Evaluation Of Left Ventricular Dyssynchrony In Patients With Myocardial Infarction By Real-time Three-triplane Echocardiography Tissue Synchronization Imaging

Objective Left ventricular systolic dyssynchrony widely exists in patients with myocardial infarction(MI),so how to evaluate the myocardial dyssynchrony accurately plays an important clinical role in the diagnosis,treatment and judgment of prognosis.It has been a hot topic in cardiac pacing and electrophysiology in recent years throughout the world. This study is to evaluate left ventricular systolic dyssynchrony in patients with myocardial infarction by real-time three-triplane echocardiography tissue synchronization imaging (RT3P-TSI),combing TSI and RT-3PE.The purposes of this study were:1.To evaluate left ventricular systolic dyssynchrony in patient with myocardial infarction by real-time three-triplane echocardiography tissue synchronization imaging (RT3P-TSI).2.To verify the accuracy of left ventricular systolic function(LVSF) in myocardial infarction patients by Two-dimensional echocardiography (2DE) modoified Simpson’s methods and real-time tri-plane echocardiography(RT-3PE),and to explore whether RT-3PE is a quick and accurate ultrasonic technology for the measurement of LVSF.3. To assess the relationship between the Left ventricular dyssynchrony indexes Ts-diff. Ts-SD and Left ventricular systolic function.Methods50controls and50MI patients (Twenty-five anterior MI and Twenty-five inferior MI patients) were enrolled in this study. The time and velocity to regional peak systolic velocity(Ts),(Vp) in six basal and six middle segments (12segments) of the left ventricular were measured semiautomatically using RT3P-TSI and two parameters of systolic dyssynchrony were computed (Ts-diff and Ts-SD). The left ventricular end-diastolic volume (LVEDV),Jeft ventricular end-systolic volume (LVESV),stroke volume (SV) and left ventricular ejection fraction (LVEF) were measured to the control group and MI patients by2DE modoified Simpson’s methods and RT-3PE. Results①Ts delays in anterior segments and interventricular septum in anterior MI group (P<0.05). Ts delayed in anterior segments and inlerventricular septum in anterior MI group (P<0.05). Ts delayed in inferior and posterior segments in inferior MI group (P<0.05).Ts of lateral was prolonged in the MI group compared with controls (P<0.05).②Vp was significantly shortest in MI group when compared with controls.③The Ts-SD and Ts-diff were prolonged in the anterior MI group and inferior MI group when compared with controls (P<0.05).④n normal people there were no statistically significant difference among the values of LVEDV、LVESV、SV and LVEF.there was good correlation between RT-3PE and2DE Simpson’s methods(r=0.914,0.892,0.815,0.996), Furthermore, In MI people there were no statistically significant difference among the values of LVEDV、LVESV、SV and LVEF between RT-3PE and2DE Simpson’s methods.There was good correlation between RT-3PE and2DE Simpson’s methods(r=0.816,0.852,0.798,0.801)⑤The values of LVEDV、LVESV、SV and LVEF were measured by RT-3PE in MI patients and the control group,has statistically significant difference⑥eft ventricular of ejection fraction (LVEF) is correlated negatively with he dyssynchrony indexes Ts-diff、Ts-SD (r=-0.652,-0.552, P<0.05).Conclusion.the systolic dyssynchrony of LV was damaged is common in MI patients. LVEF is correlated negatively with the two parameters of dyssynchrony indexes.Triplane TSI is a new and accurate methods in assessment of left ventricular dyssychrony.