Speckle Tracking Technique For Evaluation Of Ventricular Systolic Rotation And Deformation In Different-Origin Ventricular Premature Contraction

ObjectivePrevious studies have confirmed that premature ventricular contraction without structural heart disease could lead to ventricular enlargement,decreased cardiac function.Frequent premature ventricular contractions could lead to related cardiomyopathy,however,there is no reliable indicators for early assessment of the influence of different premature ventricular contraction in cardiac function.Left ventricular torsion and deformation considered as sensitive indicators of left ventricular function could detect early myocardial dysfunction.Therefore,this study aimed to apply STI technology to quantitatively analyze the myocardial motion of premature ventricular contraction,comparing sinus contraction,ventricular contraction and compensatory contraction from the patient's own different origin sites,to find the characteristics of myocardial deformation in different premature ventricular contraction.This study provided more relevant evidence for early identification,clinical treatnent and long-term follow-up.MethodsA total of 91 inpatients with premature ventricular contraction treated with radiofrequency ablation in our hospital were enrolled in this study from September 2016 to July 2017,including 28 males and 63 females.All patients were received successfully operation and identified as single-site premature ventricular contraction.The site of premature ventricular contraction is indicated by ablation site.All patients underwent echocardiography examination before operation.Two-dimensional dynamic image of apical left ventricular long axis view,four-chamber view,two-chamber view,left ventricular short-axis mitral valve and apical view reflected ventricular premature contraction,eompensatory interval,and sinus rhythm for 4 consecutive cardiac cycles,respectively.Parameters of pre-systolic,compensatory,and sinus rhythm were collected,including ? PW parameters of mitral valve:peak velocity of atrial systole(A Vel),E/A value;?PW doppler parameters of mitral annulus:early diastolic velocity of the mitral annulus(EmS),early diastolic velocity of the mitral annulus(EmL),E/e' ratio,tricuspid annulus systolic displacement(TAPSE)Left ventricular end-diastolic volume,end-systolic volume,and left ventricular ejection fraction(LVEF)were calculated by two-plane Simpson method.Three-dimensional ultrasound speckle tracking imaging technique was used to measure the parameters related to ventricular systolic rotation and deformation:left ventricular torsion angle peak,left ventricular bottom rotation angle peak,left ventricular apical rotation angle peak,and left ventricular bottom-apical rotation Peak time difference,left ventricular global longitudinal contraction peak strain,left ventricular global radial contraction peak strain,left ventricular global circumferential contraction peak strain,analyzing characteristics of ventricular systolic rotation and deformation from different sites of ventricular premature contraction,assessment of myocardial damage in different-originated premature ventricular contractions.Results1.In addition to the peak angle of left ventricular base rotation between the sinus and compensatory contraction(-5.36 ± 4.51 0 vs-5.40±458?,P=0.820),time intervals from left ventricular base to apical rotation peak among three different heart beats(0.4±20.3ms vs-9.5±95.2ms vs 3.1 ±22.0ms,P=0.142),radial peak strain of the left ventricular apical between sinus and ventricular contraction(18.6±11.1%vs 18.1±12.6%,P=0.777),the remaining STI parameters were statistically significant among the three types of heart contraction.2.In sinus contraction,there were statistically significant differences found in peak angle of rotation in the left ventricular apex,peak angle of the left ventricle,and radial peak strain of left ventricular apex among various origin sites(P=0.021,0.043,and<0.001,respectively).3.In ventricular contraction,there were statistically significant differences found in radial peak strain at base of the left ventricle,standard deviation of the left ventricular myocardial strain peak time,and longitudinal peak strain of the right ventricle among various origin sites(P<0.001,0.019,0.013,respectively).4.In compensatory contraction,there were statistically significant differences found in circumferential peak strain(mean)of the left ventricular base,circumferential peak strain of the left ventricular base(epithelium),and radial peak strain of the left ventricular apex among various origin sites(P=0.021,0.023,0.008,respectively).5.There was a strong positive correlation between cardiac interval and longitudinal peak strain(mean)of the left ventricle(r=0.732,P<0.001).Conclusion1.Compared with sinus contraction,the systolic function of left ventricular and right ventricle at ventricular premature contraction is worse,however,the systolic function of left ventricle and right ventricle of sinus contraction after compensatory interval is better than that of sinus contraction.2.The longitudinal peak strain of the left ventricle,the radial peak strain of the left ventricle base,the standard deviation of the left ventricular myocardial strain peak time,and the longitudinal peak strain of the right ventricle can be used as early sensitive indicators to evaluate the impairments of cardiac function in ventricular premature contraction.3.Three-dimensional speckle tracking imaging technology can be used to quantitatively analyze the myocardial movement of ventricular premature contraction,and early identify impaired myocardial function,which might provide the underlying evidence of clinical treatment and follow-up.