Abstract:

Objective To investigate the value of mitral annular displacement (MAD) by two-dimensional speckle tracking in evaluating left ventricular systolic dysfunction in patients with cardiac hypertrophy and remodeling. Methods Eighty-six patients with cardiac hypertrophy (left ventricular wall thickness ≥12 mm) and normal left ventricular ejection fraction (LVEF) (>50%) were selected. Philips Sonos iE33 ultrasound device was used for examinations. Relative wall thickness (RWT) was calculated by M mode ultrasound, and two-dimensional and real-time three-dimensional (RT3D) images were obtained at the apical four-chamber view. The related parameters of MAD (mitral annular middle displacement and left ventricular longitudinal fractional shortening) and LVEF measured by RT3D images (RT3D-LVEF) were obtained using on-line QLAB 6.2 software. Three dimensional myocardial remodeling parameters were calculated, including left ventricular end-diastolic volume index (LVEDVI) and left ventricular mass index (LVMI). Patients with cardiac hypertrophy, RWT＜0.45 and normal LVMI were classified into hypertrophic normal geometric group (HNG group), and the rest of patients were studied as hypertrophic remodeling group (HR group). Another 46 age-matched healthy volunteers were served as normal control group. Results RT3D-LVEF of HNG group, HR group and normal control group were normal, and there was no significant difference among groups (P＞0.05). MAD and LVEDVI in HR group were significantly lower than those in HNG group and normal control group (P＜0.01 or P＜0.05), while there was no significant difference in MAD and LVEDVI between HNG group and normal control group (P>0.05). Bland-Altman analysis indicated that MAD had a better repeatability. Conclusion MAD can evaluate left ventricular dysfunction earlier than LVEF in patients with cardiac hypertrophic and remodeling.

Key words: left ventricular hypertrophy, remodeling, mitral annular displacement, left ventricular systolic function