Evaluation Of Right Ventricular Function In Patients With Chronic Obstructive Pulmonary Disease By Strain Rate Imaging And Quantitative Tissue Velocity Imaging

ObjectiveTo evaluate right ventricular function in patients with chronic obstructive pulmonarydisease(COPD) by strain rate imaging(SRI) and quantitative tissue velocityimaging(QTVI).MethodsWe selected48COPD patients and20normal subjects for this study. The rightventricular frontal thickness(RVFT), right ventricular end diastolic diameter(RVEDd),innerdiameter of main pulmonary artery(MPA), back-flow capacity of tricuspid value and rightatrial size were measured by conventional ultrasound.According maximum back-flowvelocity of tricuspid value, while, refers back-flow capacity of tricuspid value and rightatrial size to divide the COPD patients into pulmonary artery hypertension group(groupPAH) and non-pulmonary artery hypertension group(group NPAH). The peak systolicvelocity of tricuspid value cingulum(Vs), peak early diastolic velocity(Ve), peak latediastolic velocity(Va) were measured by quantitative tissue velocity imaging, calculationslope of the ascending branch in isovolumic contraction period(IVA), Ve/Va and Tei indexof right ventricular. The peak systolic strain(Ss) and peak systolic strain rate(SRs), peakearly diastolic strain rate(SRe), peak late diastolic strain rate(SRa) were measured at eachsegment of right ventricular free walls by strain rate imaging. The differences amongdifferent groups were analyzed, the overall and local right ventricular function damageand the change of left ventricular ejection fraction in patients with COPD were analyzed.While, the value of evaluating right ventricular function in patients with chronicobstructive pulmonary disease by strain rate imaging and quantitative tissue velocityimaging were also analyzed. Results1. Comparison of generally clinical data between COPD patients and controlsCompared with controls，Heart rate and proporition of smokers significantly increasedin patients with COPD (P＜0.01).2. Comparison of conventional ultrasound measurement values between COPDpatients and controlsCompared with controls, RVFT, RVEDd and MPA significantly increased in groupPAH (P＜0.01), while there was no difference of right ventricular parameters betweenthe groups NPAH and controls. Ejection fraction of left ventricular showed no differencebetween all groups.3. Comparison of local right ventricular functionCompared with controls, Ss、SRs、SRe、SRa in each segment of right ventricular freewalls decreased in group NPAH (P＜0.05), while significantly decreased in group PAH(P＜0.01). Compared with group NPAH, Ss、SRe in each segment of right ventricularfree walls significantly decreased in group PAH (P＜0.01), while SRs、SRa decreased ingroup PAH (P＜0.05).4. Comparison of long-axis overall right ventricular functionCompared with controls, Vs、IVA、Ve、Ve/Va of tricuspid value cingulum decreasedin group NPAH (P＜0.05), while significantly decreased in group PAH (P＜0.01).Compared with group NPAH, Vs、Ve of tricuspid value cingulum decreased in group PAH(P＜0.05), while IVA、Ve/Va significantly decreased in group PAH (P＜0.01).5. Comparison of overall right ventricular functionCompared with controls, Tei index of right ventricular increased in group NPAH（P＜0.05）, while significantly increased in group PAH (P＜0.01).Compared with groupNPAH, this index significantly increased in group PAH (P＜0.05).Conclusion1. RVFT、RVEDd、MPA significantly increased in group PAH (P＜0.01). Thisresponded the reconstruction of right ventricle has occurred, while, the reconstruction ofright ventricle in the group NPAH has not occurred.2. The COPD patients whether or not accompanied by PAH, they local rightventricular systolic and diastolic function were all damaged, while, the group PAHdemages were heavier. 3. The COPD patients whether or not accompanied by PAH, long-axis overall rightventricular systolic and diastolic function were all damaged, while, the group PAHdemages were heavier.This research also show that IVA was more sensitive than Vs in theearly ventricular systolic function damage of the patients with COPD.4. The COPD patients whether or not accompanied by PAH, overall right ventricularfunction were all damaged, while, the group PAH demages were heavier.5. The COPD patients whether or not accompanied by PAH, their heart rate were allmore faster，but the ejection fraction of left ventricular has no significant change.