Evaluation Of Left Ventricular Long-Axis Systolic Function In Patients With Cardiomyopathy Using Doppler Tissue Imaging

Objective To study the application of quantitative tissue velocity imaging (QTVI) and tissue tracking imaging (TTI) in the assessment of the feature of left ventricular myocardial longitudinal axis velocity and displacement in children with cardiomyopathy and assess the left ventricular (LV) long-axis systolic function.Methods The healthy subjects are in-patient children of plastic surgery and bone surgery, can except for cardiovascular diseases by disease history, clinical symptoms, physical signs and assistant examinations.20 healthy subjects and 10 children with DCM, 15 children with EFE were studied by QTVI and TTI, peak systolic velocities (Vs) and peak systolic displacements (Ds) of LV regional myocardium were measured. The Left Ventricular Internal Diastolic (LVID), Left Ventricular Internal Systolic (LVIS), Left Ventricular End-diastolic Volume (LVEDV), Left Ventricular Endsystolic Volume (LVESV), Left Ventricular Ejection Fraction (LVEF) and Left Ventricular Fraction Shortening (FS) were measured using M-echocardiogr- aphy. All children with cardiomyopathy were gave digoxin, benazeoril hydrochloride tablets, metoprolol tartrate tablets, spironolactone and followed up. The tri-plane imaging of apical four-chamber, apical two-chamber and apical long-axis views were acquired simultaneously using Real-time Three-dimensional Echocardiography (RT-3DE) of GE Vivid 7 ultrasound imaging system, three complete cardiac cycles were stored in cineloop forma. The tri-plane TTI images were compared among the controls, EFE and DCM groups. On the Q-analysis mode, adjust the sampling volum for 5×3mm, smoothing for 30ms. The systolic velocity and displacements of the mitral annulus, basal, and mid segments of 6 ventricular walls in the long-axis direction were measured. The Vs, Ds and TTI images were analyzed before and after medical therapy in cardiomyopathy group. The Vs and Ds are the average value of three cardiac cycles.Results1. The Vs and Ds of LV segments were different in healthy controls,Vs and Ds of the mitral annulus was highest, the mid segments was lowest, but cardiomyopathy group disappeared.2. Compared with the controls ,the colors decreased seriously in cardiomyopathy group, the colors of some segments were improved from red to orange or from orange to yellow after medical therapy of EFE group, indicating the improvements of Ds.3. The correlations between Vs, Ds of Left Ventricular and LVEF were obviously positive, especially the mean Vs and Ds of mitral annulus had a good correlation with LVEF.4. Comparing with the healthy controls, LVEF and FS were significantly lower, LVID,LVIS,LVEDV,LVESV were significantly higher, Vs and Ds the of every wall of LV in cardiomyopathy patients were significantly decreased (P< 0.05), after 6 months treatment, Vs and Ds of LV segments in patients with cardiomyopathy were significantly recovery(P<0.05), there was no statistical significance that conventional ultrasound(P >0.05).5. after 6 months treatment, Vs and Ds of LV segments in patients with EFE were significantly recovery(P<0.05),there was no statistical significance that in patients with DCM(P>0.05).Conclusions1. The echocardiographic tri-plane TTI imaging could assess the left ventricular long-axis systolic function more conveniently, rapidly and directly.2. The left ventricular long-axis systolic function lower in children wit- h cardiomyopathy presenced frequently, TTI and QTVI can more accurately evaluate the LV myocardial lon-gitudinal contraction displacement and velocities in cardiomyopathy patients,partly make up the disadvantage of conventional ultrasound, TTI and QTVI are more objective and sensor in the comprehensive evaluation of LV systolic function, may be clinically used.3. There was a tendency that Vs and Ds of LV segments in patients with endocardial fibroelastosis were significantly recovery.