Evaluation Of Left Ventricular Systolic Function In Patients With Dilated Cardiomyopathy By Real-time Three-dimensional Speckle Tracking Echocardiography

Objective:In this study, we attempt to evaluate the morphology and function also the longitudinal peak systolic strain(LS) of left ventricle(LV) in dilated cardiomyopathy(DCM) patients via 3-dimensional echocardiography and 3-dimensional Speckle Tracking echocardiography (3D-STE). In additional, the potential feasibility and diagnosis accuracy could be determined on the left ventricular systolic function by LS after left ventricular configuration changed. The new efficient diagnostic and therapy of DCM might thus be raised and developed.Material and Methods:A total of 30 DCM patients and 30 healthy men were available and consent to the DCM and control groups. The regular echocardiography and 3D-STI were preformed. The end-diastolic diameters(EDD), end-systolic diameters(ESD) and LV ejection fraction were measure in 2D-echocardiography. The left ventricle end-diastolic volume(EDV), left ventricle end-systolic volume(ESV), LV ejection fraction (LVEF) and left ventricle sphericity index(SPI) were determined in 3D-echocardiography. LS and Global peak longitudinal strain(GLS) were induced in a 17-segemet LV model. GLS-A4c、GLS-LAx、 GLS-A2c and GLS-Avg were measured. The correlation analyze were conducted between the LVEF and GLS-Avg and LVEF and SPI.Results:No statistical differences were found in the basic information(gander, age, body length, body weight, body surface area) of two groups. The significant difference were existed in EDD、ESD、LVEF、EDV、ESV、SPI of echocardiography of two groups(P<0.05).In control group, the LPSS were demonstrated an increasing tendency from basic to apex segment level; the largest value was found in apex segment while no difference existed in the same level of segments. In DCM group, LS were significant lower than control group(P<0.05). The GLS-A4c、 GLS-LAx、GLS-A2c and GLS-Avg of DMC group were significant lower than control group. The correlations of LVEF were draw positively in GLS-Avg and negatively in SPI.Conclusions:1. An increasing tendency from basic to apex segment level was defined in the LS of normal myocardium.2. From the 17 segment model, the level of LS and GLS of DMC groups were found significantly lower than control group, the decreasing activity in myocardium and dysfunction in LV were conducted.3. The Pearson’s correlation analyze provided the evidence of strong link existed in LVEF, GLS and SPI. The correlations among deformation, remodeling and total systolic function in DMC’s myocardium were indicated.4. The newly developed 3D-STE technique can estimate LV regional circumferential, longitudinal, and radial strain components with easy, fast, accurate and reliable data. This methodology could be applied clinically as a potential diagnosis tool to assess DMC.