The Assessment Of Left Ventricular Rotation And Contraction Before And After Valve Replacement For Patients With Giant Left Ventricle By 2-dimensional Speckle Tracking Echocardiography

Objective:To evaluate the feasibility of speckle tracking echocardiography(STE) in assessing the rotation and contraction before and after valve replacement for patients with giant left ventricle(LV)Methods:23 patients with giant LV who underwent valve replacement in our institute from October 2008 to January 2009 were examined by GE Vivid 7 echocardiography with M3S probe before and 10 days,3 months,and 6 months after the procedure. Another 12 normal subjects were introduced as controlled group.Regional myocardial peak systolic displacement,rotation,strain,and LV torsion were measured respectively from speckle tracking imaging(STI) by EchoPAC workshop. The speckle tracking and conventional echocardiographic results were compared between controlled group and patient group before and after the operation. Afterwards the difference in the assessment of the remission of the LV shape and function were analyzed for the patients with giant LV from valve replacement.Results:The segmental regional peak systolic rotation,displacement and strain as well as basal global rotation and peak systolic torsion of patients with giant LV were significantly impaired before valve replacement,(p < 0.05).The segmental regional peak systolic rotation,displacement and strain as well as apical global rotation and peak systolic torsion became further impaired shortly after the procedure,(p < 0.05). Several segmental STI variables of the patient group were improved to the controlled group 3 months to 6 months postoperatively.In comparison,the conventional echocardiographic indexes(LVEDD,LVESD,and LVEF) were improved to some extent, but were still significantly poorer than the controlled group during the same period of follow up. Conclusions:Valve replacement could improve the LV shape and function of the patients with giant LV during a short period of time.STE could both quantitatively measure LV regional and global myocardial contraction and torsion,and sensitively evaluate and demonstrate the improvement of LV motion postoperatively.It therefore provides important information of the efficacy of valve replacement.