A Study On The Changes Of Atrial Septal Motion Using Omni-directional M-mode Echocardiography During Cardiac Surgery

ObjectiveTo study the relation between the changes of atrial septal motion and left atriumfunction by monitored atrial septal motion peak range, peak speed and peakacceleration using Omni-directional M-mode Echocardiography before opened thechest and after closed the chest immediately during cardiac surgery.MethodsObject：Eighty-three cases of patients undergoed cardiac surgery.Fifty cases ofpatients with valve diseases (34~67years old；mean age54.27±9.30years old；33men,17women) and thirty-three patients with congenital heart diseases (1~55years old；mean age33.71±6.07years old；18men,15women) were enrolled in this study.Equipment: LEJ-2Omni-directional M-mode Echocardiography which wasdeveloped by Biomedical Engineering Institute of Fuzhou University in China. GEVivid Seven Demision ultrasound system with multiplane transesophagemechocardiography probe (3.5~7.0MHz) and transesophagem echocardiography probe(1.7~3.5MHz).Methods：①All patients were examed by transesophagem echocardiography andtransthoracic echocardiography before opened the chest and after closed the chestimmediately during cardiac surgery, and standard series image were collected.②Leftatrial volume change fraction(LAVCF),left atrial diameter(LAD),end-diastolicvolume(EDV),left ventricular ejection fraction(EF) and right upper pulmonary veinspectrum a wave peek speed were measured during transthoracic echocardiographyexamine.③Atrial septal motion peak range, peak speed and peak acceleration weremeasured by LEJ-2Omni-directional M-mode Echocardiography.④Atrial septalmotion peak range, peak speed and peak acceleration which were measured before the operation were compared with that measured after the operation. The correlationsbetween atrial septal motion peak range, peak speed and peak acceleration and leftatrial volume change fraction, pulmonary vein spectrum a wave peek speed wereanalysised by pearson analysis.Results1. The comparison of the conventional measured parameters before opened thechest and after closed the chestValve diseases group the data of LAD was increaser，but the datas ofLAVCF，EDV，LVEF and pulmonary vein spectrum a wave peek speed weredecreaser before opened the chest. The datas of LAVCF，EDV，LVEF and pulmonaryvein spectrum a wave peek speed after closed the chest were increaser than beforeopened the chest（p＜0.05）. The data of LAD was no great change after closed thechest than before. The data of LAD was no obvious statistical significance（p>0.05）.Congenital heart diseases group the data of LAD was no great change，but thedatas of LAVCF，LVEF and pulmonary vein spectrum a wave peek speed weredecreaser before opened the chest. The datas of LAVCF，EDV，LVEF and pulmonaryvein spectrum a wave peek speed after closed the chest were increaser than beforeopened the chest（p＜0.05）. The data of LAD was no great change after closed thechest than before. The data of LAD was no obvious statistical significance（p>0.05）.Compared with before the operation, the datas of left atrial volume change fraction，end-diastolic volume，left ventricular ejection fraction and pulmonary vein spectrum awave peek speed were increaser after cardiac surgery（p＜0.05）.2. The comparison of the atrial septal motion parameters measured byOmni-directional M-mode Echocardiography before opened the chest and afterclosed the chestValve diseases group the changes of atrial septal motion peak range: before(2.78±0.40)mm，after(7.39±1.20)mm. the changes of atrial septal motion peak speed:before(3.13±1.51)cm/s，after (5.50±1.23)cm/s.the changes of atrial septal motion peakacceleration: before (54.94±15.36)cm/s2，after(85.79±20.04) cm/s2. Atrial septal motion peak range，peak speed and peak acceleration after the operation wasincreaser than before（p＜0.05）.Congenital heart diseases group the changes of atrial septal motion peak range:before (5.24±1.09)mm，after(2.91±0.68)mm. the changes of atrial septal motion peakspeed: before(4.14±1.47)cm/s，after (3.03±1.38)cm/s. the changes of atrial septalmotion peak acceleration: before(94.92±45.35)cm/s2，after (61.24±30.55)cm/s2.Atrialseptal motion peak range，peak speed and peak acceleration after the operation wasdecreaser than before.3. Analysis the correlation between atrial septal motion parameters measured byOmni-directional M-mode Echocardiography and conventional measuredparametersValve diseases group atrial septal motion peak range was positive correlationto left atrial volume change fraction（r=0.504） and pulmonary vein spectrum a wavepeek speed（r=0.530）. atrial septal motion peak speed was positive correlation to leftatrial volume change fraction（r=0.578）and pulmonary vein spectrum a wave peekspee（dr=0.599）. atrial septal motion peak acceleration was positive correlation to leftatrial volume change fraction（r=0.502） and pulmonary vein spectrum a wave peekspeed（r=0.530）.Congenital heart diseases group atrial septal motion peak range was negativecorrelation to left atrial volume change fraction（r=-0.516） and pulmonary veinspectrum a wave peek speed（r=-0.544）. atrial septal motion peak speed was negativecorrelation to left atrial volume change fraction（r=-0.522）and pulmonary veinspectrum a wave peek speed（r=-0.625）. atrial septal motion peak acceleration wasnegative correlation to left atrial volume change fraction（r=-0.548）and pulmonaryvein spectrum a wave peek speed（r=-0.525）.Conclusions1． Atrial septal motion peak range，peak speed and peak acceleration measured byOmni-directional M-mode Echocardiography after the operation had greatchangesthan before during cardiac surgery. 2． As for patients with valve diseases，atrial septal motion peak range，peakspeed and peak acceleration after the operation was increaser than before. But as forpatients with congenital heart diseases, atrial septal motion peak range，peak speedand peak acceleration after the operation was decreaser than before.3. Atrial septal motion peak range, peak speed and peak acceleration werecorrelation to left atrial volume change fraction and pulmonary vein spectrum a wavepeek speed.4． Atrial septal motion peak range，peak speed and peak acceleration measured byOmni-directional M-mode Echocardiography can assess left atrium function.