Evaluation Of Left Ventricular Systolic Function In Patients With Chronic Moderate To Severe Aortic Regurgitation Using Layer-specific Myocardial Strain

Objective: The aim of the study was to reflect the damage to myocardium and evaluate left ventricular systolic function by the quantitative measurement of left ventricular myocardial layer-specific strain in patients with chronic moderate to severe aortic regurgitation.Method: Thirty patients with chronic moderate to severe aortic regurgitation were enrolled and divided into two groups according to LVEF: group A(LVEF>50%)and group B(LVEF<50%).Another twenty healthy volunteers with no difference in age and gender were selected as control group.The echocardiographic parameters of each group were measured,Echo PAC workstation was used to measure myocardial strain parameters and these parameters were used for statistical analysis:1 Conventional echocardiographic parameters: LVEDD,LVESD,LAESD,Ao S,AAO,LVOT,IVST,PWT,LVEDV,LVESV,LVEF,LVEDDI,LVESDI,LVEDVI,LVESVI,LVMI,VC,JW,PHT.2 Two-dimensional strain parameters2.1 Longitudinal strain parameters: GLSwhole,GLSendo,GLSmid,GLSepi,GLSr,and ?GLS and GLSendo/GLSepi were calculated.2.2 Circumferential strain parameters: GCSwhole,GCSendo,GCSmid,GCSepi,GCSr,and ?GCS and GCSendo/GCSepi were calculated.2.3 Radial strain parameters: GRS,GRSr.Results:1 Conventional echocardiographic parameters(1)LVEDD,LVESD,LVEDDI,LVESDI,LAESD,IVST,PWT,LVEDV,LVESV,LVEDVI,LVESVI,LVMI in group A were significantly increased compared with those in control group(P<0.01);and AAO was also increased(P<0.05);(2)LVEDD,LVESD,LVEDDI,LVESDI,LAESD,IVST,PWT,LVEDV,LVESV,LVEDVI,LVESVI,LVMI,AAO in group B were significantly increased and LVEF was significantly decreased compared with those in control group(P<0.01);and LVOT,Ao S were also increased(P<0.05);(3)LVEDD,LVESD,LVESDI,LVESV,LVESVI,LVOT,JW,PHT in group B were significantly increased LVEF and LVEF was significantly decreased compared with those in group A(P<0.01);and LAESD,LVEDV,LVEDVI,Ao S,AAO,JW/LVOT were also increased(P<0.05).2 Two-dimensional strain parameters2.1 Longitudi nal strain parameters(1)GLSwhole,GLSendo,GLSmid,GLSepi,?GLS,GLSendo/GLSepi in group A were significantly decreased compared with those in control group(P<0.01);and GLSr was also decreased(P<0.05);(2)GLSwhole,GLSendo,GLSmid,GLSepi,?GLS,GLSr in group B were significantly decreased compared with those in control group(P<0.01);and GLSendo/GLSepi were also decreased(P<0.05);(3)GLSendo and ?GLS in group B were decreased compared with those in group A(P<0.05).2.2 Circumferential strain parameters(1)Circumferential strain parameters were not significantly decreased compared with those in control group(P>0.05);(2)GCSwhole,GCSendo,GCSmid,?GCS,GCSr in group B were significantly decreased compared with those in control group(P<0.01);and GCSepi was also decreased(P<0.05);(3)GCSr in group B was significantly decreased compared with those in group A(P<0.01);and GCSwhole,GCSendo,?GCS were also decreased(P<0.05).2.3 Radial strain parameters(1)GRS in group B was decreased compared with those in control group(P<0.05);(2)The rest parameters in group A and B were not significantly decreased compared with those in control group(P>0.05);3 Whole and layer-specific longitudinal and circumferential strain parameters in AR patients were associated with LVEDD,LVEDV and LVEF,and correlation coefficient of GLSendo was slightly higher.Conclusion:1.Whole and layer-specific myocardial longitudinal strain parameters in AR patients with normal LVEF were decreased,GLSendo decreased more significantly,circumferential strain parameters still remained normal.2.Whole and layer-specific myocardial longitudinal strain parameters in AR patients with reduced LVEF were further decreased,circumferential strain parameters were also decreased,GLSendo and GCSendo decreased more significantly.