCP).Methods Thirty-three patients with HDCP (HDCP group) and 32 normal pregnant women (control group) were selected. The general data of the two groups were collected. Left ventricular end-diastolic diameter(LVDd),left ventricular posterior wall thickness(LVPWTd),ventricular septal thickness(IVSTd),mitral flow velocity(E,A),mitral ring motion velocity(E ') and Tei index were obtained by conventional echocardiography and Doppler technology. Global longitudinal strain(GLS),global area strain(GAS),global lateral strain(GRS),global circumferential strain(GCS),left ventricular end-diastolic volume index(EDVI),left ventricular end-systolic volume index(ESVI),stroke volume index(SVI),ejection fraction(EF),cardiac output(CO) were obtained by 3D-STI.PSL was used to obtain left ventricular global work efficiency(GWE),global active work(GCW),global idle work(GWW),global work index(GWI),and the statistical differences of the above indexes between two groups were compared. Results ①Clinical data: the body surface area,systolic blood pressure and diastolic blood pressure in HDCP group were significantly higher than those in control group (all P < 0.05). ②Conventional echocardiographic parameters: IVSTd and LVPWTd in HDCP group were thicker than those in control group, E 'was lower than that in control group and Tei index was higher than that in control group,the differences were statistically significant (all P < 0.05). ③3D-STI parameters:GLS,GAS,GRS and GCS in HDCP group were lower than those in control group(all P < 0.05).There was no significant difference in EF between the two groups. ④PSL parameters:there was no significant difference in GWE,GCW,GWW and GWI between HDCP group and control group. Conclusion The left ventricular myocardial function of HDCP patients is reduced compared with normal pregnancy,but the left ventricular myocardial work of HDCP patients has no significant change after excluding the influence of afterload.3D-STI and PSL can accurately assess whether the myocardial function of HDCP patients is impaired,and provide help for clinical diagnose and treatment.