| Background & objective:It is very important to measure the function of myocardial movement in order to make a diagnosis and give treatment in clinic. At present there are some way to do it, for example: use 2-D sound image to determine the nature and semi-quantitative; traditional M-model Ultrasound method to measure the wall thickening of left ventricular on short-axis view in limited region ; Tissue Doppler imaging (TDI) method and so on. But it is limited by angle and quality of 2-D image, every method has advantage and disadvantage. In this article ,the author use the refined AMM, which is under developed, not only could quantify regional end-diastolic myocardial function in any direction, but also differential the myocardial movement curves to acquire transient velocity and acceleration. It is a brand new method that can be used to measure the function of myocardial movement. The present study included: combine with the contrast medium enhance the probability of AMM imaging; validating the feasibility of assessing myocardial velocity by improved AMM comparing with TDI; compare with the velocity ,acceleration and force of the end-systolic, end-diastolic and early -diastolic to measure the function of myocardial movement of the hypertension and the coronary heart disease.Machines & Methods:Machines: Omni-directional M-mode echocardiography(post processing station) which was developed by Biomedical Engineering Institute of Fuzhou University in China could detect the dynamic information from sequential echocardiography. The method for detecting dynamic information is based on the rebuilding of their gray (position)～time function on direction lines. So the system can get motion track, motion velocity and acceleration of given cardiac structure at moment. The system could also display ECG synchronously. 1. Vivid Seven digital ultrasound system (GE VingMed Ultrasound).Method:1. 40 normal subjects and 25 dilated cardiomyopathy (DCM)patients with congestive heart failure were randomly selected. Using the improved anatomical M-mode echocardiography to parastemal short axis view of left ventricular anterior septal and posterior wall of the three levels of systolic, Early and late diastolic peak velocities (S peak, E, A)were collected and measured .Under quantitative tissue Doppler imaging(QTVI), corresponding to the peak velocities were measured. Then to compare the result of contrast and relevance between improved anatomic M-mode and TDI in the same location and phase. Meanwhile myocardial different segments of the three-phase velocities of the same plane short axis(papillary muscle level) were compared by applying improved anatomic M-mode echocardiography. Two detectors in double-blind conditions repetitively test some peak velocities of the papillary muscle level.2. The studies of possibility of imaging, use the contrast medium enhance the probability of AMM imaging. The author chooses 20 simple, who are fat or have disease in lung, to inject the contrast medium in mainline, and judge the effect.3. The assessment of the velocity, acceleration and force of the myocardial movement by improved AMM: regular group include 30 samples, hypertension group include 30 samples. Left ventricular image cine loops at the mid short-axis view were stored with GE dimension which equipped with anatomic M-mode. M-mode sections were done in 3 planes: anteroseptal-posterior, inferoseptal-lateral, anterior-inferior middle segments. Then the author transported these curves into homemade improved AMM post-disposing system. The author drawn the outline of endocardium and epicardium manually, extraction of myocardial velocities acceleration and force in the subendocardium and subepicardium by post processing station. 4. Evaluate the myocardial velocities acceleration and force of the coronary heart disease: there are 16 coronary heart diseases, include two groups, one is only one strait vein, the other have more then one. Left ventricular image cine loops at the mid short-axis view were stored with GE dimension which equipped with anatomic M-mode. M-mode sections were done in 3 planes: anteroseptal-posterior, inferoseptal-lateral, anterior-inferior middle segments. Then the author transported these curves into homemade improved AMM post-disposing system. The author drawn the outline of endocardium and epicardium manually, extraction of myocardial velocities acceleration and force in the subendocardium and subepicardium by post processing station.Result:1. the measurements of improved AMM and TDI are more close, but the former is slightly higher than the latter. Consistency check shows that parts of the data between two technologies in the normal and DCM groups are statistically significant. Correlation analysis shows that the good relationship between the two technology results. Comparing in the various segments of the same plane for myocardial velocity by applying improve AMM, only a small number of peak velocity is slight differences. The two reproducible test results detected no statistically significant difference.2. There are (2.75±0.85 ) satisfied node without use the contrast medium ,and after use the contrast medium ,there are (5.56±0.61) satisfied node .The statistics different between of these is p<0.01.The possibility of imaging, use the contrast medium enhance the probability of AMM imaging hit to 85%.3. The author compare with the velocity and acceleration of the short axes of left ventricular in three level found :the regular group have statistics different in three level(p<0.05), bottom and midst bigger then top. The hypertension group have little different in three level, and there are no relationship. The study in the velocity and acceleration of the short axes of left ventricular illustrate: there no different between the regular group and the hypertension group during end-systolic period; but the regular group higher then the hypertension group during early-diastolic period, there have statistics different in three level(p<0.05); there no different between the regular group and the hypertension group in velocity during end-diastolic period ,but the acceleration of regular group higher then the hypertension group during early-diastolic, period there have statistics different in three level(p<0.05).4. The author also compare with the velocity and acceleration of the short axes of left ventricular of the coronary heart disease in three level found, there are distinctness different during systolic period(p<0.05), the velocity and acceleration improved little during diastolic period. Because of there are no different between treatment and not, so the force and acceleration have positive relationship.Conclusion:1. The author succeed improve the possibility of imaging combine with the improved AMM and the contrast medium , this can be used in the clinic , and made the improved AMM more feasibility.2. Improved AMM ultrasonic technique can measure the instantaneous velocity of any chamber, this remedy TDI ,which limited by different angle, and it is a brand new method that can be used to measure the function of myocardial movement.3. Improved AMM ultrasonic technique can reflect the situation of the coronary heart disease who had accepted the PCI therapy, and the force is more sensitivity then others.4. Improved AMM ultrasonic technique can measure the force and acceleration of the region of heart. Between the hypertension group, the regular group ,and the coronary heart disease before and after therapy , improved AMM ultrasonic technique can bring forward some new parameter that can reflect the function of heart.5. In a conclusion, improved AMM ultrasonic technique make it impossible to measure the acceleration and force of part of myocardial movement, among the coronary heart disease, the regular group and the hypertension ,different parameter reflect different state of myocardial movement, there are inner transformation rule, so the author think that the acceleration and the force can be used as a new parameter to measure the function of myocardial movement.
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