ABSTRACT
Objective To explore the accuracy of heart function assessment of the left single ventricle problems in children by three-dimensionalechocardiography (3 DE),the doppler myocardial performance index (MPI) and tissue doppler imaging(TDI).Methods Twenty-nine healthy children (the healthy control group) and 29 children with problems in the single left ventricles (the case study group) were enrolled in this study.End-diastolic volume (EDV),end-systolic volume(ESV) and ejection fraction(EF) were acquired by using IE 33 system and Q-lab software between 2 groups.MPI was calculated from doppler tracings on the ventricular inflow and outflow,and the velocity profile of atrioventricular annular was obtained by TDI.Max(dp/dt) of the left single ventricle was estimated by atrioventricular regurgitation using simplified Bernoulli equation.Results EDV,ESV and MPI in the case study group were higher than those of the healthy control group(t =2.821,5.287,2.085,all P ＜0.05),and EF of the case study group was lower than that of the healthy control group(t =-13.840,P ＜ 0.05).Em,Am and Em/Am on the side of the left ventricular lateral wall of mitral annulus in the control group were higher than those of the case study group at the nonresidual cardiac cavity side(t =-3.059,2.219,-4.762,P ＜ 0.05) ;Sm and Em/Am in the healthy control group at mitral annular lateral ventricular septal side were higher than those in the case study group at the residual cardiac cavity side(t =-2.200,-2.962,P ＜0.05).Q-Sm interval in healthy control group was lower than that in the case study group(t =2.345,P ＜ 0.05).There was a negative correlation between Max (dp/dt) and MPI in the case study group (r =-0.57,P ＜0.05),there was a positive correlation between Max(dp/dt) and EF and Q-Sm interval in the case study group(r =-0.74,0.62,P ＜ 0.05).Conclusions Impaired ventricular functions can be found in patients with left single ventricle problems,which can be assessed accurately by 3DE.
ABSTRACT
Objective To evaluate the diagnostic value of prenatal echocardiography in fetus with tetralogy of Fallot(TOF),and to analyze the reason of misdiagnosed in order to improve the echocardiographic diagnosis.Methods A retrospective echocardiographic review of 36 fetuses with TOF confirmed by prenatal magnetic resonance imaging (MRI) or postnatal echocardiography.Results Among 36 cases of TOF fetuses,31 cases (86.1 ％) were diagnosed correctly by echocardiography,and in the remaining 5 cases,4 cases(11.1％) were misdiagnosed [2 cases misdiagnosed as ventricular septal defects (VSD),2 cases misdiagnosed as double outlet of right ventricles],and 1 case (2.8％) was missed diagnoses at 20 weeks gestation and confirmed as TOF at 36 weeks gestation based on the echocardiographic findings of malalignment type VSD,overriding aorta,pulmonary stenosis,and right ventricular hypertrophy.Malalignment type VSD,overriding aorta,and pulmonary stenosis were observed in 31 cases with TOF diagnosed by prenatal echocardiography,right ventricular hypertrophy was observed only in 6 cases.The most common associated anomalies were tricuspid regurgitation in 13 cases(36.1％),aortic insufficient in 6 cases(16.7％),absent pulmonary valve in 4 cases(11.1％),right-side aortic arch in 4 cases(11.1％),persistent left superior vena cava in 3 cases(8.3％),and complete atrioventricular septal defect in 1 case (2.8％).Conclusions Combining visualization of TOF in four-chamber view,outflow tract view,and three vessels view,TOF can be accurately diagnosed by prenatal echocardiography.