Assessment Of Left Ventricular Area Strain By Three-dimensional Speckle Tracking Echocardiography In Patients With Hypertrophy Cardiomyopathy

Hypertrophic cardiomyopathy(HCM)is the most common genetic cardiomyopathy and transmits in an autosomal dominant inheritance pattern. The natural history is begin in the majority of patients and its prognosis uncertain,once the disease deterioration that can threaten life, moreover, adverse consequences,including sudden death, heart failure,and atrial fibrillation caused by embolic events,etc.Risk factors for sudden death which is mainly composed of cardiac arrest, sustained ventricular tachycardia,ventricular wall thickness≥30mm,Unexplained syncope,etc.While some of risk factors which need to be identified for clinical noninvasive aid:that changes in the movement of the heart endocardial area,as we all known traditional echocardiography have many limitations,it is difficult to find changes of heart function in time,in recent years,the development of three-dimensional speckle tracking imaging (3D-STE) of the left ventricular cavity can be obtained data in full-time three-dimensional volumetric,and the movement of the real-time tracking of myocardial spots, can evaluate endocardial’s area deformation,above all the assessment of left ventricular systolic function plays an important role in providing a more comprehensive clinical global left ventricular systolic dysfunction and local information.Objective:To assess the clinical value and early change of left ventricular area strain in HCM patients with normal left ventricular ejection fraction (LVEF) by3-dimension speckle tracking echocardiography (3D-STE). In order to find early changes of LV systolic function with HNCM, and decrease the rate of sudden cardiac death. Methods:Selected HNCM patients with normal left ventricular configuration of28cases,30cases of normal control group, the subjects left lateral position,calm breathing,simultaneously recorded ECG, Application Toshiba Artida Doppler ultrasonography, select PST-25SX probe trans thoracic acquisition apical four-chamber view,the whole volume of the left ventricle three-dimensional dynamic image storage,Get restructuring apical four-chamber apical and two-chamber and left ventricular fractional basal,intermediate,apical segment of dynamic images then image storage, application machine is equipped with a3D-STI analysis software for offline analysis of tracings success,the instrument automatically shows the left ventricular ejection fraction (LVEF), left ventricular end-systolic volume (LVESV),left ventricular end-diastolic volume (LVEDV),left ventricular16segments and the global area strain (GAS) and the corresponding curve mapResults:1HNCM group’s base level and intermediate levels and apex levels PAS lower than normal group,the difference between them have statistics significance (P<0.05).2HNCM Global AS significantly lower than the control group and the difference between the two groups was statistically significant (P<0.05).3HNCM group’s segments PAS in left ventricular systolic have significance,especially BA、ML、MA、MI、AA、AI、AL’s PAS,and the difference among them have statistics significance (P<0.05).4There is a good correlation between the Global AS and LVEF (r=0.832)Conclusion:3D-STE can effectively evaluate the peak area strain of HCM patients and evaluate the portion and overall segment of left ventricular,which provide a new method for the clinical evaluation of HCM patients left ventricular systolic function.