Echocardiography Figure Technical Evaluation Of Cardiac Patients With Left Heart Function Applied Research

Part I A evaluation of left ventricular systolic function with stereo three-dimensional echocardiography after cardiomyopathyObjective: To evaluate the accuracy and value of measurement of left ventricular systolic function in dilated cardiomyopathy (DCM) and hypertrophic Cardiomyopathy (HCM) patients with stereo three-dimensional echocardiography (S3DE).Methods: End-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV) and ejection fraction (EF) of the left ventricle were measured with M-mode echocardiography(ME), two-dimensional echocardiography (2DE) and stereo three-dimensional echocardiography (S3DE) in DCM patients (20 cases), HCM patients (20 cases), and normal controls (20 cases) .the different results among the three groups or three methods were analyzed. Results:①In all the three groups, the results of EDV, ESV, and SV obtained with ME were significantly higher than those obtained with S3DE(P <0.01); Only in normal group (P <0.01) and HCM group (P <0.05), the results of EF obtained with ME and 2DE were significantly higher than those obtained with S3DE;②By S3DE,Compared with normal group,EDV, ESV were increased and EF was decreased obviously in DCM group(P all <0.01);while in HCM group, only SV was significantly higher (P <0.01);③EDV, ESV, and EF measured by S3DE were correlated and fit well with those measured by 2DE(r = 0.778,0.876, 0.932 ;R2=0.605,0.767,0.869;P all <0.01).④Within HCM Group, excluding the impact of heart rate, cardiac output (CO) was highly correlated with SV (r = 0.987;P <0.01). Conclusions:S3DE can real-time display the stereo structure of the heart, and accurately and reliably assess the left ventricular systolic function, with a priority over traditional ME and 2DE methods; EDV, ESV, and EF are still effective indicators for the clinical assessment of left ventricular systolic function;SV obtained with S3DE will be expected to be the more sensitive and accurate value assessing left ventricular systolic function in patients with early-stage cardiomyopathy. Part II Evaluation of left ventricular diastolic dysfunction in hypertrophic cardiomyopathy with various indicators by conventional echocardiographyObjective: To evaluate the left ventricular diastolic function in hypertrophic Cardiomyopathy (HCM) patients with different indicators by conventional echocardiography. Methods: Left ventricular ejection fraction(LVEF), left atrial volume index (LAVI),left ventricular mass index (LVMI) and relative wall thickness (RWT) were calculated with M-mode echocardiography and two-dimensional echocardiography in hypertrophic obstruction cardiomyopathy (HOCM) patients (20 cases) , hypertrophic non-obstructive cardiomyopathy (HNOCM) patients (28 cases),and normal controls (20 cases). E/A ratio,S/D ratio,E/Ea ratio,E wave declaration time index (EDTI) and isovolumic relaxation time index (IRTI) were also measured by Doppler echocardiography in these patients. The different results among the three groups were analyzed. Results:①Compared with normal control group, the results of LAVI, E/Ea ratio, LVMI and RWT were all significantly higher in both HOCM group and HNOCM group (P all <0.001); Only in HOCM group, the value of ETDI was significantly higher than that in normal control group (t = 3.833;P = 0.001);E/A ratio,S/D ratio,IRTI and LVEF among the three groups showed no significant statistical differences (P all>0.05);②Compared with HNOCM group,EDTI was extended,LVMI and RWT were increased obviously in HOCM group(t=3.825,3.951,2.910;P all<0.01);while LAVI value and E/Ea ratio showed non-significant difference between the two groups (t=0.918,0.046,P=0.364,0.964);③Correlation and goodness of fit between LAVI and E/Ea were good (r = 0.494; R2 = 0.244; P all <0.01);④E/Ea measured by Doppler echocardiography were correlated and fit well with LVMI (r = 0.559;R2 = 0.312;P all <0.01). Conclusions :①EDTI and E/Ea ratio measured by Doppler echocardiography are still regarded as accurate, and reliable indicators for clinical assessment of left ventricular diastolic function;And EDTI will be expected to be a more sensitive and effective value,simple and easy to acquire;②LAVI can reflect left atrial geometry and long-term cumulative changes in left ventricular filling pressure,be expected to be the early warning indicator of deteriorated cardiac function in hypertrophic non-obstructive hypertrophy,even maybe provide clues for an early clinical doubtful diagnosis for occult obstruction;③Left ventricular diastolic dysfunction is closely related to impaired relaxation and increased passive diastolic stiffness resulted from left ventricular remodeling and concentric hypertrophy.