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Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
Left ventricular longitudinal rotation changes in primary hypertension patients with normal left ventricular ejection
1Department of Echocardiography, ChangZhou No. 2 People's Hospital Affiliated to NanJing Medical University, ChangZhou, China.
Insights
Primary hypertension patients exhibit altered left ventricular longitudinal rotation, showing a shift towards clockwise rotation and impaired early systolic function. Two-dimensional speckle tracking imaging effectively detects these changes.
Area of Science:
- Cardiology
- Medical Imaging
Background:
- Primary hypertension (PH) can affect cardiac structure and function, even with normal ejection fraction.
- Left ventricular (LV) longitudinal rotation (LR) is a key indicator of myocardial mechanics.
Purpose of the Study:
- To assess LV longitudinal rotation (LR) in primary hypertension (PH) patients with normal LV ejection fraction.
- To evaluate the utility of 2D speckle tracking imaging (2D-STI) in detecting rotational changes.
Main Methods:
- Conventional echocardiography and 2D-STI were used in 61 healthy subjects and 64 PH patients.
- Peak radial strain, strain rate, and segmental/global LR were measured.
- Time delay between LV lateral wall and septum was analyzed.
Main Results:
- PH patients showed significantly lower peak radial strain rate in early diastole compared to controls.
- Significant differences in rotational degrees were observed in the middle/base lateral and apex/middle septum walls.
- Healthy subjects displayed counter-clockwise LR, while PH patients exhibited clockwise LR, irrespective of LV hypertrophy.
Conclusions:
- 2D-STI can accurately assess time delays and clockwise LR in PH patients.
- PH is associated with altered LV early systolic function, characterized by clockwise LR.
Abstract:
In order to assess the left ventricular (LV) longitudinal rotation (LR) in primary hypertension (PH) patients with a normal LV ejection fraction. Conventional echocardiography was performed in 61 healthy subjects and 64 PH patients. The apical four-chamber views in these patients were acquired by GE-Vivid7 or E9, then the peak radial strain in the systolic period and the strain rate in systole, in early and late diastolic periods, were measured. Segmental LR and global LR were assessed by using two-dimensional speckle tracking imaging (2D-STI). The peak radial strain rate in the early diastolic period in PH patients was significantly lower than that in healthy subjects. The rotational degrees of the middle and base lateral, the apex and the middle septum walls in PH patients were significantly different from those of the healthy subjects. The healthy subjects had prominent counter-clockwise LR (0.29°±2.86°) and the PH patients had prominent clockwise LR (-2.13°±2.93°) in non-LV wall hypertrophy and (-2.43°±2.66°) in LV wall hypertrophy. The time delay between the LV lateral wall and the septum wall in PH patients correlated to the peak LR. We concluded that 2D-STI can assess the time delay between the LV lateral wall and the septum wall to the peak LR and clockwise LR in patients with PH, and prove that PH patients have a clockwise LR. By this, we conclude that in PH patients, the LV early systolic function have changed.
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