Assessment Of Left Ventricular Global Systolic Function And Systolic Synchronicity In Patients With Hypertrophic Cardiomyopathy By Real-time Three-dimensional Echocardiography

Objective To assess left ventricular global systolic function and systolic synchronicity in patients with hypertrophic cardiomyopathy by RT-3DE and 2D-STI,to explore the value of RT-3DE in evaluating the function of left ventricular in hypertrophic cardiomyopathy,to observe the correlation between RT-3DE and 2D-STI.Methods1.Subjects:38 patients with clinical and echocardiographic diagnosis of hypertrophic cardiomyopathy as HCM group,22 healthy volunteers as normal group.2.Equipments: GE Vivid E9 Demision ultrasound system(M5Sc ultrasonic probe of1.7~3.3MHz,4V ultrasonic probe of 1.7~3.3MHz)and Echo PAC work station.3.Measurement:All the subjects underwent conventional echocardiography,then imported 2D and 3D image to Echo PAC work station.Click “4D Auto LVQ” to measure left ventricular end-diastolic volume(LVEDV),left ventricular end systolic volume(LVESV),left ventricular ejection fraction(LVEF),left ventricular myocardial quality(LVM),global longitudinal strain(GLS),global radial strain(GRS),global circumferential strain(GCS)and global area strain(GAS).The body surface area was calculated to divide with LVEDV,LVESV,LVM to got left ventricular end diastolic volume index(LVEDVI),left ventricular end systolic volume index(LVESVI),left ventricular mass index(LVMI).Click “4D LV Volume” to measure systolic dyssynchrony index(SDI).Global longitudinal peak strain(GLPS),time to peak systolic longitudinal strain_Standard deviation(TTPSL_Stdev)were analyzed by using2D-SDI.The differences of results were compared between two groups,and correlation analysis was performed between SDI and TTPSL_Stdev,and between GLS and GLPS in two gruops.Finally,repeatability analysis of global strain in 2D and 3D.Results1.Compared HCM group and normal group of gender,age,heart rate,there were no significant differences(P>0.05).Compared with the normal group,LVEDV,LVESV in HCM group were all smaller than the normal group(P<0.01),LVM in HCM group were lager than the normal group(P<0.01),there were no significant differences in LVEF between two groups(P>0.05).2.Compared with the normal group,GLS,GRS and GAS in HCM gruops were less than the normal group(P<0.01),there were no significant differences between GCS(P>0.05);GLPS in HCM gruop were less than the normal group(P<0.01).3.Compared with the normal group,SDI and TTPSL_Stdev in HCM gruop were greater than the normal group(P<0.01).4.SDI were correlated to TTPSL_Stdev(r=0.57,P<0.01),GLS were correlated to GLPS(r=0.70,P<0.01).Conclusions1.Left ventricular global systolic function and systolic synchronicity in patients with HCM could be evaluated accurately and quantitatively by RT-3DE.2.SDI were correlated to TTPSL_Stdev,GLS were correlated to GLPS.