| Backgroud:Heart failure is the end-stage performance for a variety of heart disease, is one major cause of death which leading to heart disease, is a high morbidity and mortality, serious illness, and left ventricular failure is the most common in clinical. Early diagnosis and early treatment is very important to improve the prognosis of patients, shorten the course, reduce the mortality rate. In clinical practice, often through the M-and two-dimensional echocardiography and assessment of left ventricular function in NYHA classification, but this index and grading subjectivity, poor reproducibility and can not accurately reflect myocardial function sensitive to changes in not a good reflection of cardiac function, regional myocardial function of the depth of analysis. Recently developed new technique-velocity vector imaging (VVI) can provide a variety of movement parameters on regional myocardial quantitative analysis, a more accurate assessment of left ventricular systolic and diastolic function. The technology can provide an objective basis for clinicians, is beneficial in patients with left heart failure and followed for the early diagnosis of clinical treatment, is very useful for improving patient quality of life, improving diagnosis and treatment of a doctors.Objective:To investigate the regional longitudinal contraction and relaxation of left ventricle in Left heart failure patients by velocity vector imaging (VVI). To characterize the regularity of left ventricular longitudinal function in Left heart failure patients before treatment, after treatment. To discuss the important clinical value of velocity vector imaging in quantitatively evaluating regional longitudinal function of left ventricle. Measured left ventricular failure patients with VVI with left ventricular long-axis cardiac function parameters and laboratory indices of left ventricular function N-terminal pro-brain natriuretic peptide (NT-proBNP) compared VVI evaluation of left ventricular long axis function in patients with left heart failure for the feasibility and accuracy.Methods:We examined respectively 50 patients diagnosed left ventricular failure and 50 normal persons. They were matched with for sex and age. Exclusion criteria for all subjects were cardiac valve disease, congenital heart disease, permanent pacemaker implantation in patients with type, selected before the use of diuretic drugs and vasodilators, recently (1 month) traumatic brain injury, history of ischemic and hemorrhagic stroke, simply involved the right heart system, pulmonary heart disease, acute pulmonary embolism, acute attack of bronchial asthma, respiratory failure and COPD patients, the whole system of malignant tumors, three months with acute myocardial infarction, diabetes mellitus, thyroid disease, metabolic disease, connective tissue disease, dystrophy, severe dysfunction of liver and kidney, contact of toxic, alcohol abuse, pregnant woman in perinatal period. To track review the Patients with diagnosed heart failure by the Department of Cardiology into the hospital after six months of regular drug treatment. Two group indexes below were obtained from every 3 heart beat, averaged, in 16 segments respectively to assess left ventricular longitudinal contraction and relaxation:â… -systolic max velocity(SVmax), systolic max strain (SSmax), systolic max strain rate(SSRmax);â…¡-diastolic max velocity(DVmax), diastolic max strain(DSmax), diastolic max strain rate(DSRmax). Subjects were in echocardiography and measurement of blood plasma within three days of N-terminal pro-brain natriuretic peptide levels, with VVI parameters and EF measured values to do with correlation.Results:The Vmax were graduately decrease from base to apex and the Smax and SRmax were not obvious different from the base to apex in normal group. The change trends of the Vmax, Smax and SRmax were similar with the normal group in Left heart failure patients before treatment, but the values were obvious lower than normal group in Left heart failure patients before and after treatment (P<0.01), while the basal part of lateral wall and posterior wall were larger than other segments (P<0.05) in Left heart failure patients after treatment. Heart failure after treatment of myocardial systolic and diastolic long axis of the Vmax, Smax and SRmax with heart failure before treatment compared with the corresponding segment, lateral and basal interventricular septum, middle, apex, inferior wall and posterior wall and basal, middle, basal segments before the interval increased statistically significant difference (p<0.05), anterior basal, middle, apex, inferior wall of the apex and the middle section before the interval Vmax value was no change, no significant difference was found. Left ventricular heart failure after treatment the long axis of VVI change the parameters and plasma NT-proBNP concentrations were observed a negative correlation, with EF measured values were positively correlated (P<0.01).Conclusion:VVI technique showed that left ventricular function in patients with heart failure was significantly diminished, the extent of left ventricular function with conventional ultrasound and laboratory indicators of EF and NT-proBNP has a good correlation. VVI technology is a non-invasive, more accurate evaluation of the long axis of left heart failure in patients with left ventricular regional myocardial motion changes, quantitatively determine the degree of impairment of cardiac function, guidance and evaluation of heart failure treatment, the prognosis of the value of observation. This Technology combined with NT-porBNP will better for medical diagnosis and treatment for clinical patients with left heart failure and objective theoretical basis, have some clinical value, will be expected to widely used in clinical. |
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