Evaluation of the effects of right ventricular pressure load on left ventricular myocardial mechanics in patients with chronic obstructive pulmonary disease by ultrasound speckle tracking imaging

OBJECTIVE: This paper aims to evaluate the effects of right ventricular pressure load on left ventricular myocardial mechanics in patients with chronic obstructive pulmonary disease (COPD) by ultrasound speckle tracking imaging.

PATIENTS AND METHODS: 119 patients with COPD and pulmonary hypertension (PH) were selected from December 2016 to March 2018 in Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University. 42 healthy subjects were selected as control group. According to the pulmonary arterial systolic pressure (PASP), 41 patients were classified into mild group, 47 in moderate group, and 31 cases in severe group. Echocardiography and STI were used to measure the indexes.

RESULTS: Compared with those in control group, EI and E/e of moderate group and severe group increased significantly (p<0.001). Compared with those in control group, parameters in moderate and severe groups significantly decreased (p<0.001), including early diastolic mitral annular velocity/late peak blood flow velocity (E/A), left ventricular end diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), PASP and left ventricular end-diastolic diameter (LVEDD), stroke volume (SV), left ventricular end-systolic diameter (LVESD), cardiac output (CO), peak rotation angle and peak time of in the basal and apical segments. Compared with those in control group, parameters in moderate group significantly decreased (p<0.001), including left ventricular strain parameters segmental systolic peak longitudinal strain (LS), circumferential strain (CS), and radial strain (RS). Compared with those in control group, parameters in mild group significantly decreased (p<0.001), including peak rotation angle of basal segment and apical segment of the left ventricle. Compared with those in moderate group, peak rotation angle and peak time of the whole basal segment and apical segment of severe group gradually decreased (p<0.001).

CONCLUSIONS: Left ventricular whole peak rotation angle can be used to sensitively evaluate the change of left ventricular myocardial mechanics function in PH patients, and can reflect changes of left ventricular myocardial mechanics function in patients with COPD when mild PH occurs.

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