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| Twist parameter of left ventricular assessed by speckle tracking imaging in heart failure patients with preserved ejection fraction |
| ZHANG Yi, LI Shen-yi, CHEN Hong-tian, LONG Xiang-dang, XIE Juan-juan, WU Yuan |
| Department of Ultrasonography, the People’s Hospital of Hunan Province, Changsha 410005, China) |
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Abstract Objective: To evaluate the twist parameters of left ventricular(LV) in heart failure patients with preserved ejection fraction(HFpEF) by speckle tracking imaging(STI), and to analyze whether the twist parameters have clinical value in assessing the changes of LV myocardiac mechanics in HFpEF. Methods: 63 HFpEF patients were analyzed the following twist parameters by STI: peak apical rotation(Par), Peak basal rotation(Pbr), Peak LV twist(Ptw), peak twist velocity(PtwV), percent time to peak twist(TPK%), peak untwisting velocity(PutwV) and isovolumic untwisting%(Iutw%). The correlation between twist parameters and conventional echocardiography parameters were also analyzed. Conventional echocardiography parameters includes LV End-diastolic diameter(LVDD), LV posterior wall(LVPW), interventricular septum(IVS), ejection fraction(EF), left atrial volume index(LAVI), peak of early diastolic mitral flow velocity(E), ratio of peak early diastolic and peak late diastolic mitral flow velocity(E/A), ratio of peak of early diastolic mitral flow velocity and early diastolic septal annular velocity(Ｅ/e＇). 40 healthy volunteers were included as the control group. Results: LVDD and EF of HFpEF group were within the normal limits (P＞0.05), but LVPW, IVS, LAVI, E, E/A, Ｅ/e＇ were all significantly different from the controls(P＜0.05). The twist parameters show that systolic Par and diastolic PutwV and Iutw% were significantly lower in HFpEF group(P＜0.05). Although Pbr, Ptw, PtwV, TPK% were decreased slightly, there is no significant difference compared with the controls(P＞0.05). There were significant positive correlation between PutwV and E/A, Ｅ/e＇, as well as Iutw% and E/A, Ｅ/e＇. There was a significant negative correlation between LAVI and PutwV, Iutw%. Conclusions: The changes of diastolic untwist parameters measured by STI can provide information about LV myocardiac function in HFpEF patients to help clinical diagnosis and treatment. Reduced Par in HFpEF patients can sensitively reflect myocardiac dysfunction, denoting some degree of subclinical systolic dysfunction in these patients.
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Received: 28 July 2017
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2018, Vol. 29 
