An Evaluation Of Left Ventricular Systolic Function In Hyperthyroidism Patients With Different Heart Rate By Three-Dimensional Speckle Tracking Imaging

Objective The aim of this study was to investigate the different stage of left ventricular function in hyperthyroidism patients with different heart rate(HR) by 3D speckle tracking imaging(3DSTI), providing a more sensitive and objective detection methods for the evaluation of left ventricular function in the patients with hyperthyroidism.Methods Sixty cases of clinically diagnosed patients with hyperthyroidism were divided into two groups according to HR: the normal HR group including 40 cases with HR 60-100bpm(15 of male and 25 of female, the average age of 30.27±10.12) and the high HR group including 20 cases with HR>100bpm(6 of male and 14 of female, the average age of 30.15±9.12). 30 healthy volunteers were included(12 of male and 18 of female, the average age of 32.37±11.10)as reference. All subjects were examined by GE Vivid E9 color Doppler ultrasonic diagnosis apparatus. 3D-STI were recorded from left ventricular apical with four-chamber views to measure values of left ventricular end-diastolic volume(EDV), left ventricular end systolic volume(ESV), left ventricular ejection fraction(LVEF), left ventricular end diastolic mass(EDMASS), left ventricular end systolic mass(ESMASS), global longitudinal strain(GLS),global circumferential strain(GCS), global area strain(GAS), global radial strain(GRS) and the left ventricular segmental strain parameters longitudinal strain, radial strain, and circumferential strain, area strain(LS, RS and CS, AS).All the values were compared among the three groups,and the correlations between left ventricular each global strain values and left ventricular ejection fraction were analyzed in the two groups diagnosed with hyperthyroidism divided by HR.Results Compared with the control group, GLS, GCS, GAS and GRS in two hyperthyroidism groups showed a decreasing trend(P <0.05),while the left ventricular mass were higher(P <0.05), and LVEF had no significantly difference(P > 0.05) between the control group and hyperthyroidism group. Compared with the control group, the value of regional strain of high HR hyperthyroidism group decreased in 2-3 left ventricular segmental, while 4 segmental presented a decreasing trend in the value of strain of normal hyperthyroidism group. In the high HR group, GLS,GCS,GAS and GRS were correlated with LVEF significantly(r1=-0.431,P1=0.04; r2=-0.659, P2=0.004; r3=-0.608, P3=0.010; r4=0.741, P4=0.021)and as well as the normal HR group(r1=-0.506, P1=0.001; r2=-0.423, P2=0.010; r3=-0.406, P3=0.008; r4=0.442, P4=0.021).Conclusions1、The hyperthyroidism can lead to the declining of ventricular strain. The value of strains decreased more seriously in patients with normal heart rate.2、The value of regional strains in the patients with high HR declines locating in basal segments. However, the patients with normal HR declines locating in both the basal segments and apical segments.3、3D-STI can be used as a new method to evaluate the left ventricular function in the patients with hyperthyroidism.