Evaluation Of Left Ventricular Systolic Function Via Speckle Tracking Imaging In Children With Reverse-remodeled Dilated Cardiomyopathy

Objective:To provide effective and accurate basis for clinical treatment,the changes of left ventricular systolic function of children with left ventricular reverse-remodeled(LVRR)dilated cardiomyopathy(DCM)are evaluated by speckle tracking imaging.Methods:First,24 case patients with left ventricular reverse-remodeled DCM and48 healthy children subjects(control group)who underwent echocardiography during the period of 2015.8-2017.11 in Hunan Children Hospital were collected for the evaluation.The patients were divided into two groups named respectively pre-LVRR group and post-LVRR group and the normal children were categorized into control group 1 and control group 2 by the age,sex and body surface area.Left ventricular longitudinal strain(LS),Global longitudinal strain(GLS),Left ventricular circumferential strain(CS),Global circumferential strain(GCS)of all the children were measured by speckle tracking technology(STI)and were contrasted through statistics methods.The difference between the LVRR group and the normal control were recorded.Additionally,left ventricular end diastolic diameter(LVEDD)was measured in a parastemal long-axis view.Left ventricular ejection fraction(LVEF),Left ventricular end-diastolic volume(LVEDV),Left ventricular end-systolic volume(LVESV)were calculated via the biplane Simpson’s method and converted into Z score.Meanwhile,left ventricular end-systolic and end-diastolic spherical index(SI_S、SI_D)were calculated through routine echocardiography.The characteristics of indices were analyzed by statistical software.Results:(1)The Z scores of LVEDD,LVEDV,LVESV in pre-LVRR group and NT-proBNP、the modified ROSS scores in pre-LVRR group were higher than those in post-LVRR group.The Z scores of LVEF were lower than those of post-LVRR group,and the difference was statistically significant(P<0.01).The SI_S and SI_D in pre-LVRR group were lower than those in post-LVRR group and control group,and the difference was statistically significant(P<0.01).(2)All segments’ LS and CS of left ventricular in pre-LVRR group were considerably lower than control group 1,and the difference was statistically significant(P<0.001).The LS and CS of left ventricular in post-LVRR group were considerably higher than pre-LVRR group,the rate of improvement is 100%,and the difference was statistically significant(P<0.01).13 segments’ LS and 10segments’ CS in post-LVRR group were significantly lower than control group 2(P<0.05),except for 4 segments’ LS of basal anterior,basal inreroseptal,mid anterosrptal,apical anterior and 6 segments’ CS of basal anterolateral,basal inferolateral,basal inferoseptal,mid anterior,mid anterolateral,apical anterior(P>0.05).The recovery rate of LS and CS is 23.5%,37.5%respectively,unrestored rate was 76.5%,62.5%respectively.(3)The LS and CS at different levels of left ventricular changed regularly in the control group and the post-LVRR group,it goes up from basal segments to apical segments,and the difference was statistically significant(P<0.05).The LS and CS were irregular in pre-LVRR group.Different levels of LS,CS,GLS,GCS in the pre-LVRR group and the post-LVRR group were lower than control group 1 and control group 2 respectively,and the difference was statistically significant(P<0.001).The LS、CS、GLS、GCS in the post-LVRR group were higher than the pre-LVRR group,and the difference was statistically significant(P<0.001).Conclusions:The GLS,GCS and LS,CS were significantly improved in the DCM patient with LVRR,Some segments myocardial systolic function returned to normal,but some segments haven’t.STI can quantitative evaluate left ventricular global and regional myocardial function which can provide a reference value to assesse clinical efficacy.