ABSTRACT
Objective@#To explore the value of parameters obtained by dual-pulse wave Doppler to predict the recurrence of atrial fibrillation (AF) after radiofrequency catheter ablation(RFCA) and the value of the technology to evaluate the left ventricular diastolic function of the AF.@*Methods@#Sixty-seven AF patients who were subjected to ablation were selected as the case group, and 47 patients with sinus rhythm were matched as control group. The general clinical data of the case group and the control group was collected, routine ultrasound examination and dual-pulse wave Doppler examination were performed to all of them. A 24-hour Holter examination was performed at 3, 6 and 12 months after radiofrequency catheter ablation in the case group, the patients were divided into two groups with and without recurrence according to the results. Dual-pulse wave Doppler parameters included: ①the time interval between the onset of early transmitral flow velocity (E) and that of early diastolic mitral annular velocity (e′) (TE-e′); ②peak early diastolic transmitral flow velocity (E) and tissue Doppler septal (S) mitral annular early diastolic velocity (e′), peak early diastolic transmitral flow velocity (E) and tissue Doppler lateral (L) mitral annular early diastolic velocity (e′), E/e′(S) and E/e′(L). The differences between the case group and the control group, and between the recurrent and the non-recurrent group were compared. The factors influencing the recurrence of AF after RFCA were analyzed with univariate and multivariate Logistic regression.@*Results@#①The parameters E/e′(S), E/e′(L) and TE-e′ of case group were higher than those of control group (all P<0.05); ②During follow-up examinations after the ablation, 21 (31.34%) patients recurred. TE-e′ of the recurrence group was higher than that in the nonrecurrence group (P<0.001). The parameters E/e′(S) and E/e′(L) in the recurrence group had no difference compared with those in nonrecurrence group without recurrence(all P>0.05); ③Univariate and multivariate Logistic regression suggested that TE-e′ was an independent predictor for the recurrence of AF patients after the ablation(P=0.001).@*Conclusions@#Dual-pulse wave Doppler can evaluate left ventricular diastolic function of atrial fibrillation, TE-e′ is an independent predictor for the recurrence of AF patients after radiofrequency catheter ablation.
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Objective To discuss the function and advantages of ultrasound technology in various factors in the diagnosis of vertebral artery stenosis lesions.Methods The objective data of ultrasonography were selected in 60 patients (120 vertebral arteries) with paroxysmal,reversible vertigo and headache as the chief complaint,the internal relations were summarized and analyzed.Results In the subjects of study,the vertebral artery stenosis for 38.2％,vertebral artery course tortuosity changer accounted for 33.3％,congenital abnormal development accounted for 9.8％,mixed cause 18.6％,dominant etiology was vertebral artery sclerosis and vertebral artery tortuosity change.Conclusion Ultrasound technology has important value of clinical application in the reasons diagnosis of vertebral artery stenosis disease,it can help extend clinical diagnosis.
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Objective To define the mechanical features of mitral annulus at various sites,and to investigate the specific mechanics characterization at different mitral annulus sites in evaluation consequences of left ventricular function by dual pulse-wave Doppler (DPW) technology.Methods The DPW spectrums were obtained at lateral and aboral interval,anterior and inferior and posterior mitral annular from 112 normal adults.The peak systolic velocity (Sm),peak early diastolic velocity (Em),peak late diastolic velocity (Am),the beginning time of the peak and the time to peak were measured,and E/A,Em/Am,E/Em,left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) were computed.Results 1)Sm,Em,Am and Em/Am measured in the free wall annulus were significantly greater than measured in the interval annulus of mitral annular sites.However,E/Em was opposited (P ＜ 0.05).Sm of the posterior wall mitral annulus accelerated frist and experienced shortest duration in all the mitral annular sites (P ＜ 0.01).There were no significant differences of Em time parameters among different mitral annulus sites.Am of the beginning time and peak time in the free wall annulus were significantly longer than that in the interval annulus of anterior mitral annular sites.However,the acceleration time was opposited(P ＜0.05).2) Sm was correlated with LVEF and LVFS (r =0.243 and r =0.227,P ＜0.01) only at the posterior mitral annular site,Em/Am of anterior and posterior wall mitral annulus had the highest correlations with mitral orifice flow E/A(r =0.545 and 0.545 respectively,P ＜ 0.01).Conclusions There are significant differences among the mechanics patterns at different mitral annulus sites in normal adults.The mechanics characterization at different mitral annulus sites have different conclusions of left ventricular function.
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ObjectiveTo quantify the underestimation of cardiac blood flow velocities measured by Doppler echocardiography and to explore a method for correction using a new explored dual PW/TDI technique.MethodsThe dual PW/DTI mode was used to simultaneously record the aortic,mitral,tricuspid and pulmonary valvular blood flow velocity and the adjacent valvular annulus velocity in forty healthy volunteers,then the underestimations of the flow velocities were calculated.ResultsThe true blood flow velocity relative to the valvular annulus could be obtained by dual PW/TDI technique.Conventional Doppler echocardiographic measurements significantly underestimated the true velocity ( P ＜ 0.001).The actual aortic blood flow velocity had a significant underestimation of (8.5 ± 1.2) ％,the actual flow velocity of the pulmonary artery had a significant underestimation of (6.6 ± 1.1) ％,the underestimations of E and A wave of mitralvalve's were (13.4 ± 1.7)％ and (16.7± 3.4)％,the underestimations of E and A wave of tricuspid valve' s were ( 18.7 ± 1.9) ％ and (26.0 ± 16.1 ) ％.ConclusionsThe cardiac blood flow velocity measured by Doppler ultrasound has been significantly underestimated and this underestimation can bequantified and corrected using dual PW/DTI technique based on the principle of motion relativity.