Evaluation Of Left Ventricular Systolic Asynchrony Using Speckle Tracking Imaging In Patients With Congestive Severe Heart Failure

ObjectiveSpeckle Tracking Imaging(STI) can evaluate the myocardial dyssynchrony quickly,noninvansive,no angle,repeatability.Left ventricular(LV) myocardial asynchrony exitswidely in patients with Congestive Severe Heart Failure(CHF).It plays an importantclinical role in the diagnosis,treatment and judgment of prognosis that how to evaluateLV systolic asynchrony. This study was to assess LV movement between CHF groupand normal group using STI.The purpose of this study were:1. To evaluate thedifference of Ls and Rs between patients with CHF and normal people.To evaluatefurther LV systolic dyssynchrony in patients of CHF.To discuss the value of STIdiagnosing LV systolic asynchrony.2To study the correlation between left ventricularejection fraction(LVEF) and asynchrony index.MethodsThirty normal adults were included as the control group and thirty adults with CHF. Theimages were obtained from LV short-axis views and series long-axis views.Simpsonmethod was used to measure LVEF. Q-lab software was used to measure Peak systolic longitudinal strain,Peak systolic radial strain(LS,RS),it time to peak point from eachsegment(Tls,Trs) and the maximal temporal difference of Tls,Trs(Tls-diff、Trs-diff).Results1．Compared the control group and CHF group,there were significant differences inLVEDd,LVESd,LVEDL, LVESL,LVEF,FS (P<0.01),no differences in age,sex andHR(P＞0.05).2．In comparison with the control group,the LS and RS of each segment was decreasedin the CHF group (P<0.01).The GLS and GRS of each view of CHF group wasobviously lower than the control group （P<0.01）. Compared with the control group，the parameters of Tls/Trs in CHF group have obvious ahead or delayed(P <0.05).3．The number of segments with asynchrony detected by STI short-axis longer than thatby STI long-axis （P<0.01）.4.Compared with the control group,the parameters of Tls-diff/Trs-diff GLS-Avg,GRS-Avg,were significantly differences in CHF group （P<0.01）.Tls-diff and Trs-diffcorrrlated negatively to LVEF,GLS-Avg and GRS-Avg corrrlated positively to LVEF.Conclusion1.STI can accurately evaluate the LS and RS of the CHF patients, which provides aquantitative,simple,fast,accurate,repeatability and no angle method for measuring LVfunction for clinical.2.The LV longitudinal strain curve was consistent with radial strain curve in contronlgroup,there was no significant difference in Tls and Trs in contronl group,whichdemonstrated that there is a highly LV synchronicities in normal group.3.There exit the prevalence of systolic asynchrony in patients with CHF in both left ventricular long-axis and stort axis.4.STI can accurately assess LV systolic asynchrony in patients with CHF. STI short-axishas a predominate and pratical values in selecting pre-CRT patients.5. Asynchrony indexes are valid indexes in evaluateing LV systolic asynchrony of CHFpatients.There were significant correlation between asynchrony indexes and LVEF.