Quantitative evaluation of right heart function in hyperthyroidism patients using real-time three-dimensional combined speckle tracking technology

YAN Tianhui; TANG Min; SU Chencheng; ZHANG Xia; SUN Hui

doi:10.12122/j.issn.1674-4500.2023.06.11

Abstract：Objective To explore real-time three-dimensional(RT-3DE)combined with speckle tracking technology(2D-STI)to quantitatively assess right heart function in patients with hyperthyroidism.Methods Eighty patients with hyperthyroidism were selected among the patients attending our hospital,of which 30 patients with pulmonary artery systolic pressure>35 mmHg were included in the hyperthyroidism pulmonary hypertension group,and the remaining 50 were included in the hyperthyroidism without pulmonary hypertension group,while 40 healthy people with physical examination in the same period were selected as the control group.Parameters were obtained by conventional ultrasound techniques:right ventricular basal segment,right ventricular mid-segment,right ventricular long-axis,right atrial upper and lower diameters,right atrial left and right diameters,right atrial systolic area,right ventricular field of change,tricuspid annulus systolic displacement,tricuspid annulus systolic peak lateral wall velocity,right ventricular myocardial work index,capillary wedge pressure,and parameters obtained by RT-3DE technique:right ventricular end-diastolic volume(RVEDV),right ventricular end-diastolic volume index(RVEDVi),right ventricular end-systolic volume(RVESV),right ventricular end-systolic volume index(RVESVi),right ventricular output(RVSV),right ventricular ejection fraction(RVEF),applying 2D-STI technique to obtain the parameters:right ventricular free wall longitudinal strain(GLS-FW),right ventricular global longitudinal strain(GLS),and comparing the differences in the above mentioned results.Pearson's analysis was performed to obtain the correlation between the parameters.Results In the comparison among the three groups,right ventricular basal segment,right ventricular mid-segment,right ventricular long-axis,right atrial upper and lower diameters,right atrial left and right diameters,right atrial systolic area,capillary wedge pressure,tricuspid annulus systolic displacement,tricuspid annulus systolic peak lateral wall velocity,and right ventricular myocardial work index increased in the control group,hyperthyroidism without pulmonary hypertension group,and hyperthyroidism with pulmonary hypertension group,and right ventricular field of change decreased in the control group,hyperthyroidism without pulmonary hypertension group and hyperthyroidism with pulmonary hypertension group(P<0.05).RVEDV,RVESV,RVEDVi,RVESVi,RVSV increased sequentially,and there was a statistically significant difference by pairwise comparison(P<0.05),but the difference was not statistically significant compared to the RVEF of the three groups(P>0.05).GLS-FW and GLS decreased sequentially in the control group,hyperthyroidism without pulmonary hypertension group and hyperthyroidism with pulmonary hypertension group,and there was a statistically significant difference by pairwise comparison(P<0.05).Correlation test analyses showed that RVEDV was positively correlated with RVESV and SV(r=0.534,0.760,P<0.01),and RVEDV was negatively correlated with GLS-FW and GLS(r=-0.915,-0.886,P<0.01).Conclusion The results of RT-3DE and 2D-STI parameters showed that patients with hyperthyroidism had increased volume load and decreased right heart function compared with the control group,and that the combination of both pathologies,pulmonary hypertension and hyperthyroidism,would lead to a further increase in volume load and a further decrease in right heart function.Therefore,RT-3DE combined with 2D-STI technology can accurately assess the status of right heart function,provide technical support for clinical assessment of patients conditions,and provide important theoretical support for further development of diagnostic and therapeutic programmes.