| Congenital heart diseases are congenital malformations caused by heart and vessels dysplasia in foetal period. This kind of frequently seen disease will harm the growth of children badly. If the child patients can not be diagnosed or treated well, some will even die. Recently, with the development of pediatric cardiology research and novel diagnosis techniques, we have done better in the diagnosis, cure, prognosis. Since it is expected that the children will live a better life and enjoy long term survival, we need estimate all round damages and disorders of pediatric heart diseases, in order to diagnose and treat the patients well.An important part of ultrasound cardiogram research is to study the left ventricular wall motion. The analysis of left wall motion is not only vital to diagnosis, but also plays a guiding role in follow-up visiting. The left wall motion is influenced by blood supply of cardiac muscles, force of ventricular muscle fibers, and ventricular chamber pressures. In congenital heart diseases with the left to right shunting(VSD, PDA), left ventricle enlarges and left wall becomes pachynsis because of the abnormal shunting and volume overload. After operations, abnormal shunting stops, so hemodynamics and geometry configuration of left ventricle recover. These changes of geometry configuration lead to a series of variations left wall motion.With the development of novel techniques, ultrasound cardiogram becomes a useful tool of clinical quantitative assessment (/half) of left ventricular wall motion. These techniques are all based on tissue motion evaluations by Doppler survey. So, many parameters of these techniques are confined by Doppler aspects, such as angle dependence, good frame frequency.VSI imagine is a novel technique that is able to study structural mechanics of cardiac muscle and analyze left wall motion. VSI has a unique display mode of virtual probe; it is based on 2D imagine and has no angle dependence; it can analyze heart motions including radial, length wise, circle motions; it can quantitate velocity, straining, strain rate of all heart motions; it is easy to analyze and repeat. So, in this way, we can get information of all round motions of ventricular wall, and study them better.Aim: Use Vector Strain Imaging-VSI to study perioperatively changes in children with congenital heart diseases of left to right shunting type, and discuss the efficiency and feasibility of VSI.Method: We have examined with VSI: 21 healthy children (Group N); 27 children with congenital heart diseases (including 16 with ventricular septal defects, 11 with patent ductus arteriousus) sorted to be Group P(Preoperative) and Group A(1 week Postop). We examined motions of the 16 left ventricular wall segments.Results:(1)P velocities are higher than N velocities (P<0.05): radial motion of Segment 9/16, circle motion of Segment 3/16, length motion of Segment 7/16.(2) A velocities are higher than N velocities (P<0.05): radial motions of Segment 5/16, circle motions of Segment 3/16, length motions of Segment 2/16.(3) Comparing A and P: A velocities are much lower than P velocities (P<0.05), including radial motions of Segment 4/16, length motions of Segment 9/16. Circle motions of B0 and B1 have no significant difference (P>0.05).Conclusion: In congenital heart diseases with left to right shunts, motions of left ventricle are reduced to normal level regularly with the hemodynamics changes in 1 week after operation. VSI is able to examine and quantitate dynamic changes of left ventricular wall motions. So, VSI has very good prospects in clinical work. |
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