Research On The Applications Of Cardiovascular Function Evaluation For Patients With Leucocythemia By The Instantaneous Wave Intensity

Purpose:In this study, we aimed to investigate the clinic value of Wave Intensity(WI), a new way for clinical research in assessment of early myocardialdamage and cardiac artery adaptive function non-invasively, and to determinethe left ventricular function and specified artery elasticity condition in patientswith leukemia.Methods：Thirty patients (male17, female13) with leukemia before chemotherapyand thirty two health subjects (male18, female14) as control were included inthis study. Patients with severe anemia were excluded. Primary M-modeechocardiography (Prosoundα10, ALOKA Company, Japan) was performed inleft ventricular long axis view to assess left ventricular structure and systolicfunction. Echocardiographic parameters of diameter of left atrial (LA), leftventricular (LV) and right ventricular (LV), thickness of interventircularseptum (IVS) and left ventricular post wall (LVPW), fractional shortening (FS)and mean velocity of circumferential shortening (mvcF) were selected.Secondly, pulsed-wave Doppler was performed in the apical5-chamber view.Aortic peak velocity (Vmax), blood flow acceleration time (ACT), strokevolume (SV), cardiac output (CO), cardiac index (CI) and left ventricular ejectfraction (EF) were recorded. Thirdly, pulsed-wave Doppler was performed inthe apical4-chamber view to obtain peak E (early diastolic)(MVVE), peak A (late diastolic)(MVVA), mitral valve of flow acceleration time (EACT), mitralvalve of flow deceleration time (EDCT), mitral valve of flow decelerationvelocity(DCVE), and mitral valve of flow acceleration velocity(DCVE). Theabove parameters measured three times to take the average, store images andrecord data. Morphology and function of valves, myocardial and pericardialechogenicity, thickness, mobility, and pericardial effusion were recorded.Finally, right common carotid artery (RCCA) was selected for ultrasonicimaging to obtain WI indices, including amplitude of the peak during earlysystole (W1), amplitude of the peak during late systole (W2), area of thenegative wave during mid-systole (NA), arterial stiffness (β), pressure-strainelasticity coefficient (Ep), arterial compliance (AC), pulse wave velocity β(PWVβ). The correlation among these parameters was analyzed.Results:Heart rate was statistically significant higher in patients with leukemiacompared to normal subjects (P<0.05). There was no statistically significantdifference for age, systolic pressure (Ps), diastolic pressure (Pd) and meanblood pressure（Pmb）in patients with leukemia, as compared to normal subjects.Diameters of LA, RV, LV, and thickness of IVS and LVPW was statisticallysignificant higher in leukemia group compared to normal subjects (P<0.05). Nosignificance difference were found for ACT, Δ D%and mvcF betweenpatients with leukemia and normal subjects. There were statistically significantdifference for MVVA，ACVE and DCVE in patients with leukemia compared to normal subjects (P<0.05). For carotid WI, there were statistically significantdifference for W1, NA (P<0.05) and β、EP、PWVβ(P<0.01) in leukemiagroup compared to normal subjects. There were no statistically significance forW2、AC、AI、R-W1、W1-W2between patients with leukemia and normalsubjects.Conclusions：Wave intensity (WI) is a hemodynamic index, which can evaluate theworking condition of the heart interacting with the arterial system. The use ofWI in the leukemia patients has the potential to provide valuable insights intothe patient condition and to facilitate the development of novel monitorstrategies of heart functions.