Evaluation Of Left Ventricular Systolic Function In Patients With Hypertensive Disorder Complicating Pregnancy By Two-dimensional Speckle Tracking Imaging

Objective: Using two-dimensional speckle tracking imaging technology to measure the Hypertensive disorder complicating pregnancy patients with left ventricular longitudinal strain, radial strain and circumferential strain value; To investigate the correlation between with left ventricular systolic longitudinal strain, radial strain, circumferential strain and left ventricular ejection fraction.Methods: The group normal controls consisted of 30 subjects; Selected 36 Patients with HDCP group consisted of gestational hypertension(6cases), preeclampsia-eclampsia(12cases), severe preeclampsia(18cases). All of subjects checked by two dimensional-speckle tracking imaging apical four chambers,three chambers,two chambers and left ventricular short axis of mitral annulus, papillary muscle and apical level to measure left ventricular left ventricular longitudinal strains(LS), radial strains(RS), and circumferential strains(CS);From the apical four chamber view:the image of mitral inflow was obtained and peak velocity of early filling(E), peak velocity of atrial filling(A), the ratio of E/A. M-mode tracings from the parasternal long-axis view were used to measure 1eft ventricular end-diastolic diameter(LVEDD) and interventricular septal end-diastolic dimension(IVSTd), and left ventricular posterior wall end-diastolic thickness(LVPWTd) LVEF was measure by simpson Single plane.Results:(1) Comparison of clinical data: There was no significanty difference in the age,height and weight between HDCP group and control group(all P>0.05); But the systolic pressure,diastolic pressure and protein/24 h in HDCP group were significantly higher than control group(all P<0.05).(2)Analysis of two dimensional ultrasound data: Compared among two groups: LVEF has no significantly difference(all P>0.05); There has significanty difference between two groups in interventricular septal end-diastolic dimension(IVSTd),left ventricular posterior wall end-diastolic thickness(LVPTWd),left ventricular end-diastolic diamete(LVEDd),left ventricular mass index(LVMI),left ventricular mass(LVM), peak velocity of atrial filling(A) were( all P<0.05),peak velocity of early filling(E) and the ratio of E/A(all P<0.05).(3)2D-STI data comparisons:Compared with control group, GLS, LS,CS, RS were significantly reduced in HDCP group( P<0.05 or P<0.01); and the value of LS were increased from the base to the apex no matter HDCP group or control group( P<0.05).while radial strain and circumferential strain were no significant differences of each segment( P>0.05).(4) Linear correlation analyses: Good correlation were noted between GLS and LVEF( r=-0.467, P<0.05).Conclusions: 2D-Speckle tracking imaging technique can early and sensitive to assess the left ventricular systolic function in patients with HDCP, and overcome the limitation of the traditional doppler technique of acoustic beam angle dependent and judgment to the patient as a whole and regional systolic function has important value. Provide a new noninvasive method for cardiac function of pregnant women for clinical evaluation.