| Objective:Utilizing Ultrasonic Velocity Vector Imaging(VVI)to evaluate the kinetic coordination of ventricular walls regional myocardial of left ventricle of thyroid function hyperthyroidismcardiopathy at segment time. Methods: Utilizing SIEMENS SC2000 ultrasonic diagnostic instrument and VVI imaging processing software, to make quantitative analysis of 61 cases of hyperthyroidism cardiopathe's left ventricular segmental systolic myocardial motion in peak speed, 50% peak speed-time, 75% peak speed-time. According to the damage degree of ascending aorta, we divide the hyperthyroidism cardiopath into two groups, Group I: the inner diameter of ascending aorta > 30 mm-- 24 cases, age:(55.23 + 13.76), course of disease(6.33-3.29) years. Group II: the inner diameter of ascending aorta< 30 mm, 37 cases, age:(47.35 + 10.54), course of disease(5.14-2.16) years. Control group: 30 healthy volunteers aged at(43.51-8.57) years old. Making conventional echocardiography, collecting and storing the three phases of the cardiac cycle of four cavities of apex cordis, two cavities, sternum beside the left ventricular long axis and short axis valvulabicuspidalis level, papillary muscle level dynamic two-dimensional gray-scale image.VVI software is applied to select the clear image of left ventricle wall to describe endocardial boundary, and the system will automatically divide the four-chamber heart cut and short axes section of the left ventricle into lateral wall, antetheca, anterior septum, inferior wall, posterior septum to make follow-up survey. We analyze three cardiac cycle of each segment myocardial longitudinal motion of left ventricle at the peak speed-time, 50%peak speed-time and 75% peak speed-time,as well as the peak speed-time, 50% peak speed-time and 75% peak speed-time ofradial motion of each segment myocardium of short axis valvulabicuspidalis level, musculipapillareslevel. Results: 1.Longitudinal axis of the left ventricle muscle contraction movement indicates that: left ventricular longitudinal muscle movement of normal control group axis speeds up to peak time at apex, intermediate and basal in a progressive increase. But at the speed of 50% and 75% peak speed, the trend changes without any significance(P > 0.05). The comparison of lateral wall, middle segment of back wall, basal segment as well as the wall under the apex section Group I and IIwith the control group is significant(P < 0.05); 50% peak speed time of inferior wall apical segment of Group I, basal segment of antetheca, all segments of paries posterior are larger than Group II(P < 0.05); 75% peak speed time of inferior wall apical segment of Group I is larger than Group II(P < 0.05); basal segment of antetheca of Group II is larger than control group(P < 0.05); there is significance for the peak speed time of basal segment of antethecaof Group II is larger than control group(P < 0.05). 2.The left ventricle short axis of the level of myocardial contraction movement indicts: The first inferior wall,paries posterior 50% peak velocity and time 75% of the Control group are higher than the peer group anterior septum, antetheca media wall, postseptal of the peer group(P<0.05), the pariesposterior inferior wall of the control group are remarkably higher than the anterior septum, antetheca and side wall of the peer goup. And the difference is notable(p<0.05). 75%peak time and velocity,50% peak time and velocity side wall and rear wall the first and Group IIboth larger than the control group(p<0.05), inferior wall the Group I all bigger than the the Group II and control group(p<0.05). 3.The myocardial contraction movement of ventricle minor axis papillary muscles indicts that: inferiorwall is bigger than the peer group antetheca(P<0.05) the Group I rear group is bigger than the antetheca of the peer group(P<0.05). 75%the velocity and speed of the anterior septum is bigger than the peer group antetheca(P<0.05). The inferior wall the Group I,the rea wall of the second wall is bigger than the antetheca and anterior septum the peer group(P<0.05).Each room wall movement of the 50%velocity and speed the rear wall and inferior wall of the Group I are bigger than the anterior septum of the peer group(P<0.05, inferior wall,rear wall, posterior septum and anterior septum of the control group are bigger than the antetheca and side wall(P<0.05). Posterior septum the Group I is bigger than the control group(p<0.05) and when it is at the 50% of the peak velocity and time the Group I is bigger than the Group II(p<0.05), and the antetheca of Group II is larger than the control group(P<0.05). Conclusion:1.The motor coordination of myocardium of left ventricular long and short axis in patients with Hyperthyroidcardiopathy is worse than control group. 2.The motor coordination of myocardium of left ventricular long and short axis in Group I is worse than Group II. It indicates that the increase damaged segments of myocardium would improve the severity of motor incoordination in myocardial contraction when the ascending aorta is abnormal. 3.It is valuable that to evaluate the abnormality of left ventricular myocardial contraction by full time of peak velocity, 50%time of peak velocity and 75%time of peak velocity, 50% peak speed time delay myocardial segments, most can obviously reflect the heart sarcomere segment movement not sync. 4.The technology of VVI could precisely and efficiently detect the micro changes in myocardial contraction of left ventricular long and short axis, and it provides a precise, non-invasive and simple way of evaluating theregional myocardialmotor coordination for clinic. |
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