Assessment Of Left Ventricular Systolic Function In Patients With Rheumatoid Arthritis By Speckle Tracking Imaging Technology

Objective:Two-dimensional speckle tracking imaging(STI)technology was used to quantitively analyze the global and regional systolic strain of left ventricular myocardium so as to analyze the application value of various strain parameters in assessing the cardiac function in patients with rheumatoid arthritis(RA).The purpose of this study was to detect systolic dysfunction early and provide effective imaging information for accurate diagnosis and treatment.Materials and methods:The study subjects were divided into two groups:59 patients with RA(RA group)and 40 healthy volunteers(control group).The RA group was divided into two subgroups:short disease duration subgroup(28 patients with disease duration≤5 years)and long disease duration subgroup(31 patients with disease duration>5 years).All groups underwent conventional echocardiography and quantitative STI analysis.Conventional echocardiography measured the parameters of left ventricular systolic function,including the end diastolic length(L),end diastolic volume(EDV),end systolic volume(ESV),stroke volume(SV),ejection fraction(EF)and fractional shortening(FS),while STI technology analyzed and measured left ventricular systolic global longitudinal peak strain(GLS),global circumferential peak strain(GCS),global radial peak strain(GRS),standard deviation of peak time of longitudinal strain(SD-LSPT)and standard deviation of peak time of circumferential strain(SD-CSPT).Compared the differences in routine cardiac function parameters and strain exercise parameters between the short duration subgroup,long duration subgroup and the control group,analyzed the influence of different durations on the cardiac function of RA patients,analyzed the correlation between GLS,GCS,GRS,SDLSPT,SD-CSPT and disease duration,erythrocyte sedimentation rate,C-reactive protein,rheumatoid factor.Results:1.Compared with the control group,the left ventricular L,ESV,EDV,SV,EF,FS in RA group showed no significant difference(P>0.05).2.Compared with values in the control group,the GLS,GCS and GRS values of the short duration subgroup decreased,showing statistically significant difference(P<0.05);the SD-LSPT and SD-CSPT values increased,but showing no statistically significant difference(P>0.05).3.Compared with values in the control group,the GLS,GCS and GRS values of the long duration subgroup decreased,showing statistically significant difference(P<0.05);the SD-LSPT and SD-CSPT values increased,showing statistically significant difference(P<0.05).4.Compared with values in the short duration subgroup,the GLS and GCS values of the long duration subgroup decreased,showing statistically significant difference(P<0.05);the SD-LSPT and SD-CSPT values increased,showing statistically significant difference(P<0.05).5.Compared with values in the control group,the longitudinal peak strain(LS)and circumferential peak strain(CS)values of multiple myocardial segments in the short duration subgroup and the long duration subgroup decreased.6.There were correlations between the SD-LSPT,SD-CSPT and the disease duration in the RA group,with correlation coefficients of 0.26 and 0.28 respectively(P<0.05).Conclusion:Left ventricular myocardium is damaged in RA patients,as a result,overall and segmental myocardial contractility is reduced and different myocardial segment movements are out of sync,which has a certain correlation with the disease duration.Conventional echocardiography cannot detect subclinical cardiac dysfunction in RA patients.As a contrast,STI technology can analyze myocardial multidirectional motion strain parameters to accurately evaluate the subclinical damage of cardiac function in RA patients,so as to provide effective imaging information for early accurate diagnosis and treatment.