| Objective:To evaluate the changes of left ventricular shape and function in patients with gouty arthritis of different course by conventional echocardiography and two-dimensional speckle tracking imaging(2D-STI).Methods: 102 gout patients with preserved ejection fraction were divided into two groups according to the course of disease: group I(53 patients with course of disease<10 years)and group II(49 patients with course of disease ≥ 10 years),and 40 control groups.Record the general data of all subjects,including gender,age,height,weight,heart rate,etc.Conventional parameters measured by transthoracic echocardiography include LVEDD,LVESD,IVST,and LVPWT;LVEF and LVFS were measured by M-mode ultrasound;Left ventricular end diastolic volume(LVEDV)and left ventricular end systolic volume(LVESV)were obtained from apical four chamber and two chamber views.Left ventricular indexes were standardized by BSA to obtain left ventricular end diastolic volume index,left ventricular end systolic volume index and left ventricular mass index.The early diastolic peak blood flow velocity(E)and the late diastolic peak blood flow velocity(A)of the mitral valve orifice were measured by pulsed Doppler,and the E/A value was calculated;The mitral annular septal motion velocity(e ’)was measured by tissue Doppler imaging(TDI),and the E/e’value was calculated;The 2D-STI technique was used to obtain the left ventricular global longitudinal strain(LVGLS)and the longitudinal strain of four chamber,two chamber and three chamber sections(LVLS-AP4,AP2,AP3).Compare the differences of the above data between groups.Spearman or Pearson correlation was used to analyze whether the course of disease was related to LVGLS,serum uric acid and creatinine.Results:(1)There was no statistical difference in age,male proportion,height,weight,BSA and BMI among the three groups(all P>0.05);The serum uric acid level in gout group I and II was significantly higher than that in the control group(P<0.05),the creatinine level in gout group I andⅡwas significantly higher than in the control group(P<0.05),and there was no significant difference between gout group I and gout group II(P>0.05);(2)There was no significant difference in LVRWT among the three groups(P>0.05).Compared with the control group,the IVST,LVEDD,LVPWT,LVESD,LVM and LVMI of gout group I and gout group II were significantly increased(all P<0.05);and gout group I and group II showed no statistical difference(P>0.05);(3)There was no significant difference in LVEDV,LVEDVI,LVESV,LVESVI,LVEF,LVFS,E,A,E/A,e ’/a’ parameters among the groups(all P>0.05);The E/e ’ of group II was significantly higher than that of control group and group I,with significant difference(P<0.05);The e ’and a’ values in group II decreased significantl compared with group I and control group(both P<0.05);(4)Compared with the control group,the absolute values of LVLS-AP4,LVLS-AP2,LVLS-AP3 and LVGLS in group I decreased(all P<0.05).Compared with the control group and group I,the absolute values of LVLS-AP4,LVLS-AP2,LVLS-AP3,LVGLS and LAGLS in group II decreased significantly(both P<0.05);(5)Correlation analysis results: The duration of gout patients was negatively correlated with LVGLS(r=-0.717,P<0.05),but not with creatinine and serum uric acid levels(P>0.05).Conclusion: The left ventricular structure and function of gout patients with preserved ejection fraction changed;With the increase of the course of disease,the damage of left ventricular systolic function was aggravated.2D-STI technology combined with conventional echocardiography can be used to evaluate the changes of left ventricular function and configuration in gout patients. |
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