Abstract:

Objective To quantitatively evaluate the early injury in left ventricular myocardial strain in patients with postprandial hypotension (PPH) by using 2D speckle tracking imaging (2D-STI). Methods Twenty patients who were first diagnosed with PPH (PPH group) and 21 patients without PPH (NPPH group) were recruited. The global longitudinal strain (GLS), global radial strain (GRS), and global circumferential strain (GCS) of left ventricle were measured before and 1.5 h after meal with 2D-STI. Meanwhile, cardiac structure and function were evaluated by conventional method. Results There was no significant difference in heart structure evaluated by conventional method between two groups. Before meal, GLS in the PPH group was significantly lower as compared with the NPPH group (P=0.02), but there was no significant difference in GCS and GRS. GLS in the PPH group was significantly decreased 1.5 h after meal as compared with that before meal (P=0.045), whereas there was no significant change in the overall myocardial strain in the NPPH group after meal. Logistic regression analysis showed that GLS before meal (P=0.02,OR=0.46), and GLS (P=0.001, OR=0.27), GCS (P=0.008，OR=0.41), and GRS (P=0.004，OR=0.33) after meal were significantly correlated to PPH. The area under the ROC curve of GLS after meal (AUC=0.86, P=0.001） was significantly greater than 24 h average SBP (AUC=0.66, P=0.08) and LVEF (AUC=0.44, P=0.47). Conclusion PPH may result in occult cardiac function injury. STI is superior to conventional echocardiography in detecting the early injury in left ventricular myocardial function for patients with PPH.

Key words: postprandial hypotension（PPH）, 2-dimensional speckle tracking imaging (2D-STI）, cardiac function, myocardial strain