ObjectiveTo evaluate the changes of left ventricular systolic synchronization in patients with rheumatoid arthritis（RA）in different course by two-dimensional speckle tracking imaging（2 D-STI）and real-time three-dimensional echocardiography（RT-3 DE）

and to compare the differences between the two methods in evaluating left ventricular systolic synchronization.Methods A total of 90 RA patients in our hospital were selected.According to the course of disease

RA patients were divided into three groups（A

B and C）

according to 1～5 years

5～10 years and more than 10 years

with 30 patients in each group.Another 30 healthy volunteers of the same period were selected as the control group.Conventional echocardiography

2 D-STI and RT-3 DE were performed in all subjects.The left ventricular global longitudinal strain（LVGLS）

left ventricular global circumferential strain（LVGCS）

left ventricular longitudinal strain and circumferential strain reaching peak time standard deviation（Tls-SD

Tcs-SD）were obtained by 2 D-STI.The synchronization parameters were obtained by RT-3 DE

such as left ventricular 16-segment standard deviation（Tmsv-16-SD）and maximum time difference（Tmsv-16-Dif）

the percentage of standard deviation（Tmsv-16-SD%）and the percentage of maximum difference（Tmsv-16-Dif%）of the time for the 16 segments of the left ventricle to reach the minimum systolic volume after R-R interval correction.The differences of the above parameters in each group were compared

the correlation analysis of Tls-SD and Tcs-SD with Tmsv-16-SD and Tmsv-16-Dif were carried out and the repeatability tests were performed for Tls-SD

Tcs-SD

Tmsv-16-SD

Tmsv-16-Dif

Tmsv-16-SD% and Tmsv-16-Dif%.Results Pair-wise comparison among group A

group B and group C showed that with course of disease increased

the LVGLS gradually decreased

while Tcs-SD and Tls-SD gradually extended

with statistically significant difference（all P<0.05）.Compared with the control group

Tmsv-16-SD

Tmsv-16-Dif

Tmsv-16-SD% and Tmsv-16-Dif% in group A

B and C were gradually extended

and the differences were statistically significant（all P<0.05）.Tls-SD was positively correlated with Tmsv-16-SD and Tmsv-16-Dif（r=0.307

0.345

both P<0.01）and Tcs-SD was positively correlated with Tmsv-16-SD and Tmsv-16-Dif（r=0.340

0.359

both P<0.01）.2 D-STI and RT-3 DE had good consistency in the measurement of left ventricular synchronization indexes

and Tmsv-16-SD% had the best repeatability（ICCwithin observer=0.985

ICCbetween observers=0.977

both P<0.001）.ConclusionBoth 2 D-STI and RT-3 DE can detect the changes of left ventricular synchronicity in RA patients

and can quantitatively evaluate left ventricular systolic synchronicity.However

RT-3 DE is more sensitive to the changes of left ventricular synchronicity.