Evaluation Of Left Ventricular Remodeling And Function In Patients With Bone And Joint Degeneration Using Real-time Three-Dimensional Echocardiography

ObjectiveTo assess left ventricular remodeling in patients with bone and joint degeneration using real-time three-dimensional echocardiography(RT-3DE)and study the clinical application value of the ultrasonic technique.Methods(1)One hundred and fifteen cases of healthy volunteers(normal control group)and one hundred and twenty-five patients with bone and joint degeneration(research group)were divided into two subgroups according to the age respectively.The body surface area(Body surface area,BSA)and body mass index(BMI)were recorded.(2)We used the S5-1 probe to obtain ventricular complex M image,and the measurement of interventricular septum thickness,posterior wall thickness and left ventricular end diastolic diameter of left ventricle,left ventricular volume and systolic function.According to the Devereux formula to calculate the left ventricular mass.(3)In the apical four chamber view,the application of Simpson“double plane method”measured left ventricular endocardial volume,left ventricular end diastolic epicardial volume(LVEDVepi)and systolic function,then calculating left ventricular mass(LVM=1.05 ×(LVEDVepi-LVEDV)),left ventricular remodeling index(LVRI=LVM/LVEDV).(4)The X5-1 probe was used to synchronize the ECG,and the full volume imaging mode was selected.Four consecutive cardiac cycle images were collected and stored for offline analysis.The left ventricular volume,systolic function and left ventricular mass were automatically obtained by software.Full-volume image data were acquired by RT-3DE underwent volume-time curve analysis,and calculating peak ejection rate(PER)?peak filling rate(PFR).The differences and correlations between groups and within each group were compared.Results1.(1)Correlation coefficients of the age and LVRI were0.711?0.568 in research group and normal control group respectively.(2)Correlation coefficients of the body mass index and LVRI were0.787?0.620 in research group normal and control group respectively.(3)Correlation coefficients of the duration of disease course and LVRI was 0.655.(4)Correlation coefficients of the age and PFR were 0.79?0.749 in research group and normal control group respectively.(5)Correlation coefficients of the body mass index and PFR were0.844?0.695 in research group and normal control group respectively.(6)Correlation coefficients of the duration of disease course and PFR was 0.661.The age and body mass index of research group showed higher correlation with LVRI and PFR than normal control group.There were good relativity between the duration of disease course and LVRI? PFR.With the extension of the disease course,LVRI increased and PFR decreased gradually.2.The LVMI and LVRI in research group were significantly higher than those in the normal control group with same age(F=14.517?4.318,P<0.05).3.The LVEDVI?LVESVI?LVEF and PER in normal control group and research group were no significant difference(F=2.156?2.150?2.070?1.775,P>0.05).4.Through correlation analysis,correlation coefficients of left ventricular remodeling by RT-3DE and M-mode echocardiography were 0.800(LVEDVI)?0.959(LVMI)and 0.934(LVRI)respectively.Correlation coefficients of left ventricular remodeling by RT-3DE and two-echocardiography were 0.837(LVEDVI)?0.970(LVMI)and 0.942(LVRI)respectively.RT-3DE showed higher correlation with two-dimensional echocardiography than M-mode echocardiography.5.The LVEDVI?LVMI and LVRI by RT-3DE and M-mode echocardiography were significant difference(t=15.024?3.126?11.376,P<0.05).The LVEDVI?LVMI and LVRI by RT-3DE and two-echocardiography were significant difference(t=12.805?3.862?5.861,P<0.05).6.The good agreement of measured LVRI by two-dimensional echocardiography and RT-3DE was superior to M-mode echocardiography and RT-3DE were found by the Bland-Altman consistency check.Conclusion1.The age,body mass index and the course of the disease in in patients with bone and joint degeneration is closely related to the occurrence and development with left ventricular remodeling.2.The patients with bone and joint degeneration have left ventricular remodeling.Left ventricular mass and left ventricular remodeling index were increased.Left ventricular diastolic function was decreased.3.Real time three-dimensional echocardiography provides a precise evaluation of left ventricular morphology relative to conventional two-dimensional ultrasound,and has better accuracy and reproducibility in evaluating left ventricular remodeling and function.4.Real time three-dimensional echocardiography measurements of LVRI?LVEF?PER and PFR can comprehensively assess left ventricular remodeling,systolic function and diastolic function of patients with osteoarthritis,then actively treat patients and improve their survival and quality of life.