Abstract：
OBJECTIVE: Studies have shown that gout can increase the risk of cardiovascular disease. Three-dimensional speckle-tracking echocardiography (3D-STE), a sensitive imaging technology, enables the detection of subtle myocardial dysfunctions. Our aim is to evaluate the left ventricular (LV) functions in patients with gout using 3D-STE.
METHODS: 80 subjects: 40 with gout and 40 as normal controls were involved. We obtained and analyzed these parameters from the dynamic images of a 3D full-volume dataset: global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS), Twist, 16-segmental time-to-peak longitudinal strain (TTP) and systolic dyssynchrony index (SDI)besides other relevant parameters.
RESULTS: Compared with the normal group, gout patients were more likely to have left ventricular remodeling. The patients with gout showed decreased Em, increased E/Em and larger volume index of the left atrium (LAVI) indicating reduced diastolic function. The peak GLS (-17.42 ± 2.02 vs. -22.40 ± 2.57, P < 0.001), GCS (-27.04 ± 3.75 vs. -34.85 ± 4.99, P < 0.001), GRS (38.22 ± 4.28 vs. 46.15 ± 5.17, P < 0.001), and Twist (15.18 ± 5.45 vs. 19.02 ± 5.29, P = 0.015) were significantly lower in patients with gout than in healthy participants. The SDI (5.57 ± 1.46 vs. 4.91 ± 1.19, P = 0.016) was significantly increased in patients with gout compared with normal controls. There was no significant between-group difference in TTP (P = 0.43). The systolic GLS, GRS and GCS peak values increased gradually from the base to the apex, with the lowest values in the basal segment in patients with gout. Receiver-operating characteristic curve analysis revealed among these strains GLS has the largest area under the curve (AUC: 0.93, P < 0.001), the cutoff value of -18.97% with a sensitivity and specificity of 80.0% and 92.0%, respectively, for differentiating two groups. A multivariate linear regression analysis shows that the relationship between gout and strain parameters including GLS, GRS, and GCS is statistically significant (P < 0.001).
CONCLUSIONS: Although patients with gout having a normal ejection fraction, structural remodeling of the left ventricle and subclinical LV deformation may occur. 3D-STE can detect subtle cardiac dysfunctions in patients with gout at an early stage.
METHODS: 80 subjects: 40 with gout and 40 as normal controls were involved. We obtained and analyzed these parameters from the dynamic images of a 3D full-volume dataset: global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS), Twist, 16-segmental time-to-peak longitudinal strain (TTP) and systolic dyssynchrony index (SDI)besides other relevant parameters.
RESULTS: Compared with the normal group, gout patients were more likely to have left ventricular remodeling. The patients with gout showed decreased Em, increased E/Em and larger volume index of the left atrium (LAVI) indicating reduced diastolic function. The peak GLS (-17.42 ± 2.02 vs. -22.40 ± 2.57, P < 0.001), GCS (-27.04 ± 3.75 vs. -34.85 ± 4.99, P < 0.001), GRS (38.22 ± 4.28 vs. 46.15 ± 5.17, P < 0.001), and Twist (15.18 ± 5.45 vs. 19.02 ± 5.29, P = 0.015) were significantly lower in patients with gout than in healthy participants. The SDI (5.57 ± 1.46 vs. 4.91 ± 1.19, P = 0.016) was significantly increased in patients with gout compared with normal controls. There was no significant between-group difference in TTP (P = 0.43). The systolic GLS, GRS and GCS peak values increased gradually from the base to the apex, with the lowest values in the basal segment in patients with gout. Receiver-operating characteristic curve analysis revealed among these strains GLS has the largest area under the curve (AUC: 0.93, P < 0.001), the cutoff value of -18.97% with a sensitivity and specificity of 80.0% and 92.0%, respectively, for differentiating two groups. A multivariate linear regression analysis shows that the relationship between gout and strain parameters including GLS, GRS, and GCS is statistically significant (P < 0.001).
CONCLUSIONS: Although patients with gout having a normal ejection fraction, structural remodeling of the left ventricle and subclinical LV deformation may occur. 3D-STE can detect subtle cardiac dysfunctions in patients with gout at an early stage.
摘要：
目的：研究表明痛风可增加心血管疾病的风险。三维斑点追踪超声心动图(3D-STE),一种灵敏的成像技术,可以检测细微的心肌功能障碍。我们的目的是使用3D-STE评估痛风患者的左心室（LV）功能。
方法：80例受试者：痛风患者40例，正常对照组40例。我们从3D全体积数据集的动态图像中获得并分析了这些参数：全局纵向应变（GLS），全局周向应变(GCS)，全局径向应变(GRS),Twist,除其他相关参数外，16段峰值时间纵向应变（TTP）和收缩不同步指数（SDI）。
结果：与正常组相比，痛风患者更容易出现左心室重构。痛风患者表现为Em下降，E/Em增加和左心房体积指数（LAVI）增加，表明舒张功能降低。峰值GLS(-17.42±2.02vs.-22.40±2.57，P<0.001），GCS(-27.04±3.75vs.-34.85±4.99,P<0.001),GRS(38.22±4.28vs.46.15±5.17，P<0.001），和扭曲（15.18±5.45vs.痛风患者的19.02±5.29，P=0.015）明显低于健康参与者。SDI（5.57±1.46vs.与正常对照组相比，痛风患者的4.91±1.19，P=0.016）显着增加。TTP组间差异无统计学意义(P=0.43)。收缩期GLS,GRS和GCS峰值从基部到顶点逐渐增加，痛风患者基底段的最低值。受试者-工作特征曲线分析显示，在这些菌株中，GLS具有最大的曲线下面积（AUC：0.93，P<0.001），截断值为-18.97%，敏感性和特异性分别为80.0%和92.0%，分别,区分两组。多元线性回归分析表明,痛风与应变参数包括GLS,GRS,和GCS有统计学意义(P<0.001)。
结论：尽管痛风患者的射血分数正常，可能发生左心室结构重塑和亚临床左心室变形。3D-STE可以在早期检测痛风患者的细微心功能障碍。
方法：80例受试者：痛风患者40例，正常对照组40例。我们从3D全体积数据集的动态图像中获得并分析了这些参数：全局纵向应变（GLS），全局周向应变(GCS)，全局径向应变(GRS),Twist,除其他相关参数外，16段峰值时间纵向应变（TTP）和收缩不同步指数（SDI）。
结果：与正常组相比，痛风患者更容易出现左心室重构。痛风患者表现为Em下降，E/Em增加和左心房体积指数（LAVI）增加，表明舒张功能降低。峰值GLS(-17.42±2.02vs.-22.40±2.57，P<0.001），GCS(-27.04±3.75vs.-34.85±4.99,P<0.001),GRS(38.22±4.28vs.46.15±5.17，P<0.001），和扭曲（15.18±5.45vs.痛风患者的19.02±5.29，P=0.015）明显低于健康参与者。SDI（5.57±1.46vs.与正常对照组相比，痛风患者的4.91±1.19，P=0.016）显着增加。TTP组间差异无统计学意义(P=0.43)。收缩期GLS,GRS和GCS峰值从基部到顶点逐渐增加，痛风患者基底段的最低值。受试者-工作特征曲线分析显示，在这些菌株中，GLS具有最大的曲线下面积（AUC：0.93，P<0.001），截断值为-18.97%，敏感性和特异性分别为80.0%和92.0%，分别,区分两组。多元线性回归分析表明,痛风与应变参数包括GLS,GRS,和GCS有统计学意义(P<0.001)。
结论：尽管痛风患者的射血分数正常，可能发生左心室结构重塑和亚临床左心室变形。3D-STE可以在早期检测痛风患者的细微心功能障碍。
