Clinical significane of two-dimensional speckle tracking technique in the evaluation of diagnosis and prognosis of heart failure with left ventricular ejection fraction preservation

Abstract

Objective To observe the clinical effect of two-dimensional speckle tracking technique in diagnosis and prognosis evaluation of heart failure with left ventricular ejection fraction preservation. Methods A total of 64 heart failure patients with reduced left ventricular ejection fraction (HFNEF) and 64 healthy volunteers in the Integrated Traditional Chinese and Western Medicine Hospital of Wenzhou were selected from July 2016 to July 2018.Conventional echocardiography and two-dimensional speckle tracking were performed in all subjects.The hemodynamic parameters and strain parameters of two-dimensional speckle tracking were recorded.The differences of conventional echocardiographic parameters and two-dimensional speckle tracking strain parameters in different subjects were analyzed. Results The E/A (0.79±0.24) and E/E' value (18.93±3.41) in HFNEF patients had statistically significant differences compared with healthy subjects [(1.28±0.35) and (6.84±1.37)] (t=9.507, 23.294; P=0.000, 0.000). There were no statistically significant differences in HR, LAD, LVD, LVSD, LVPWD, LVEF and LVFS between HFNEF patients [(71.37±5.93)times/min, (35.32±4.37)mm, (47.13±5.01)mm, (9.24±1.76)mm, (9.35±1.82)mm, (63.98±5.37)%, (35.49±4.46)%] and healthy subjects [(70.14±5.28)times/min, (37.64±4.69)mm, (49.26±5.54)mm, (9.39±1.82)mm, (9.48±1.90)mm, (66.35±5.41)%, (34.02±4.17)%] (t=0.384-1.628; P=0.102-0.564). In HFNEF patients, the anterior septum, anterior wall, posterior wall, inferior wall and posterior wall of apical segment of left ventricle, the inferior wall and posterior wall of papillary muscle and the posterior wall, inferior wall and posterior wall of basal segment, SRs and ROT of left ventricle were significantly lower than those of healthy subjects, while GLS (-13.52±4.18) and GCS (-10.43±3.85) of left ventricle in HFNEF patients were significantly higher than those of healthy subjects [(-19.89±4.61) and (-15.67±4.24)] (t=8.947~14.063; P=0.000-0.000<0.05). After treatment, the clinical symptoms of HFNEF patients improved significantly in the whole apical segment of left ventricle, inferior and posterior wall of papillary muscle segment, posterior lateral wall, inferior wall, posterior wall SRs and left ventricular GLS, GCS and ROT (t=7.258-13.193; P=0.000-0.000<0.05). Two-dimensional strain GLS and GC values in HFNEF patients were negatively correlated with E/A values and positively correlated with E/E' value (r=-0.817, -0.763; P=0.004, 0.012<0.05), while two-dimensional strain ROT results were positively correlated with E/A values and negatively correlated with E/E' values (r=-0.805, -0.759; P=0.006, 0.014<0.05). Conclusion Left ventricular systolic function damage has occurred in HFNEF patients.Two-dimensional speckle tracking technique is highly sensitive to the changes of myocardial systolic function for HFNEF patients.It has high clinical value in the diagnosis and prognosis evaluation of HFNEF.Relevant clinical workers should pay attention to it. Key words: Two-dimensional speckle tracking technique; Echocardiography; Heart failure with left ventricular ejection fraction preservation; Relevance; Left ventricle; Myocardial dysfunction; Diagnosis; Prognostic evaluation