Methodological study on real-time three-dimensional echo-cardiography and its application in the diagnosis of complex congenital heart disease / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Real-time three-dimensional echocardiography (RT-3DE) has made revolutionized improvements of cardiac imaging during the past few years. However, there is no standard examination method for RT-3DE so far. This study aimed to establish the diagnostic method of RT-3DE and evaluate its application in the diagnosis of complex congenital heart diseases (CHD).</p><p><b>METHODS</b>Fifty patients with complex CHD were examined by RT-3DE with modes of Live 3DE and Full Volume. A series of novel volumetric views combined with Van Praagh sequential segmental approach were introduced to reveal the pathological morphology of the hearts, which were compared with the findings of two-dimensional echocardiography (2DE), angiography and cardiac surgery.</p><p><b>RESULTS</b>In 50 patients, 190 image acquisitions of Full Volume were performed at several acoustic windows including subcostal, apical and parasternal regions. Among them, 94.2% (179/190) of image acquisitions were successful. Most sectional volumetric views could be clearly displayed in 92.6% of the successful image acquisitions. However, sectional volumetric views could not be clearly displayed in 7.4%, which was mainly due to poor perspective conditions of examination location, improper instrument multi-parameter setting and insufficient information of whole heart captured in Full Volume acquisitions. As compared with surgical findings and angiography, RT-3DE made correction to the diagnoses in 2 cases including 1 with corrected transposition of the great arteries and the other with single atrium and mitral cleft. The diagnoses initially made by 2DE for these 2 patients were double outlet right ventricle with transposition of the great arteries and complete atrio-ventricular septal defect.</p><p><b>CONCLUSIONS</b>RT-3DE can clearly display the pathological morphology of complex CHD by a series of novel volumetric views combined with sequential segmental approach through providing more spatial informative cardiovascular structures, which provides a practical method for RT-3DE diagnosis.</p>

Myocardial impairment in asphyxiated newborn piglets / 中华儿科杂志

<p><b>OBJECTIVE</b>To establish a piglet model of acute hypoxic myocardial impairment.</p><p><b>METHODS</b>Nineteen newborn piglets were divided into two groups: control group (CON, n = 8) and asphyxia group (ASP, n = 11). In ASP group, asphyxia was induced by disconnecting the animal from the ventilator and clamping the inhalation tubing for 10 minutes. Six hours after cardiopulmonary resuscitation (CPR), the levels of serum creatine kinase MB (CK-MB) and cardiac troponin T (cTnT) were detected. Cardiac functions were evaluated by echocardiography. Parameters included left ventricular ejection fraction (LVEF), right ventricular ejection fraction (RVEF), ratio of peak E velocity and peak A velocity of mitral flow and tricuspid flow (MVE/A and TVE/A), ratio of peak velocity and a velocity of mitral annulus motion and tricuspid annulus motion (MVe/a and TVe/a), isovolumic relaxation time of left ventricle (LVIRT), index of mitral regurgitation and tricuspid regurgitation (MR and TR). The CON group was examined at the corresponding time points. The pathologic changes in piglets' hearts were examined. The myocardial histopathologic damage score (MHDS) was used to evaluate the severity of myocardial impairments.</p><p><b>RESULTS</b>Six hours after CPR, the CK-MB and cTnT in ASP group [(423 +/- 156) IU/L and (0.85 +/- 0.64) microg/L] were both higher than those in CON group [(213 +/- 30) IU/L and (0.08 +/- 0.02) microg/L, P < 0.01]. The LVEF, RVEF, TVE/A, MVe/a and TVe/a in ASP group [(59.6 +/- 8.6)%, (60.2 +/- 7.1)%, 0.79 +/- 0.21, 0.77 +/- 0.12 and 0.78 +/- 0.19, respectively] were all lower than those in CON group [(67.5 +/- 6.9)%, (68.8 +/- 7.4)%, 1.14 +/- 0.16, 1.19 +/- 0.18 and 1.03 +/- 0.27, respectively, P < 0.05]. The MHDS in ASP group was higher (2.82 +/- 0.98) than that in CON group (0.38 +/- 0.53, P < 0.01), but no significant difference was observed in MHDS between the left ventricle and right ventricle.</p><p><b>CONCLUSION</b>Asphyxia can lead to obvious myocardial impairment in newborn piglet, which could be very useful for the studies of acute hypoxic myocardial impairment in the newborn infants.</p>