| ObjectiveThe adverse perinatal outcome of preeclampsia is multiple target organ dysfunction,left heart dysfunction in cardiovascular terms,and even left heart failure in severe pregnant women.In this study,three-dimensional speckle tracking imaging was used to determine myocardial function,and the factors affecting myocardial strain rate were analyzed and analyzed to explore the application value of three-dimensional speckle tracking imaging in the evaluation of myocardial function in patients with preeclampsia,providing a diagnosis and treatment basis for the clinical evaluation of myocardial function injury in patients with preeclampsia.MethodsFrom November 2019 to December 2020,132 pregnant women who underwent regular prenatal examination and inpatient delivery in the Outpatient Department of the Third Affiliated Hospital of Guangzhou Medical University and underwent echocardiography and three-dimensional speckle tracking imaging at the same time with complete general clinical data were collected,22 patients who did not meet the requirements were excluded,and a total of 110 patients were included in the study.They were divided into preeclampsia group(n = 71)and normal control group(n =39);they were divided into preeclampsia group(n = 38)with severe manifestations and preeclampsia group(n = 33)without severe manifestations,early-onset group(n= 34)and late-onset group(n = 37)according to different conditions of preeclampsia.Routine echocardiography was performed between 28 and 34 weeks,followed by speckle tracking imaging,and each parameter was recorded.The height,weight,blood pressure,number of pregnancies and other basic data,echocardiographic and speckle tracking imaging parameters of pregnant women in each group were compared,and the factors affecting myocardial strain rate were analyzed.To investigate the value of three-dimensional speckle tracking imaging in the evaluation of myocardial function in patients with preeclampsia.Results1.There was no significant difference in height,age,weight,parity,body surface area,pre-pregnancy body mass index,weight gain during pregnancy and heart rate between normal preeclampsia group and normal preeclampsia group(P > 0.05).There were significant differences in examination(37.79 ± 2.02 weeks vs 33.60 ± 4.26weeks),delivery(37.92 ± 2.11 weeks vs 33.62 ± 4.26 weeks)and pregnancy(3.23 ±1.77 times vs 2.56 ± 1.53 times)between normal preeclampsia group and normal preeclampsia group(P <0.05).There were significant differences in echocardiographic parameter parameters IVS(8.05 ± 1.27 mm vs 8.71 ± 1.33 mm),LVPW(8.11 ± 1.06 mm vs 8.79 ± 1.04 mm),E/a ′ value(1.21 ± 0.44 vs 0.86 ± 0.39),Tei index(0.51 ± 0.12 vs0.58 ± 0.13),AV(1.43 ± 0.23 m/s vs 1.35 ± 0.21 m/s),MVE(0.92 ± 0.24 m/s vs 0.80 ±0.19 m/s),and LVM(113.07 ± 31.88 g/m2 vs 125.26 ± 26.98 g/m2)between the two groups(P < 0.05).There were no significant differences in LVEDV,LVESV,LVEF,SV,LAd,RVd,LVEDD,LVESD,AV,RA supero-inferior diameter,MVE,and LVMI between the two groups(P > 0.05).There were significant differences in GLSg(-16.65± 2.72% vs-14.88 ± 2.91%),GLSA2C(-17.13 ± 2.64% vs-15.37 ± 3.14%),and GRSA(0.43 ± 0.11% vs 0.38 ± 0.11%)between the normal preeclampsia group(P <0.05).There was no significant difference in GLSA4 C,GLSA3C,GCSg,GRSM,GCSB,GRSg,GCSA,GRSB,and GCSM between the two groups(P > 0.05).2.There was no significant difference in height,age,weight,examination,pregnancy,parity,body surface area,body mass index,weight gain during pregnancy and heart rate between the preeclampsia group with severe manifestations and the preeclampsia group without severe manifestations(P>0.05).Among the echocardiographic parameter parameters: there were significant differences in E/a ′values(0.78 ± 0.36 vs 0.97 ± 0.40)and LVM(130.48 ± 28.77 g/m2 vs 119.08 ± 23.63g/m2)between the two groups(P < 0.05).There were no significant differences in LVEDV,LVESDV,SV,LVEF,LAd,RVd,LVEDD,LVESD,IVS,LVPW,Tei index,AV,MVA,MVE,LVMI,and RA supero-inferior diameter between the two groups(P > 0.05).There were significant differences in GLSg(-14.18 ± 2.8% vs-16.05 ±2.74%),GLSA4C(-15.02 ± 3.05% vs-17.68 ± 3.19%),GLSA3C(-12.54 ± 3.71%vs-14.01 ± 2.56%),GLSA2C(-14.76 ± 2.96% vs-16.61 ± 3.58%),GCSA(-18.46 ± 5.19% vs-22.94 ± 6.85%),and GRSA(0.36 ± 0.10% vs 0.42 ± 0.12%)between the two groups(P < 0.05).3.Comparison of early onset preeclampsia group and late onset preeclampsia group(29.87±3.31 weeks vs 36.77±1.73 weeks),delivery(31.97±3.77 weeks)Weeks vs 35.53±4.08 weeks),heart rate(79.94±12.24 beats per minute vs 86.27± 9.53 beats per minute)were significantly different(P<0.05),and there was no significant difference in height,weight,age,weight,pregnancy,parity,body surface area,body mass index,and weight gain during pregnancy between the two groups(P>0.05).There was no significant difference in echocardiographic parameters between the two groups referring to LVEDV,LVESDV,SV,LVEF,Tei index,LAd,RVd,IVS,LVEDD,LVESD,AV,MVE,MVA,LVM,LVMI,and RA supero-inferior diameter(P > 0.05).There was a significant difference in E/a values(0.82 ± 0.38 vs 0.90 ± 0.40)between the two groups(P < 0.05).There were significant differences in GLSg(-14.55 ± 3.22% vs-15.46 ± 2.53%),GLSA4C(-15.6 ± 3.52% vs-16.79 ± 3.14%),GLSA3C(-12.26 ± 3.51% vs-14.11±2.86%),GLSA2C(-15.24 ± 3.77% vs-15.9± 2.89%),GCSg(-18.58 ± 4.12% vs-20.19 ±3.96%),GCSA(-19.41 ± 6.01% vs-21.58 ± 6.62%),and GRSA(0.37 ± 0.11% vs 0.41 ± 0.11%)between the two groups(P < 0.05).There were significant differences in GCSB,GCSM,GCSM,GRSg,GRSB,and GRSM between the two groups(P < 0.05).4.Comparing the longitudinal strain rate line graphs of PE patients with different disease severity,the strain rate PE of the early-onset PE group with severe manifestations was mainly concentrated between-10% and-15%,and the strain rate PE of the late-onset PE group without severe manifestations was mainly concentrated between-15% and-20%.5.Pearson correlation analysis showed a correlation between GLS and systolic blood pressure,diastolic blood pressure,and LVPW(r =-0.303,-0.281,-0.031,-0.182,-0.160,respectively,P < 0.05 for systolic blood pressure,diastolic blood pressure,and LVPW).Using GLS as the dependent variable,further multiple linear regression analysis showed that systolic blood pressure,diastolic blood pressure,and LVPW had a significant effect on GLS reduction(β = 0.122,0 – 0.002,and 0.171,respectively,P= 0.003,0.012,and 0.026),with systolic blood pressure having the most significant effect on GLS reduction.Conclusion1.Compared with conventional echocardiography,STI technique can detect the decrease of regional myocardial strain rate.2,left ventricular myocardial strain rate has decreased and changed in preeclampsia patients with normal left ventricular systolic function.3,the more severe the impairment of myocardial strain rate in patients with preeclampsia with the aggravation of the disease.4.Longitudinal strain rate decreased earlier than radial strain rate and circumferential strain rate decreased in PE patients with impaired cardiac function.5.Systolic blood pressure,diastolic blood pressure and posterior wall thickness are the main influencing factors of myocardial strain rate. |
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