Evaluation Of Left Ventricular Systolic Function In Patients With Idiopathic Scoliosis By Speckle Tracking Imaging

Objective The purpose of this study is to analyze the longitudinal systolic strain of left ventricle and the myocardial strain of 17 segments of left ventricular wall in patients with idiopathic scoliosis by using two-dimensional speckle tracking imaging technology,and to explore the changes and characteristics of left ventricular function in patients with idiopathic scoliosis,so as to provide a basis for the prediction of the damage to cardiac function caused by the continuous progress of scoliosis.Methods From September 2017 to January 2020,45 patients with idiopathic scoliosis who were hospitalized in the Second Affiliated Hospital of our school for scoliosis correction(mainly thoracic scoliosis)were selected as the scoliosis group,with an average age of(12.8±4.2)years.The patients were divided into mild scoliosis group(Cobb angle < 70°)and severe scoliosis group(Cobb angle?70°),and the gender was selected 45 healthy subjects matched with patients in scoliosis group,excluding cardiovascular disease and spinal deformity as control group,with an average age of(13.4±3.2)years,and collected basic clinical data such as gender,age,Cobb angle,etc.GE logic was used in both groups The conventional echocardiographic parameters such as ejection fraction(LVEF),left ventricular end systolic diameter(LVESD)and left ventricular end diastolic diameter(LVEDD)were obtained by M-echocardiography.Two dimensional speckle tracking imaging was used to measure the longitudinal strain(LS)of 17 segments of left ventricular systolic period and the overall longitudinal mean peak strain(GLPS Avg)of left ventricular systolic period,and time-strain curve and "bull eye map" were generated.Compare the data of control group and scoliosis group;compare the data of control group,mild scoliosis group and severe scoliosis group;analyze the correlation between GLPS-Avg and Cobb angle of scoliosis group.Result 1.General data: there was no significant difference in gender and age between the scoliosis group and the control group,the mild scoliosis group and the severe scoliosis group(P > 0.05);2.Echocardiographic parameters: LVEF of control group,mild scoliosis group and severe scoliosis group are in normal range(50%-70%),with no significant difference(P>0.05);there was no significant difference in LVESD and LVEDD between the scoliosis group and the control group(P>0.05),there was no significant difference in LVESD and LVEDD between the mild scoliosis group and the severe scoliosis group(P>0.05),compared with the control group,the LVESD of the severe scoliosis group was significantly increased,and the difference was statistically significant(P < 0.05).3.Left ventricular systolic function parameters of 2D-STI: GLPS-Avg in scoliosis group was significantly lower than that in control group(P<0.05).GLPS-Avg in mild scoliosis group and control group had no significant difference(P>0.05).GLPS-Avg in severe scoliosis group was significantly lower than that in control group(P<0.05).The posterior wall of basal segment(POST),interval of basal segment(SEPT),anterior interval of basal segment(ANT-SEPT),anterior interval of middle segment(ANT-SEPT)and lateral wall of apical segment(LAT)LS in scoliosis group were lower than those in control group,the difference was statistically significant(P<0.05).Compared with the control group,the severe scoliosis group has lower basal segment posterior wall(POST),basal segment septum(SEPT),basal segment anterior septum(ANT-SEPT),basal segment inferior wall septum(INF),middle segment posterior wall(POST),middle segment anterior septum(ANT-SEPT),apical segment anterior wall(ANT)and apical segment lateral wall(LAT)LS,with statistically significant differences(P<0.05),with the basal segment as the focus.4.Correlation analysis: Cobb angle of scoliosis group was significantly positively correlated with GLPS-Avg(r = 0.77,P<0.05).Conclusion 1.Compared with conventional cardiac ultrasound,two-dimensional speckle tracking imaging can reflect the changes of left ventricular myocardial systolic function in patients with idiopathic scoliosis more early,sensitively and accurately.2.The change of thoracic cavity morphology in patients with idiopathic scoliosis leads to the decrease of the overall systolic function of left ventricular myocardium,and with the aggravation of scoliosis,the overall longitudinal systolic function of left ventricular myocardium in patients with idiopathic scoliosis decreases.3.The longitudinal contraction strain parameters of the basal and middle segments of the left ventricle can reflect early and sensitively the changes of left ventricular contraction function during the continuous progress of idiopathic scoliosis,which can provide basis for predicting the damage to cardiac function caused by the continuous progress of scoliosis.