Evaluation Of Left Ventricular Twist And Rotation In Patients With Chronic Heart Failure By Three-dimensional Ultrasound Speckle-tracking Imaging

Chronic heart failure is the last stage of sorts of heart diseases, whoseearly diagnosis is extremely important to clinic diagnose&treatment. Cardiactwist and rotation is the significant index when evaluating systole.Three-dimensional speckle tracking can probe the early changes of leftventricular twist and rotation of chronic heart failure patients.Objective: observe the motion feature of left ventricular rotation andtwist of CHF patients by means of ultrasound3D-STE, discuss its changes andapplication value, help to diagnose CHF in clinical treatments, remedy in timeto reduce the mortality.Methods: Twenty-nine CHF patients at appropriate age, there areeighteen males and eleven females among them; thirty-three healthy volunteers,there are twenty-three males and ten females among them. Under quietcondition, persons to be inspected take right lateral position, and they will bemeasured their left ventricular diameter and left ventricle thickness applyingconventional echocardiography. Then, we use PST-25SBT three-dimensionalmatrix probe to collect the motional images of heart apical four-chamber andtwo-chamber, acquiring three-dimensional full volume images and storing them.After that, we accommodate the lines by hand, which will be in keeping withendocardium and ventricular thickness; the instrument would calculate LeftVentricular Volumes at the End of Diastole (LVEDV), Left Ventricular Volumesat the End of Systole (LVESV), Left Ventricular Ejection Fraction (LVEF),peak basal rotation (Prot-B), peak apical rotation (Prot-A), Peak of Left Ventricular Apical segment Twist (Ptwi-A), Peak of Left Ventricular BasalSegment Twist (Ptwi-B), Peak of Left Ventricular Middle segment Twist(Ptwi-M), Peak of left Ventricular Global Twist(Ptwi-G) and peak twist angle(Prot-glo) automatically by3-DT procedure, meanwhile, it could display TimePtwi-B、 Time Ptwi-M、 Time Ptwi-A、 Time Ptwi-G. We can makecomparisons between CHF group and reference group on the aspects of indexdifferences.Results: LVESV and LVEDV of CHF patients are higher than that of thereference group（P<0.05）. The profile trend of Left ventricular rotation andtwist of CHF patients and its basic form are agreed with the normal group, butthe twist and rotation angle reduce obviously, in the level of tips and bottoms ofheart for significant. In the meantime, we could see the Time Ptwi-B、TimePtwi-M、Time Ptwi-A、 Time Ptwi-G extend. Left ventricle overall torsionand rotation angle lower obviously（P<0.05）.Conclusion: The function of left heart rotation and twist of CHF patientslessen clearly. Three-dimensional speckle tracking technology could acquirethe parameter of left heart rotation and twist to find the early cardiac musclechanges of chronic heart failure, providing a new tool for evaluation of leftventricular function. This method is convenient, noninvasive, and it could bespread broadly as a new type of technology in the clinical examination.