WANG Jian,YANG Menghui,SUN Lingyue, et al. Quantitative evaluation of myocardial work by ultrasonic pressure-strain loop in patients with pulmonary arterial hypertension[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2021, 51(11): 867-872, 880.
Abstract：Objective: To investigate the feasibility of pressure-strain loops (PSL) for quantitative assessment of left (LV) and right ventricular (RV) myocardial work in patients with pulmonary arterial hypertension (PAH).Methods: Forty patients with PAH were enrolled in outpatient as PAH group, and twenty healthy controls were recruited during the same period. Upper arm cuff pressure measurements and conventional transthoracic cardiac ultrasound were completed for all subjects, and myocardial work parameters of LV and RV were evaluated using PSL to obtain four main parameters, including global work efficiency (GWE), global work index (GWI), global constructive work (GCW) and global wasted work (GWW). The difference of myocardial work parameters between the two groups was compared, and further comparison was made between different myocardial work parameters under different cardiac function, with an analysis of the correlation between myocardial work parameters and conventional ultrasonic parameters. Results: Compared with control group, PAH group had increased LVGWW, RVGWI, RVGCW and RVGWW significantly (P<0.001). Moreover, LVGWE, LVGWI,LVGCW and RVGWE were significantly lower than those of control group (P<0.01). With the deterioration of cardiac function, LVGWE and LVGWI showed a significant decline, while LVGWW increased significantly. There was a significant correlation between RVGWW and cardiac function status, and RVGWE was significantly different between patients with WHO-FC I/II and III/IV. Correlation analysis showed that the majority of myocardial work parameters correlated well with conventional ultrasonic assessments (P<0.05). Conclusion: PSL can well quantify left and right cardiac function in patients with PAH, which provides a new basis for clinical management of patients.
