A Study On The Respiration, Cardia And Blood Vessel Coupling By Ultrasound

Objective The relation among respiration, cardia and blood vessel was probed. The concept of"respiration-heart-blood vessel"coupling was introduced.Methods The software–"radius of curvature and arc measurement"and"cardiac cycle standardization"was combined with the new ultrasound technology - speckle tracking imaging (STI), velocity vector imaging (VVI) and wave intensity (WI) to evaluate the relation among respiration, cardia and blood vessel.(1)"Radius of curvature and arc measurement"and"cardiac cycle standardization"software was verified. It provided the tools for the study.(2) During inspiration and expiration, left ventricular end-diastolic dimension (LVEDD) was measured by M-mode echocardiography and speed of blood flow through each valve was observed by pulse Doppler, respectively. The software of"radius of curvature and arc measurement"was applied to measure the motion of interventricular septum (IVS) in two respiration phases too. The relationship of respiration and cardia was studied in the 21 normal subjects.(3) VVI was performed in 15 healthy volunteers and obtained dynamic images. Circumferential end-systole stain of IVS was gotten after the cardiac cycle was standard. In the same short axis view, the static images were captured at end-systole and end-diastole respectively. The arc and radius of curvature of IVS were measured automatically by the software, and the shortening rates of them were calculated. The relationship among strain, arc and radius of curvature was studied.(4) Twenty-four healthy subjects were performed examination under the normal quiescent and cold pressor test (CPT) condition respectively. The W1, W2, inside diameter and its different rate of common carotid artery (CCA) were measured under two different conditions respectively. The new parameter–mean wave intensity (MWI) was deducted. The relationship of cardia, blood vessel and MWI was studied.(5) Thirty-nine patients with hypertension and 30 control subjects were performed examination. The W1, W2, MWI, inner diameter difference, and different rate of CCA were measured and calculated respectively. The relationship of heart and vascular function was studied deeply.(6) 561 people were assigned into six groups based on age. The parameters of arterial stiffness (CVAI and CFPWV)) and heart function (Tei index, E/A, e/a, E/e and EF) were measured and calculated. The result was compared. The relationship of heart and vascular in crowd was study.Results(1)"Radius of curvature and arc measurement"software can be applied to evaluate the relationship of pressure and radius. The stimulant ventricles were measured by the software and showed that there was positive correlation between pressure and radius of curvature for viscoelastic tissue. The depth of pool contributed more influence on interventricular septum (IVS) than free walls. The direction and value of IVS were changed with ventricular pressure. The software is useful tools to assess the deformation of myocardium led by respiration.(2) There was significantly significant correlation between"Cardiac cycle standardization"software and manumotive method."Cardiac cycle standardization"software was useful to analysis deformation of myocardium at optional time during cardiac cycle exactly and fast. The software is useful tool to assess the deformation of myocardium led by respiration.(3) During normal respiration phases, the peak E velocity of mitral valve and the velocity of aortic valve decreased, while the peak E velocity of tricuspid valve and the velocity of pulmonary valve increased. The changes of LVEDD were(1.65±1.26)mm when measured by M-mode. The radius of curvature of IVS (RCIVS) were(25.91±6.08 )mm and(22.30±4.40)mm during inspiration and expiration, respectively. There was significant difference between two respiratory phases (P<0.0001). The change of RCIVS was(2.95±2.00)mm.. There was no significant difference measured by M-mode and RCIVS.(4) The arc and radius of curvature was longer at end-diastole than that at end-systole (P < 0.0001). There was no significant difference between shortening rate of arc and circumferential end-systole stain of IVS (P= 0.123), but there was significant correlation (r =0.840).(5) The different rate of diameters and W1 of CCA were decreased when subjects suffered CPT (P<0.05), but the inside diameter, MWI and W2 of CCA were increased (P<0.05). The areas under the ROC curves were 0.858, 0.731and 0.698, corresponding MWI, W1 and W2. There was no significant difference among them(P>0.05).(6) The difference and different rate of diameters of CCA were decreased (P<0.05), but the inside diameter, MWI and W2 were increased (P<0.05) in hypertension group than those of control people. W1 was no significant difference between two groups. There were significant correlation between W2 and rapid filling time (RFT), DTI-(aP<0.05);there were significant correlation between MWI and RFT, isovolumic relaxation time (IRT), DTI-s, DTI-a(P<0.05). (7) In 561 people, the ventricular wall became thicker with the age; Tei index, E/A, e/a and E/e changed with the age; CAVI and CFPWV increased with the increase of age. The relationship between CAVI, CFPWV and Tei index, E/A, e/a, E/e was significant correlation, respectively. The relationship adjusted age only between Tei and CAVI; E/A and CFPWVβwere correlation.Conclusion The respiration contributes diastolic function of cardia by changing the ventricular volume of end-diastole, then it affects on the ventricular contractive function indirectly. Blood vessel adjusts chiefly the ventricular contractive function, and leads to relaxed function of heart changing, so the influence of respiration on ventricular relaxed function is amplified or diminuend. The respiration, heart and blood vessel make up feedback loop and affect each other. The weight of respiration, cardia and blood vessel is different when people suffer different diseases.