Evaluation of left ventricular myocardial systolic function in patients with premature ovarian insufficiency using real-time three-dimensional speckle tracking imaging

doi:10.3877/cma.j.issn.1672-6448.2021.06.009

Abstract

Abstract:

Objective

To quantitatively evaluate the changes of subclinical left ventricular myocardial systolic dysfunction in premature ovarian insufficiency (POI) women with normal left ventricular ejection fraction (LVEF) using real-time three-dimensional speckle tracking imaging (RT3D-STI).

Methods

Fifty-four women with normal LVEF diagnosed as having POI were employed as a POI group, and 42 healthy women with matched age, height, and body mass were enrolled as a control group. Both groups underwent conventional transthoracic echocardiography to obtain conventional left ventricular geometric and functional parameters, while RT3D-STI was performed to obtain the three-dimensional left ventricular myocardial systolic function parameters: Global longitudinal strain (GLS), global circumferential strain (GCS), global area strain (GAS), global radial strain (GRS), and three-dimensional left ventricular ejection fraction (3D-LVEF). The differences of the above parameters between the two groups were compared.

Results

The end-diastolic interventricular septal thickness in the POI group was significantly larger than that in the control group (P＜0.05). The values of E, E/A, and lateral e in the POI group were significantly lower than those in the control group (P＜0.01 or P＜0.05). The myocardial performance index in the POI group was significantly higher than that in the control group (P＜0.01). There was no significant difference in two-dimensional left ventricular ejection fraction (2D-LVEF) between the two groups (P＞0.05). The GLS, GCS, GAS, and GRS were significantly decreased in the POI group compared to the control group (P＜0.01), but there was no significant difference in 3D-LVEF between the two groups (P＞0.05).

Conclusion

The left ventricular myocardial systolic function might be impaired subclinically in POI women with normal LVEF. Compared with LVEF, three-dimensional strain parameters of RT3D-STI can be more sensitive to assess the subclinical changes of left ventricular myocardial systolic function for POI women, indicating that RT3D-STI could be used as a non-invasive method to evaluate the early impairment of left ventricular myocardial systolic function in POI women.

Key words: Echocardiography, Speckle tracking imaging, Premature ovarian insufficiency, Ventricular function, left, Myocardial contraction

Yulin Wang, Lixue Yin, Mei Li, Yue Wu, Zhiyu Guo. Evaluation of left ventricular myocardial systolic function in patients with premature ovarian insufficiency using real-time three-dimensional speckle tracking imaging[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2021, 18(06): 590-596.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2021.06.009

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Figures/Tables 7

组别	例数	年龄［岁，M（Q_R）］	BSA（m²， $x ¯$ ±s）	收缩压（mmHg， $x ¯$ ±s）	舒张压［mmHg，对照组M（Q_R），POI组 $x ¯$ ±s］	心率（次/min， $x ¯$ ±s）
对照组	42	35.00（8.00）	1.50±0.09	113.52±9.03	70.00（9.00）	72.24±8.96
POI组	54	37.00（8.00）	1.50±0.11	114.96±11.62	71.13±9.51	75.98±11.33
检验值		Z=-1.631	t=0.084	Z=-0.410	Z=-0.844	t=1.756
P值		0.103	0.933	0.682	0.399	0.082

组别	例数	年龄［岁，M（Q_R）］	BSA（m²， $x ¯$ ±s）	收缩压（mmHg， $x ¯$ ±s）	舒张压［mmHg，对照组M（Q_R），POI组 $x ¯$ ±s］	心率（次/min， $x ¯$ ±s）
对照组	42	35.00（8.00）	1.50±0.09	113.52±9.03	70.00（9.00）	72.24±8.96
POI组	54	37.00（8.00）	1.50±0.11	114.96±11.62	71.13±9.51	75.98±11.33
检验值		Z=-1.631	t=0.084	Z=-0.410	Z=-0.844	t=1.756
P值		0.103	0.933	0.682	0.399	0.082

组别	例数	LVPWT ［mm，对照组 $x ¯$ ±s，POI组M（Q_R）］	IVST［mm，M（Q_R）］	LVEDD（mm， $x ¯$ ±s）	LVM ［g，对照组M（Q_R），POI组 $x ¯$ ±s］	LVMI ［g/m²，对照组M（Q_R），POI组 $x ¯$ ±s］
对照组	42	7.41±1.20	8.00（1.00）	41.50±3.95	94.53（18.52）	62.25（10.94）
POI组	54	8.00（1.00）	8.50（2.00）	40.19±3.67	95.26±16.92	63.43±9.31
检验值		Z=-0.896	Z=-2.250	t=-1.677	Z=-0.458	Z=-0.665
P值		0.370	0.024	0.097	0.647	0.506

组别	例数	LVPWT ［mm，对照组 $x ¯$ ±s，POI组M（Q_R）］	IVST［mm，M（Q_R）］	LVEDD（mm， $x ¯$ ±s）	LVM ［g，对照组M（Q_R），POI组 $x ¯$ ±s］	LVMI ［g/m²，对照组M（Q_R），POI组 $x ¯$ ±s］
对照组	42	7.41±1.20	8.00（1.00）	41.50±3.95	94.53（18.52）	62.25（10.94）
POI组	54	8.00（1.00）	8.50（2.00）	40.19±3.67	95.26±16.92	63.43±9.31
检验值		Z=-0.896	Z=-2.250	t=-1.677	Z=-0.458	Z=-0.665
P值		0.370	0.024	0.097	0.647	0.506

组别	例数	E ［m/s，对照组 $x ¯$ ±s，POI组M（Q_R）］	A（m/s， $x ¯$ ±s）	E/A［M（Q_R）］	e_侧壁（m/s， $x ¯$ ±s）	e_间隔壁（m/s， $x ¯$ ±s）	平均E/e（m/s， $x ¯$ ±s）	2D-LVEF（%， $x ¯$ ±s）	MPI［对照组M（Q_R），POI组 $x ¯$ ±s］
对照组	42	0.93±0.16	0.60±0.15	1.55（0.58）	0.15±0.04	0.13±0.04	6.99±1.69	66.95±5.16	0.33（0.07）
POI组	54	0.80（0.14）	0.62±0.15	1.38（0.43）	0.14±0.02	0.11±0.02	6.43±1.67	64.94±6.22	0.38±0.08
检验值		Z=-3.699	t=0.554	Z=-2.009	Z=-2.648	Z=-1.266	Z=-0.698	t=-1.688	Z=-3.456
P值		0.000	0.581	0.045	0.008	0.206	0.485	0.095	0.001

组别	例数	E ［m/s，对照组 $x ¯$ ±s，POI组M（Q_R）］	A（m/s， $x ¯$ ±s）	E/A［M（Q_R）］	e_侧壁（m/s， $x ¯$ ±s）	e_间隔壁（m/s， $x ¯$ ±s）	平均E/e（m/s， $x ¯$ ±s）	2D-LVEF（%， $x ¯$ ±s）	MPI［对照组M（Q_R），POI组 $x ¯$ ±s］
对照组	42	0.93±0.16	0.60±0.15	1.55（0.58）	0.15±0.04	0.13±0.04	6.99±1.69	66.95±5.16	0.33（0.07）
POI组	54	0.80（0.14）	0.62±0.15	1.38（0.43）	0.14±0.02	0.11±0.02	6.43±1.67	64.94±6.22	0.38±0.08
检验值		Z=-3.699	t=0.554	Z=-2.009	Z=-2.648	Z=-1.266	Z=-0.698	t=-1.688	Z=-3.456
P值		0.000	0.581	0.045	0.008	0.206	0.485	0.095	0.001

组别	例数	GLS（%， $x ¯$ ±s）	GCS ［%，对照组M（Q_R），POI组 $x ¯$ ±s］	GAS（%， $x ¯$ ±s）	GRS［%，对照组 $x ¯$ ±s，POI组M（Q_R）］	3D-LVEF［%，对照组 $x ¯$ ±s，POI组M（Q_R）］
对照组	42	-21.68±2.51	-18.10（2.40）	-33.43±2.98	59.95±8.79	65.89±5.20
POI组	54	-18.05±2.86	-16.44±2.83	-28.74±4.03	51.85（14.70）	64.00（12.00）
检验值		t=6.511	Z=-2.789	Z=-5.418	Z=-4.649	Z=-1.535
P值		0.000	0.005	0.000	0.000	0.125

组别	例数	GLS（%， $x ¯$ ±s）	GCS ［%，对照组M（Q_R），POI组 $x ¯$ ±s］	GAS（%， $x ¯$ ±s）	GRS［%，对照组 $x ¯$ ±s，POI组M（Q_R）］	3D-LVEF［%，对照组 $x ¯$ ±s，POI组M（Q_R）］
对照组	42	-21.68±2.51	-18.10（2.40）	-33.43±2.98	59.95±8.79	65.89±5.20
POI组	54	-18.05±2.86	-16.44±2.83	-28.74±4.03	51.85（14.70）	64.00（12.00）
检验值		t=6.511	Z=-2.789	Z=-5.418	Z=-4.649	Z=-1.535
P值		0.000	0.005	0.000	0.000	0.125

应变参数	观察者间（n=10）		观察者内（n=10）
应变参数	Cronbach's α	ICC（P值）	Cronbach's α	ICC（P值）
GLS	0.916	0.858（0.001）	0.953	0.918（0.000）
GCS	0.881	0.804（0.002）	0.979	0.962（0.000）
GAS	0.954	0.920（0.000）	0.974	0.954（0.000）
GRS	0.952	0.917（0.000）	0.961	0.930（0.000）

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