Real-time Three-dimensional Echocardiography And Two-dimensional Strain Imaging In Evaluation On Left Ventricular Systolic Function In Alcohol-induced Myocardial Damage

Objective:To evaluate the effect of alcohol-induced myocardial damage on left ventricular by real time three dimensional echocardiography(RT-3DE) and two-dimensional imaging(2DSI).Methods:92 chronic alcohol abusers were divided into three groups:mild alcoholics (group A, n=30) more than 90g ethanol or (1000-1500ml) of beer daily for 5-8 years, 3-5 days per week; moderate alcoholics:(group B, n=30) more than 90g ethanol or (1000-1500ml) of beer daily for 9-20 years,3-5 days per week; severe alcoholics (group C, n=32) more than 150 g ethanol or more than 2000ml of beer daily for 10 years or more,6 to 7 days per week, and 40 healthy adults without drinking history were enrolled (group D). Exclusion criteria included a history of hypertension, diabetes, ischemic or vascular heart diseases, rhythm problems, systemic and metabolic diseases that could adversely affect the cardiac structure and function, or the use of cardiac medications. The parameters of the conventional echocardiography and RT-3DE and 2DSI were obtained respectively, including left ventricular end diastolic diameter(LVDd), left ventricular end systolic diameter(LVDs), interventricular septum thickness diastolic(IVSTd), left ventricular posterior wall thickness diastolic(PWTd) and E/A. Left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left ventricular ejection fraction (LVEF), left ventricular mass (LVM), left ventricular mass index (LVMI) and systolic dyssynchrony index(SDI) were measured by RT-3DE and two-dimensional echocardiography (2DE). The left ventricular short-axis views at the levels of mitral annulus and apex peak systolic rotation two-dimensional strain of left ventricular short-axis, and the peaks systolic torsion of left ventricular were measured by 2DSI.Results:1. Patient characteristics:No significant difference was observed among four groups regarding age, heart rate, blood pressure, body surface area (all P> 0.05).2.2DE and RT-3DE parameters:E/A in group B was decreased compared with control group and group A (both P<0.05). LVDd, LVDs, IVSTd, PWTd, and E/A in group C were larger than those of control group and group A and B(both P< 0.05).Compared with group D, the LVM and LVMI of group A increased significantly (all P<0.05). LVEDV, LVESV, LVEF and SDI showed no significant difference (all P> 0.05). Compared with group D, the LVM, LVMI, LVEDV and LVESV of group B increased significantly (all P<0.05), LVEF and SDI showed no significant difference (all P>0.05). Compared with group D, the LVM, LVMI, LVEDV and LVESV of group C increased significantly (all P<0.05), LVEF and SDI lowered down significantly (all P<0.05).3.2DSI parameters:Comparison of the left ventricular short-axis views at the levels of mitral annulus and apex peak systolic rotation two-dimensional strain of left ventricular short-axis, and the peaks systolic torsion of left ventricular:Comparison between groups A and D has no significantly difference (all P>0.05). Comparison between group B and group D, group A has no significantly difference (all P>0.05). Compared with group D, group A and group B, parameters in all section group C lowered down remarkably (all P<0.05).Conclusion:1.RT-3DE is able to reflect left ventricular dysfunction and asynchrony in alcohol-induced myocardial damage.2.2DSI can effectively assess the change of left ventricular peak systolic rotation and torsion of alcohol-induced myocardial damage.