Evaluation Of Left Ventricular Function And Synchrony After Radiofrequency Ablation In Wolff-parkinson-white Syndrome Patients By Using 2D-STI

Objective:To evaluate left ventricular function and synchrony after radiofrequency ablation in Wolff-Parkinson-White syndrome patients by using 2D-STI.Methods:51 patients of Wolff-Parkinson-White syndrome（WPW）with supraventricular tachycardia who underwent radiofrequency ablation were included in this study as observed groups:Group A（WPW patients before radiofrequency ablation）and Group B（WPW patients 2 days after radiofrequency ablation）.51 healthy volunteers were included as controls with age and gender matched.Echocardiographic examinations were performed by using a GE Vivid E9 ultrasound system（GE,USA）.Subsequently the EchoPAC（V.113.O.X）analysis software was used to analyze left ventricular function and synchrony parameters.Results:（1）There was no significant difference in body mass index（BMI）,age,blood pressure and heart rate between the two observation groups and the control group（P>0.05）.There was no statistical difference at the incidence of hypertension,diabetes and dyslipidemia（P>0.05）.（2）Comparison of left ventricular volume:The mean values of LVEDV in Group A,Group B and control group were 98.6±23.7ml,90.5±15.3 ml and 83.4±17.6 ml,respectively;the average values of LVEDV were 45.5±14.9ml,38.6±11.2 ml and32.7±13.4 ml,respectively.The differences among each groups were statistically significant（P<0.05）.（3）Comparison of left Ventricular diastolic function index:compared with the control group,the E peak and A peak in Group A and Group B were much lower than those in the control group;the EDT was longer,the E/A ratio was lower and the ratio of E/E’was higher than that in the control group.There was significant difference between the observation groups and the controls（P<0.05）.（4）Comparison of left ventricular torsion parameters:There was no statistical difference for the mean value of TTPA and TTPLV between Group A,Group B and control group（P>0.05）.The parameters of Rot_A and TTP_B in Group A were significantly lower than those in the control group（P<0.05）,while,there was no statistical difference for those between Group A and Group B,as well as Group B and the control group（P>0.05）.The parameter of Twist_LV in Group A was significantly lower than that in Group B and the control group,and the RD_A-B was significantly higher than that in Group B and the control group（P<0.05）.（5）Comparison of left ventricular myocardial strain parameters:GLS of the left ventricular myocardium in Group A,Group B and control group were-17.2±1.0,-18.1±1.8 and-21.1±1.5,respectively.Obvioulsy,GLS in Group A was significantly lower than that in Group B（P<0.05）.（6）Comparison of Synchronization of the left ventricular myocardial motion:The mean IVMD of Group A,Group B and control group were 51.6±23.3 ms,16.5±16.8 ms and 7.1±4.5 ms,respectively.The average values of LV-SDt in the three groups were57.8±16.3 ms,39.2±9.8 ms and 32.8±13.6 ms,respectively.The IVMD and LV-SDt in Group A were significantly lower than those in Group B and the control group,moreover,those in Group B were significantly higher than those in the control group（P<0.05）.（7）Correlation analysis:Twist_LV was negatively correlated with LVEDV,LVESV and LVEF.Conversely,RDA-B was positively correlated with LVEDV and LVESV.Furthermore,GLS was negatively correlated with LVEDV,LVESV and LVEF,and the correlation coefficient r was statistically significant（P<0.05）.Conclusions:（1）Compared with the healthy controls,left ventricular end-diastolic volume,end-systolic volume increase and diastolic function decrease in WPW patients.In addition,the Twist_LV,Rot _A and Rot_B are significantly decreased,RD_A-B is delayed,and the interventricular and intraventricular movements are out of synchrony in WPW patients.（2）Radiofrequency ablation can effectively improve the torsion,myocardial longitudinal strain and synchrony of the left ventricular in WPW patients,but which could not return to normal levels.（3）2D-STI can be used to assess the efficiency of radiofrequency ablation for WPW.