The Comparison Of Tei Index In Evaluating The Left Ventricular Function Of Patients With Ventricular Septal Defect And Atrial Septum Defect During The Operation Using Omni-directional M-mode Echocardiography And Quantitative Tissue Velocity Imaging

Objective1.To investigate the change of the left ventricular Tei index which is obtained during the opteration of simple ventricular septal defect (VSD) and simple atrial septum defect (ASD) patients, to provide the guidance basis for the evaluation of left ventricular function.2.Comparing the merits, demerits and correlation of the left ventricular Tei index measured respectively by omni-directional M-mode echocardiography (OME) and quantitative tissue velocity imaging(QTVI) to inquire an effective, practical and handy method of measuring Tei index.MethodsObject:Paticipants consisted of25simple VSD patients and24simple PDA patients with regular rhythm of the heart.Equipment:Using GE Vivid Seven Demision ultrasound system which was equipped with multi plane adult and pediatric esophagus ultrasound probe, Echo PAC work staion,QTVI image analysis software and LEJ-2omni-directional M-mode echocardiography which was developed by Biomedical Engineering Institute of Fuzhou University in China.Measurement:①All patients were measured by transesophageal echocardiography to get series of images in three cardiac cycle before cutting the skin in operation (preoperative) and after closing chest immediately(postoperative).②Using the collected images to measure parameters such as left ventricular end-systolic dimension(LVESD), left ventricular end-diastolic dimension(LVEDD), left ventricular fraction shortening(LVFS), R-R interphase, left ventricular ejection fraction(LVEF) and septal defect diameter.Furthermore,the left ventricular Tei index was measured respectively by OME and QTVI.Results1.Compared with preoperative,LVEDD, LVFS and LVEF are significantly descended in VSD patients(P<0.05),but they are significantly elevated in ASD patients (P<0.05).LVESD is no significant change,however,the R-R phase is significantly decreased in both groups(P<0.01).2.OME-Tei and QTVI-Tei index are obviously enhanced compared with preoperative in VSD patients,while they tend to another direction in ASD patients.3.To a certain extent,the change of Tei index is seemed to be positively correlated with septal defect diameter in VSD patients, while it is negatively correlated in ASD patients. And the change of Tei index is negatively correlated with LVEDD, LVEF and LVFS in both groups.4.The Tei index,generally speaking,the QTVI-Tei is higher than OME-Tei,but there is a significant correlation between QTVI-Tei and OME-Tei.Conclusions1.The changes of left ventricular preload can lead to changes of Tei index during the operation, It is necessary to consider the left ventricular preload changes when we use the Tei index for evaluating the ventricular function in the clinic.2.QTVI-Tei and OME-Tei index increased significantly after the surgery in VSD patients, and the change of Tei index is seemed to be positively correlated with septal defect diameter.However,they are significantly decreased in ASD patients,and the change of Tei index is seemed to be negatively correlated with septal defect diameter.3.OME-Tei and QTVI-Tei index are highly correlated,omni-directional M-mode echocardiography is a practical and handy method of measuring Tei index.