Evaluation Of Left Ventricular Two-dimensional Strain By Speckle Tracking Imaging In Patients With Rheumatoid Arthritis

Objective:To investigate the global and regional myocardial strain of left ventricular in patients withrheumatoid arthritis（RA）, and assess the function of left ventricular in RA patients withspeckle tracking imaging（STI）.Methods:65subjects were divided into two groups. Normal group consisted32cases and RA groupincluded33patients. All individuals underwent transthoracic conventional echocardiographicexamination firstly, and recorded the high frame rate two-dimensional echocardiography imagesfrom the left ventricular short-axis views at the levels of papillary muscle、mitral annulus、apexand the left ventricle apical long-axis view、four-chamber view，two-chamber view of everysubjects. Global peak systolic strain (GS) and global peak systolic strain rate (GSRs)、earlydiastolic global strain rate (GSRe)、advanced diastolic global strain rate (GSRa) of each view andevery segment of left ventricular peak systolic longitudinal strain、circumferential strain andradial strain measured by Echo-PAC. Then conduct comparision for all examination data.Results:（1） In left ventricle long-axis view: compared with normal group, GS、GSRs and GSRe werereduced, but the values of GSRa were higher in RA group, in some values, the differenceswere statistically significant（P<0.05）. Compared with normal group, the ratio betweenGSRe and GSRa in RA patients were reduced, however except two-chamber view, thedifferences were no significance（P>0.05）.（2） In the left ventricular short-axis views: at the levels of papillary muscle and mitralannulus, the ratio between GSRe and GSRa in RA patients were reduced when comparedwith normal group, there were statistically differences (P<0.05).（3） Except some segments of apex, the longitudinal strain peak were significantly reducedwhen compared with normal groups（P<0.05）.（4） Except the segment of ant-sept, the radial strain of every segment at the levels of mitral annulus were significantly reduced when compared with normal groups（P<0.05）；Therewas no significant difference in the peak systolic radial strain at the levels of papillarymuscle and apex between two groups（P>0.05）.（5） There was no significant difference in the peak systolic circumferential strain betweentwo groups（P>0.05）.Conclusions：The reduce of left ventricular global and regional strain can be detected by STI, it suggests theimpairment of cardiac function in RA. STI is a new method to diagnose cardiac impairment earlyin RA patients.