Assessment Of Early Changes Of Left Ventricular Rotation,Twist And Torsion In Childhood Simple Obesity With Three-dimensional Speckle

Objective:The aims of this study were to evaluate the change of left ventricular rotation and systolic function in childhood with simple obesity by three-dimensional speckle tracing imaging(3D-STI),and to analyze the value of 3D-STI in the evaluation of subclinical left ventricular dysfunction in childhood with simple obesity,for the sake of providing reliable basement for early clinical intervention of myocardial dysfunction in simple obese children.Methods:A prospective study was conducted in 103 healthy volunteers and 72 overweight children(overweight group)and 83 obese children(obese group)aged from 7 to 18 years old.The comparator groups were matched for age and sex.The data of interventricular septum end-diastolic dimension(IVSd),left ventricular posterior wall end-diastolic dimension(LVPWd),the left ventricular end-diastolic diameter(LVEDD),the left ventricular end-systolic diameter(LVESD)and ejection fraction of left ventricular(LVEF)acquired from traditional sections.Left ventricular volumetric parameters,strain and rotation parameters were acquired semiautomatically by imported the left ventricle full volume image into the Tom-tec workstation.Including left ventricular mass(LVM),left ventricular End-diastolic volume(LVEDV),end-systolic volume(LVESV),global longitudinal strain(GLS),global circumferential strain(GCS),global radial strain(GRS),apical rotation(RoA),basal rotation(Ro B),Twist,torsion,peak time of basal rotation(Pti-basal),peak time of apical rotation(Pti-apical),peak time of twist(Pti-twist)et al.To analyze and explore the difference of these index with control and experimental groups.Results:1?Compared with control group,obese group had significantly greater LVESD,LVESV,IVSd,LVPWd and LVM,with statistical difference(p<0.05).Compared with overweight group,obese group had significantly greater LVESD,IVSd,LVPWd,with statistical difference(p < 0.05).Compared with control group,overweight group had significantly greater LVM,with statistical difference((p<0.05).2?Comparing with control group and overweight group,GLS,GCS,GRS were lower in obese group,with statistical difference(p<0.05).Comparing with control group,GLS,GRS were lower in overweight group,with statistical difference(p <0.05).3?Comparing with control group,RoA,Twist were larger in overweight group and obesity group,with statistical difference(p<0.05).Comparing with overweight group,RoA was larger in obese group,with statistical difference(p<0.05).RoB,Ptibasal,Pti-apical,Pti-twist have no statistical difference between the three groups.Conclusion:1?Compared with control group,the simple obese children left ventricular size and geometry have changed,LV strain in overweight and obese children were lower and rotation,twist were compensatory increased in the early stag,Prompted that simple obese children with left ventricular systolic function have been the event of damage whereas LVEF were not significantly different.2?An increased twist is associated with left ventricular remodeling and it maybe the factor to remain normal ejection fraction of left ventricular.3?The change of LV rotation,twist about simple obesity children with normal LVEF can be detected by 3D-STI,3D-STI analysis can provide a richer amount of information compared with conventional echocardiography,and can quantify cardiac function accurately and comprehensively,.Left ventricular twist parameters can be used as a sensitive indicator of subclinical myocardial dysfunction.