Preliminary Study On Left Ventricular Systolic And Diastolic Function In Graves Disease By Two-dimensional Speckle Imaging

Objective:Two-dimensional speckle tracking echocardiography was used to study the changes of left ventricular diastolic and systolic function in Graves disease patients who were initially diagnosed as hyperthyroidism and subclinical hyperthyroidism.Methods: Based on the laboratory results,patients diagnosed with Graves’ disease in the First Affiliated Hospital of Wannan Medical college from March 2019 to March 2021 were divided into two groups: hyperthyroidism group and subclinical hyperthyroidism group,and 30 healthy subjects were selected as the control group.All three groups were examined by chest echocardiography.LVDd,LVSd,LVPWd,IVSd,LA were measured by two-dimensional echocardiography.LVEF was measured by Simpson’s method.E,A,e’,a’were measured by Doppler ultrasound.The E/A ratio,e ’/ a’ and IVRT were calculated.Then,strain values of left ventricle and left atrium were calculated by speckle-tracking technique of two-dimensional echocardiography.The left ventricular myocardium was divided into endocardial,medial and epicardial layers,and the total longitudinal peak strain and circumferential peak strain of each layer were recorded.Simultaneously record the three-layer myocardial LS in AP2,AP3,and AP4 views,and the three-layer myocardial CS in SAXM,SAXB and SAXA views;then statistical analysis of the strain value data obtained by the three groups of subjects.Results: Compared with the control group,in the subclinical hyperthyroidism group,two-dimensional conventional echocardiography and Doppler echocardiography showed no statistical difference in the selected conventional variables(P>0.05);while the hyperthyroidism group Although LVDd and LVDs increased compared with the control group,the difference did not reach a statistically significant value.IVRT and A in the hyperthyroidism group were higher than those in the control group and the subclinical hyperthyroidism group,and the differences in E/A,E ’,e ’/ a ’were statistically significant(P<0.05).The comparison of myocardial GLS and GCS in each slice of the subclinical hyperthyroidism group,the hyperthyroidism group and the control group showed that Endo-GLS,Mid-GLS and Mid-GCS of the subclinical hyperthyroidism group and the hyperthyroidism group were lower than those of the control group.Statistically significant(P<0.05).In the hyperthyroidism group,the three-layer myocardial GLS in each section was lower than that of the control group,and the difference was statistically significant(P<0.05),and the Mid-GLS and Mid-GCS in the hyperthyroidism group,And Epi-GCS were also lower than those in the subclinical hyperthyroidism group(P<0.05).Further found that hyperthyroidism group in AP2,AP3,AP4 view on three aspects of three layers of myocardial LS decreased than the control group,the difference was statistically significant(P<0.05),while in subclinical hyperthyroidism group,although no hyperthyroidism group change significantly,but can be found in the Epi,subclinical hyperthyroidism group AP2,AP3,AP4 three aspects of the LS reduced than the control group,the second AP2 Epi-LS and AP4 Epi-LS are relatively lower than control(P<0.05).In the hyperthyroidism group,except for SAXBMid-CS,the CS of the other layers was lower than that of the control group,the difference was statistically significant(P<0.05);although the circumferential peak strain of each slice in the subclinical hyperthyroidism group was also lower than that of the control group,But only in SAXMEndo-CS,SAXAEndo-CS,SAXMMid-CS,SAXAMid-CS,SAXBEpi-CS,the difference between CS and the control group was statistically significant(P<0.05).In the left atrial GLS comparison,the EDS of the subclinical hyperthyroidism group and the hyperthyroidism group was lower than that of the control group,and the EDS of the hyperthyroidism group was lower than that of the subclinical hyperthyroidism group.The difference was statistically significant(P<0.05).Conclusion:Two-dimensional ultrasound speckle tracking technique can be used for early detection of abnormal myocardial motion of left ventricle and left atrium in patients with Graves disease,and even for patients with subclinical hyperthyroidism,the decrease in strain value can be found,suggesting the left ventricle Myocardial systolic function and left atrial duct function are impaired;further through the stratified strain technology,it is found that especially in the endocardial layer,we are more likely to find the drop in the longitudinal peak strain value of the myocardium.When dealing with busy clinical work,The longitudinal peak strain value of the endocardial layer can be observed first to facilitate the investigation of myocardial damage in patients with Graves disease.