Assessment Of Left Ventricular Myocardial Function By Using Two-dimensional Speckle Tracking Echocardiography In Patients With Postmenopausal Osteoporosis

Objective: To evaluate left ventricular myocardial mechanical function of patients with postmenopausal osteoporosis(PMOP)by two-dimensional speckle tracking echocardiography(2D-STE)and provide valuable information for early and accurate clinical evaluation of cardiac function in PMOP patients.Methods: From September 2016 to March 2018,in the Affiliated Zhongshan Hospital of Dalian University,45 patients in osteoporosis department were selected as the PMOP group,while 42 outpatients health checkers were selected as the control group.Main detection contents: 1.conventional echocardiography:left ventricular end-diastolic diameter(LVEDD),left ventricular end-systole diameter(LVESD),interventricular septal thickness end-diastolic(IVSTd),left ventricular posterior wall thickness end-diastolic(LVPWTd),relative wall thickness(RWT)and left ventricular mass index(LVMI)were measured and calculated respectively.The left ventricular ejection fraction(LVEF)was measured and calculated by Simpson' s method on the apical four-chamber and two-chamber views.The peak early diastolic transmitral flow velocity(E),peak late diastolic transmitral flow velocity(A)were measured by pulsed Doppler,and E/A ratio was calculated.2.Two-dimensional speckle tracking echocardiography(2D-STE): peak value of myocardial strain and strain rate curve of each segment were measured respectively,and the contraction function parameters of each segment were recorded as follows: peak circumferential strain(CS),peak radial strain(RS),longitudinal longitudinal strain(LS),early diastolic peak circumferential strain rate(CSRe),late diastolic peak circumferential strain rate(CSRa),early diastolic peak radial strain rate(RSRe),late diastolic peak radial strain rate(RSRa),early diastolic peak longitudinal strain rate(LSRe),late diastolic peak longitudinal strain rate(LSRa).3.Bone mineral density(BMD)measurement: BMD at the lumbar spine(L1~L4)and femoral neck were measured using dual-energy X-ray absorptiometry.4.Serological laboratory examination indicators included total cholesterol,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol, triglyceride,estradiol,follicle-stimulating hormone.All items were compared between PMOP group and the control group.The correlation of 2D-STE indexes LS,LSRe,LSRa and BMD were analyzed by correlation test.Results: 1.Conventional echocardiography: LVEDD,LVESD,LVEF,LVMI and E/A ratio had no difference between two groups.IVSTd,LVPWTd were thicker and RWT was greater in PMOP group than those in control group(P<0.05).2.2D-STE parameters: Compared with the control group,the LSRe in each segment in PMOP group was decreased,LSRa was increased,the LS and CSRe in basal inferoseptal were decreased,and the CSRa was increased,the difference was statistically significant(P<0.05).3.Serological laboratory examination showed that estradiol in PMOP group was lower and follicle-stimulating hormone was higher than that in control group(P<0.05),while total cholesterol,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol,triglyceride had no difference.4.Correlation analysis,after removing the influence of estrogen,the LSRe,LSRa in each segment and the LS in basal inferoseptal in PMOP group had a good correlation with BMD,that is,with the decrease of BMD,the LSRe in basal,middle and apical segments and the LS in basal inferoseptal were positively correlated with T-Score(r=0.779,P=0.000;r=0.738,P=0.000;r=0.736,P=0.000;r=0.310,P=0.004),whereas the LSRa in basal,middle and apical segments were negatively correlated with T-Score(r=-0.390,P=0.000;r=-0.673,P=0.000;r=-0.524,P=0.000).Conclusion: 1.Left ventricular diastolic function of each segment and regional systolic dysfunction occur in PMOP patients when the global left venricular systolic function is still normal.2.2D-STE could evaluate left ventricular myocardial function of each segment in PMOP patients non-invasively and accurately,and LS,LSRe,LSRa are expected to be effective indexes for quantitative assessment of early cardiac dyfunction in patients with PMOP.