Echocardiographic examination
Echocardiography was performed by using the Philips iE33 ultrasound
system (Philips, The Netherlands) and a 5 Mhz transducer. Conventional
echocardiography and STE were performed before and after treatment (4-6
weeks after-when acute phase reactants decrease). Systolic function was
assessed by M-mode derived FS and EF. Left ventricular EF
>54% and FS >28% were accepted as normal
left ventricular systolic function [11].
For STE, two-dimensional four-chamber images together with short-axis
mid-circumferential images of the left ventricle were obtained. Three
cardiac cycles were recorded as cine loop clips. Strain and strain rate
measurements were performed using the software package QLAB Advanced
Quantification Software (version 6.0, Philips, The Netherlands). Main
measures were left ventricular global longitudinal strain (LVGLS) and
left ventricular global longitudinal strain rate (LVGLSR), left
ventricular global circumferential strain (LVGCS) and left ventricular
global circumferential strain rate (LVGCSR), right ventricular global
longitudinal strain (RVGLS) and right ventricular global longitudinal
strain rate (RVGLSR). All the images were obtained in the left lateral
decubitus position under ECG monitoring. All echocardiographic
parameters were analyzed by one researcher at two different time points.