Early Changes Of Right Ventricular Function In Alcohol-induced Myocardial Damage By Two-dimensional Speckle Tracking Echocardiography And Real-time Three-dimensional Echocardiography

Objective:To characterize right ventricular function in alcohol-induced myocardial damage by two-dimensional speckle tracking echocardiography(2D-STE)and real-time three-dimensional echocardiography(RT-3DE).Methods:Ninety-two male asymptomatic alcoholics,42-65 years old,were examined between June 2013 and June 2015 and served as the experimental group.These patients were categorized into three groups according to the amount and duration of alcohol consumption: mild group(group B,n=30),more than 90 mg ethanol or 2-3 bottles of beer,3-5 days per week for 5-8 years;moderate group(group C,n=31),more than 90 mg ethanol or 2-3 bottles of beer,3-5 days per week for 9-20 years;and severe group(group D,n=31),more than 150 mg ethanol or 4 bottles of beer,6-7 days per week for 10 years or more,which met the standard for diagnosis of alcoholic cardiomyopathy(ACM).30 age-matched healthy males without drinking history were enrolled as control group(group A).The exclusion criteria included a history of congenital heart disease,hypertension,ischemic or vascular heart diseases,coronary heart disease,pulmonary hypertension,systemic and diabetes mellitus that could affect cardiac structure and function or using cardiac medications.Conventional echocardiography(2DE),2D-STE and RT-3DE parameters were obtained,including left ventricular ejection fraction(LVEF),right ventricular end-diastolic diameter(RVEDd),right ventricular end-diastolic area(RVEDA),end-systolic area(RVESA),the right ventricular fractional area change(RVFAC),right ventricular peak systolic longitudinal displacement(D),strain(S),systolic strain rate(SRs),early diastolic strain rate(SRe),late diastolic strain rate(SRa),right ventricular end-diastolic volume(RVEDV),end-systolic volume(RVESV),stroke volume(RVSV)and ejection fraction(RVEF).Results:1.2DE parameters:Compared with groups A,B and C,RVEDd,RVEDA and RVESA significantly increased in group D(all P<0.05).LVEF and RVFAC in group D significantly decreased(all P<0.05).2.2D-STE parameters:No difference of all measured variables was found between groups A and B(all P>0.05).In group C,the longitudinal SRe and SRa of the basal,mid,and apical segments of the RV free wall were significantly lower than those of groups A and B(all P<0.05).In group D,all the 2D-STE parameters were significantly lower than those of the other groups(all P<0.05).3.RT-3DE parameters:Compared with groups A,B and C,RVEDA and RVESA in group D were significantly higher and RVEF in group D significantly decreased(all P < 0.05).RVEDV and RVESV in group C were higher than those of groups A and B(all P<0.05).Whereas there was no significant difference of RVSV in four groups(all P>0.05).Conclusions:1.2D-STE provides an effective method to assess RV longitudinal function of patients in alcohol-induced myocardial damage.2.RT-3DE can accurately reflect RV systolic function of patients in alcohol-induced myocardial damage.