Assessment Of Cardiac Function In Patients Of Myocardial Infarction By Doppler Tissue Imaging

Assessment of cardiac Function in Patients of myocardial infarction by Doppler Tissue ImagingAims: Chronic heart failure (CHF) is a kind of severe clinical disease. Its hazardness to human health is very serious. It's the final step for all kinds of heart disease. The fatality rate is 30-40% for the patient with severe heart failure. Myocardial infarction is the most important reason of CHF, It has Important clinical meaning to evaluate MI heart function exactly for clinical diagnose, patient's condition monitoring, therapeutic effect and prognosis evaluation. Because of ventricle reconstitution, the shape of the heart become irregular, so two dimension echocardiograph is not a good method to evaluate the heart function for this kind of patients. Doppler tissue imaging (DTI) provides us a simple and valuable method for assessing the myocardial velocity. Especially the mitral velocity don't change while cardiac position and shape change, it can reflect the whole heart systolic and diastolic function, this study was to assess the changes of left ventricular function before and 6 month, 12month after anti-aldosterone treatment with DTI and 2D-echocardiograpy, To evaluae the clinical value of DTI, and compared the differents of these two technology of echocardlography.Methods: 130 patients with myocardial infarction were enrolled and randomly assigned to anti-aldosterone treatment group (spironolactone 20-40mg per day plus fosinopril 5-10mg per day, n=61) or conventional group (enalapril 10-20mg per day, n=69). The ultrasoundcardiogram and DTI were performed at enrolling time, and after 6, 12 months.Results: In the anti-aldosterone treatment group (n=61), the average mitral systolic wave(s) was remarkablely increased after six months (p<0.05), LVEF has the tendency to raise,but has no statistical significance. The plasma was still remarkablely increased after twelve months (p<0.05) , LVEDD,LVEF alsoincreased after twelve months (p=0.036, p=0.02). while in the conventional group the index above was no statistical significance. s was related to LVEF. But the sensitivity of s wave is better than LVEF's. there was no difference In the anti-aldosterone treatment group and conventional group in Ratio of peak early to late diastolic filling velocity(e/a). Conclusions: 1. the average mitral systolic wave was related to LVEF(r=0.24,p=0.018) . But the sensitivity of s wave is better than LVEF's. 2.The combined use of anti-aldosterone and ACEI treatment in patients with myocardial infarction improve the left ventricular global systolic function after six monsths ( p<0. 05 ) . while the diastolic function was no statistical significance. 3. The use of ACEI treatment in patients with myocardial infarction has the tendency to improve the left ventricular global function, but has no statistical significance.Clinical Study on Assessment of cardiac Function in Patients of myocardial infarction with Percutaneous coronary intervenetion by Doppler Tissue Imaging: One year follow-upObjective: The purpose of this study is to assess the changes of cardiac function before and after Percutaneous coronary intervention (PCI) with Doppler tissue imaging (DT I) and 2D echocardiography. To evaluate the clinical value of DT I in the Patients of myocardial infarction with Percutaneous coronary intervention for Long term follow-up. Methods: eighty-six patients of MI in patient were enrolled in this study. Forty-five patients received PCI(mean age 56.8±10years, male 42, female 3) and Forty-one patients received conventional therapy (mean age 60.3±10years, male 39, female 2). Patients with valvular heart disease, cardiomyopathy and congenital heart disease were excluded. Each examination consisted of two-dimensional echocardiography (2DE), pulsed wave Doppler blood flow and pulsed DTI measurements. The left ventricular ejection fraction (EF), peak E, peak A wave velocities and peak E versus peak A (E/A) were recorded. The velocity of systolic wave(s) ,early diastolic filling wave(e), late filling wave(a) and wave e versus wave a (e/a) were measured by DTI at the septum,anterior, inferior and lateral point of mitral annulus. Results:The left ventricular EF and the average velocity of systolic wave (s) of mitral annulus was increased after pci (P < 0.05). s wave was related to LVEF, but the sensitivity of s wave is better than that of LVEF. There were no differences in the pulse Doppler trans mitral flow velocity E/A before and after pci(P> 0.05), but the average velocity of mitral annulus (e/a) was remarkably increased after pci (P < 0.01).Conclusions: The results of this study suggest that the global left ventricular systolic and diastolic function in MI patients be improved after PCI. This study also demonstrated that DTI is more sensitive method to detect the cardiac functionof MI and PCI can be one of the important factors for the cardiac function improvement in patients of MI.