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BACKGROUND: Propofol induced a decline in the left ventricular (LV) systolic performance in non-cardiac surgery. We tested the hypothesis that propofol decreased the LV contractile function by dose dependent manner in cardiac surgery patients. METHODS: Anesthesia was maintained with target-controlled infusions of propofol and remifentanil in cardiac surgery patients. With a fixed effect-site concentration (Ce) of remifentanil (20 ng/mL) after sternotomy, the Ce of propofol was adjusted to maintain a Bispectral index of 40–60 (Ce1). Mitral annular Doppler tissue image tracings and other echocardiographic variables, including end-diastolic and end-systolic volumes, stroke volume, and mitral inflow pulse wave Doppler profile at Ce1, were recorded using transesophageal echocardiography. Echocardiographic recordings were repeated after the Ce-values of propofol were doubled and tripled at 10-minute intervals (defined as Ce2 and Ce3, respectively). Serial changes in echocardiographic variables for each Ce of propofol were assessed using generalized linear mixed effect modeling. The pharmacodynamic relationship between the Ce of propofol and peak systolic mitral annular velocity (Sm) was analyzed by logistic regression using non-linear mixed effect modeling (NONMEM). RESULTS: Means of Ce1, Ce2, and Ce3 were 0.8, 1.6, and 2.4 μg/mL, respectively, and their means of Sm (95% confidence interval) were 9.7 (9.3–10.2), 8.7 (8.2–9.1), and 7.5 cm/sec (7.0–8.0), respectively (P < 0.01). Ce values of propofol and Sm showed a significant inter-correlation and predictability (intercept, 10.8; slope–1.0 in generalized mixed linear modeling; P < 0.01). Ce values producing 10% and 20% decline of Sm with 50%-probability were 1.4 and 2.1 μg/mL, respectively. CONCLUSION: Propofol reduces LV systolic long-axis performance in a dose-dependent manner. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01826149
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Humans , Anesthesia , Echocardiography , Echocardiography, Transesophageal , Linear Models , Logistic Models , Propofol , Sternotomy , Stroke Volume , Thoracic SurgeryABSTRACT
Objective:To investigate the exercise echocardiography in the diagnosis Heartbeat application map in elderly coronary heart disease.Methods: One hundred and ninety-six elderly patients with coronary artery disease screening in 2013 January to 2014 June in our hospital were, as the research object. All patients underwent coronary angiography or operation treatment for coronary heart disease confirmed, first Heartbeat figure examined and diagnosed with conventional ultrasound, by exercise echocardiography combined with Doppler tissue imaging Heartbeat graph counting diagnosis and disease evaluation, diagnosis and disease evaluation results of statistical conventional echocardiography and exercise load method, and compare with a gold standard of coronary angiography.Results: conventional ultrasound Heartbeat diagram group detected 143 cases (72.96%), the joint inspection group detected 188 cases (95.92%), two inspection scheme comparison of the results of the existence of significant differences, exercise load method and the gold standard to compare the same no statistical significance; evaluation of coronary heart disease in conventional ultrasound Beckoning evaluation map was lower than the exercise ability load method, without statistical significance.Conclusion: exercise echocardiography beckoning diagram combined with Doppler tissue imaging in elderly patients with coronary artery disease detection rate and coronary angiography results are basically the same, and no iatrogenic injury to the patients, more convenient operation, inspection, examination cost is relatively low, with the clinical application and popularization value.
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Objective: To explore the early diaghostic value of thyroid hormone level in patients with left ventricular diastolic dysfunction. Methods: Our work included 4 groups:①Normal control group, n=40,②Impaired left ventricular diastolic function group, n=40,③Failure of left ventricular diastolic function group, n=41 and④Impaired left ventricular systolic function group, n=40. The cardiac function was assessed by color Doppler lfow imaging and tissue Doppler imaging for the early diastolic mitral lfow velocity (E), the peak early diastolic mitral annular velocity (Em) and the ratio of E/Em. The blood levels of NT-proBNP and FT3, FT4, TSH, rT3 were examined in clinical laboratory. Results: Blood levels of FT3 and rT3 were different in pair wise comparison among 4 groups, P0.05. The ratio of E/Em was negatively related to FT3 (r=-0.724, P Conclusion: The changes of thyroid hormone level may exist in patients with impaired diastolic function and it may vary with the severity of the cardiac dysfunction. Blood levels of NT-proBNP with thyroid hormone might be used as a reference index for early diagnosis of diastolic dysfunction.
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Objective To reveal the potential different longitudinal motion characteristics and differences of left and right muscular band (L-MB,R-MB)of interventricular septum (IVS) during systole and diastole in normal subjects.Methods Dual Doppler tissue imaging was applied for the longitudinal velocity curves of L-MB and R-MB of anterior and posterior interventricular septum(P-IVS,A-IVS) at basal,mid,and apical levels in eighty-two healthy subjects.Peak isovolumetric contraction (VIVC),systolic (Vs),early(Ve) and late (Va) diastolic velocities were measured,and myocardial velocity gradient(MVG)and Ve/Va ratio of each segment of L-MB and R-MB were calculated.Results ①Peak velocity of MB:the VrvC,Vs,Ve and Va of R-MB of both A-IVS and P-IVS were higher than those of L-MB; the VrvC,Vs,Ve and Va were gradually decreased from the base to apex of both A-IVS and P-IVS;the VIVC and Vs of A-IVS were higher than those of P-IVS; the Ve and Va of A-IVS were lower than those of P-IVS.②Correlation and MVG analyses of peak velocity of MB:the systolic and diastolic velocities between L-MB and R-MB of both A-IVS and P-IVS have shown a very strong positive correlation;the isovolumetric systolic MVG1 of L-MBof A-IVS,systolic MVG1 of R-MB of P-IVS and the diastolic MVG1 of both A-IVS and P-IVS were higher than those of MVG2.Conclusions The heterogeneity of longitudinal peak systolic and diastolic velocity and regional myocardial compliance,the consistency of moving direction and positive correlation of longitudinal peak systolic and diastolic velocity between L-MB and R-MB of both A-IVS and P-IVS have been demonstrated in normal subjects.
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Objective To evaluate the distribution characteristics of left ventricular systolic dyssynchrony (LV-SD) in dilated cardiomyopathy (DCM) patients with chronic heart failure (CHF) and normal QRS wave width, by pulsed-wave Doppler tissue imaging (PW-DTI), and study its relation with left ventricular systolic function, ventricular remodeling, and functional mitral regurgitation (FMR). Methods The time to peak systolic velocity (Ts) in 12 left ventricular segments was evaluated by PW-DTI, from which the standard deviation (SD) of Ts in the 12 segments (Ts-SD) and maximum Ts difference (Ts-maxD) were calculated. Results Ts-SD and Ts-maxD in the 12 LV segments of the DCM patients with CHF were significantly higher than those of the healthy controls (P＜0.01). In DCM patients with CHF and normal QRS wave width, the incidence of LV-SD was 29.8% (14/47) and the inferior wall was the most frequent distribution site of contraction delay. Linear regression analysis revealed a negative correlation between Ts-SD, Ts-maxD, and left ventricular ejection fraction (LVEF) (P＜0.01), but a positive correlation between Ts-SD, Ts-maxD and left ventricular end-diastolic volume (LVEDV), lefe ventricular end-systolic volume (LVESV), New York Heart Association (NYHA) cardiac function, FMR (P＜0.01) in DCM patients with CHF. Conclusion LV-SD exists in DCM patients with normal QRS width. LV-SD aggravates the LV systolic function damage, which is closely associated with left ventricular remodeling. LV-SD may contribute to the FMR in DCM patients.
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@#ObjectiveTo study the effects of anti-aldosterone on left ventricular function in patients with myocardial infarction. Methods130 patients with myocardial infarction were divided into anti-aldosterone group (spironolactone 20～40 mg/d + enalapril 10～20 mg/day, n=61) and control group (enalapril 10～20 mg/d, n=69). The echocardiogram and Doppler tissue imaging (DTI) were performed at enrolling time, and 6, 12 months after treatment. ResultsIn the anti-aldosterone group, the average mitral systolic wave (s) was significantly increased 6 months after treatment （P<0.05） to the enrolling time. LVEF and LVEDD improved 12 months after treatment （P<0.05）. In the control group, the average mitral systolic wave, LVEDD and LVEF did not significantly improve (P>0.05). Ratio of peak early to late diastolic filling velocity (e/a) was no significantly different between the anti-aldosterone group and the control group. ConclusionThe combination of anti-aldosterone and ACEI in patients with myocardial infarction can improve the left ventricular systolic function after 6 and 12 months, but cannot to the diastolic function.
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Objective To quantitatively assess the left ventricular systolic and diastolic function in the elderly patients with dilated cardiomyopathy (DCM) by using Doppler tissue imaging (DTI) and to explore its clinical value. Methods A total of 20 normal controls and 22 old patients with DCM were enrolled in the study. The left ventricular end-diastolic diameter (LVEDd), left atrial diameter (LAD) and left ventricle ejection fraction(LVEF) were obtained by routine echocardiogram. And the systolic and early diastolic peak velocity (Vs and Ve) were detected by quantitative tissue velocity imaging (QTVI) and the mean value was accounted. The systolic mitral valve displacements (MVD) in 6 sites were determined by tissue tracking technique and the mean value was calculated. Results The LVEDd and LAD were significantly higher in DCM group than in normal group [LVEDd: (67.56±10.27) mm vs. (43.36±4.20) mm; LAD: (49.91± 6.27) mm vs. (32.00+4.53) mm, t=10.229 and 10.359, both P<0.01]. And the LVEF, Vs and MVD were lower in DCM group than in normal group [LVEF: (26.50 ± 8.25)% vs. (64.00 + 4.72)%; Vs:(5.14+1.30) cm/s vs. (8.89+1.87) cm/s; MVD:4.82+1.85 vs. 10.23± 1.95, t=18.502, 7.716 and 8.143, all P< 0.01].The Vs and MVD were significantly positively correlated with LVEF (r=0.78 and 0.89, both P<0.01). Conclusions DTI can quantitatively assess global and regional left ventricular systolic and diastolic function of elderly patients with DCM, and provide the reliable information for the judgment of pathogenetic condition.
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AIM: To evaluate the cardiac contractility and relaxation by Doppler tissue imaging (DTI) combined with myocardial contrast echocardiography (MCE) via injection of contrast media, Albunex. METHODS： Nineteen healthy mongrel dogs were conducted 60 min ligation of left anterior descending coronary artery (LAD), followed by reperfusion of 60, 120 and 180 min to establish an acute myocardial ischemic-reperfused canine model. (1) MCE was performed by bolus injection of Albunex at pre-reperfusion and at post-reperfusion. The perfused defect area defined by MCE at pre-reperfusion was regarded as risk area (RAMCE), while perfused defect area at post-reperfusion was regarded as no-reflow area (NRAMCE). When the ratio of NRAMCE to RAMCE exceeded 25%, myocardial reperfusion was considered incomplete, I.e., no-reflow group; If the ratio was <25%, myocardial reperfusion was considered adequate, I.e., reflow group. (2) Left ventricular ejection fraction (LVEF) and wall thickness ratio (△T%) of LV anterior wall were determined. (3)S-wave, e-wave and a-wave velocities at the LV anterior wall were determined by DTI. The e/a ratio was measured. RESULTS: The results of MCE showed 7 dogs in reflow group and 10 dogs in no-reflow group. (1) LVEF in reflow group gradually increased with time course after myocardial reperfusion, and in no-reflow group, however, LVEF increasingly declined with ongoing myocardial reperfusion. At the same reperfusion time point, LVEF of no-reflow group was significantly lower than that of reflow group. (2) △T% in reflow group improved gradually, and however, it can not come back to that of baseline at 180-min reperfusion. △T% in no-reflow group had no signal of recovery with progressive reperfusion. (3) S-wave, e-wave velocities measured by DTI significantly declined after ligation of LAD, and a-wave velocity increased, leading to decline of e/a. After myocardial reperfusion, s-wave, e-wave velocities and e/a in reflow group gradually increased at post-reperfusion, and a-wave velocity somewhat declined. In no-reflow group, on the other hand, s-wave, e-wave velocities and e/a progressively declined and a significant difference was present between reflow group and no-reflow group (P<0.05). CONCLUSION: Cardiac contractility and relaxation can not be recovered during myocardial microvascular impairment. This change may be further deteriorated with size enlargement of no-reflow area. DTI may provide a sensitive, reliable method for quantifying cardiac contractility and relaxation.
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AIM:To detect and compare the longitudinal mitral annulus diastolic velocity and time interval changes by pulsed Doppler tissue imaging(DTI)in patients with angina pectoris(AP)and myocardial infarction(MI),and to explore the value of mitral annulus diastolic velocities and time intervals for evaluation of global left ventricular diastolic dysfunction.METHODS:Fifty patients with established coronary artery disease were divided into AP group(16 cases)and MI group(34 cases).Sixteen age-matched healthy individuals served as the control group.The septum,lateral,anterior and inferior walls of the mitral annulus were displayed,and selected for DTI spectrum sampling.Peak early and late diastolic velocities and their ratio,time to the onset and peak of the early diastolic wave,and regional isovolumic relaxation time were measured,and the average values of the four mitral annular sites were calculated and presented as Em,Am,Em/Am,QEm,TEm and IVRTm,respectively.RESULTS:Compared with the control group,Em and Em/Am were significantly lower in both the AP and the MI groups(P＜0.01).Em was even lower in the MI group than that in the AP group(P＜0.01).QEm,TEm and IVRTm were significantly longer in the AP and the MI groups than those in control group(P＜0.01 or P＜0.05).IVRTm was even longer in the MI group than that in AP group(P＜0.01).IVRTm had significantly negative correlation with Em(r=-0.64,P＜0.01).CONCLUSION:Em,Em/Am,QEm,TEm and IVRTm as measured by pulsed DTI may be promising indexes for quantitative assessment of global left ventricular diastolic dysfunction in patients with coronary artery disease.Em and IVRTm may indicate the severity of ischemic myocardial damage.
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@#Objective To investigate left ventricular systolic function with mitral annulus motion velocity(Sa) with pulsed-wave Doppler tissue imaging(PW-DTI) in patients with coronary arteriosclerosis disease(CAD) after percutaneous coronary intervention(PCI).Methods 52 patients with CAD,who were determined by coronary artery angiography,were divided into two groups,PCI group(n=33) and non-PCI group(n=19).They were followed up with PW-DTI and conventional echocardiography before and 5 d,3 months and 6 months after intervention in PCI ones,before and 6 months after angiography in non-PCI ones.In PCI group,the patients were divided two subgroups: EF≥50% and EF=30%～50%.Results The Sa improved significantly in PCI group 6 months after intervention(P<0.001).EF correlated with Sa(r=0.705,r=0.770 pre-and post-intervention respectively,P<0.0001).Conclusion Sa can be used to evaluate left ventricular systolic function of CAD patients.
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@#Objective To evaluate the application of Doppler tissue imaging (DTI) in assessment of cardiac function after percutaneous coronary intervention (PCI) for myocardial infarction (MI) for long term follow-up. Methods 86 patients with MI were divided in PCI group (45 cases) and conventional therapy group (41 cases). All the patients received two-dimensional echocardiography (2DE) and DTI measurements. The left ventricular ejection fraction (LVEF), peak E, peak A wave velocities and peak E versus peak A (E/A) of 2DE were recorded, as well as the velocity of systolic wave(s), early diastolic filling wave(e), late filling wave(a) and wave e versus wave a (e/a ) of DTI. Results The LVEF and the average velocity of systolic wave (s) of mitral annulus was increased after PCI (P<0.05). S wave was related to LVEF, but the sensitivity of s wave is better than that of LVEF. There was no difference in the pulse Doppler trans mitral flow velocity E/A before and after PCI (P>0.05) , but the average velocity of mitral annulus (e/a ) was remarkably increased after PCI (P<0.01).Conclusion The left ventricular systolic and diastolic function in MI patients be improved after PCI. DTI is a sensitive method to detect the cardiac function after MI and PCI.
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Objective To explore the value of Doppler tissue imaging(DTI) in assessing the left ventricular diastolic function of patients with essential hypertension.Methods Twenty healthy person(group A),35 essential hypertension(EH) patients with normal left ventrecular mass index(LVMI,group B) and 30 EH patients with left ventricular hypertrophy(LVH,group C) were included.The mitral annular velocity in early diastole(Ea) and late diastole(Aa) were detected by DTI,meanwhile the mitral inflow velocity E and A were detected.Results The E,E/A,Ea,Ea/Aa of group B and group C were lower than those of group A(P0.05).The Ea,Ea/Aa of group C were lower than those of group B(P
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Objective: To assess the regional systolic and diastolic function of left ventricle by pulsed wave Doppler tissue imaging ( PW-DTI) in patients with coronary artery disease ( CAD ) . Methods : Seventy-seven cases of coronary angiography were adopted for study and grouped in terms of severity of coronary arterial lesion. Peak systolic, peak early diastolic, and peak late diastolic motion velocities (Sm, Em and Am, respectively) were recorded at 6 different sites on the basal and medial segments corresponding to the anteroseptal, posteroseptal, lateral, anterior, inferior, and posterior walls of the left ventricle with PW-DTI. Results: Am in segments corresponding to normal coronary arteries (group A) was lower than in segments corresponding to slightly stenosed coronaries (group B). There was no significant difference in Sm and Em between group A and group B. Compared with group A, Sm, Em and Am were significantly decreased in segments corresponding to severely stenosed coronary arteries ( group D). Conclusion : PW-DTI could be used to evaluate quantitatively and accurately the regional mvocardial function of left ventricle in patients with CAD.
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Objective: To assess the regional systolic and diastolic function of left ventricle before and after coronary stent implantation by pulsed wave Doppler tissue imaging (PW-DTI). Methods: Twenty-six patients with coronary artery disease ( CAD) involving only left anterior descending coronary artery ( LAD) were examined within 1-3 days before, 7 days and 30 days after coronary stenting with PW-DTI. Peak systolic , peak early diastolic, and peak late diastolic motion velocities ( Sm, Em, and Am respectively) were measured at 6 different sites on the basal and medial segments corresponding to the anteroseptal, postero-septal, lateral, anterior, inferior, and posterior walls of the left ventricle. Results:In corresponding segments depending on LAD blood flow supply, Sm was increased significantly 7 days after the stenting proce- dure. Em was also increased 7 days after the procedure in most of the corresponding segments. There were little changes in other segments that were independent on LAD blood flow supply. Conclusion: These findings suggest that there is an early improvement in the regional systolic and diastolic function of the left ventricle after the coronary stenting, and that PW-DTI techniques could evaluate quantitatively the regional ventricular performance in patients receiving percutaneous coronary intervention.
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BACKGROUND: Abnormalities of the left ventricular (LV) diastolic dysfunction are common in patients with end-stage renal disease (ESRD). Recently, Doppler tissue imaging (DTI) has been introduced as a method to evaluate diastolic function or myocardial relaxation by measuring mitral annulus velocity during diastole. This study was undertaken to assess resting diastolic function and diastolic functional reserve during exercise in ESRD patients starting dialysis treatment. METHODS: Mitral inflow velocities by Doppler echocardiography and septal mitral annular velocities by DTI were measured at rest and during supine bicycle exercise in 22 new ESRD patients and 23 age- and sex-matched subjects with normal renal function as a control. RESULTS: LV end-diastolic and end-systolic dimensions, septal thickness, and left atrial volume index were significantly higher in patients with ESRD compared with those of controls (p<0.01). LV ejection fraction was significantly lower in ESRD group (p<0.05). There were no significant differences in mitral inflow velocities (E, E/A, DT) between the two groups except A velocity, which was significantly higher in ESRD group (p<0.01). However, early diastolic mitral annular velocity (E') at rest (5.3+/-1.3 cm/sec vs. 6.5+/-1.5 cm/sec, p=0.013) and augmentation of E' with exercise (deltaE') were significantly lower in ESRD group compared with controls (at 25W exercise, 1.3+/-1.6 cm/sec vs. 4.0+/-3.0 cm/sec, p=0.002; at 50W exercise, 3.3+/-2.3 cm/sec vs. 6.5+/-5.3 cm/sec, p=0.030). CONCLUSION: Unlike conventional mitral inflow parameters, longitudinal resting diastolic function and diastolic functional reserve during exercise assessed by DTI were significantly reduced in ESRD patients starting dialysis treatment.
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Humans , Dialysis , Diastole , Echocardiography, Doppler , Kidney Failure, Chronic , RelaxationABSTRACT
En la etapa indeterminada de la enfermedad de Chagas (ECh) las alteraciones de la función diastólica preceden a las de la función sistólica. El Doppler tisular pulsado (DTP), es una nueva técnica no invasiva que permite analizar la función diastólica mediante el registro de la velocidad de estiramiento miocárdica en el eje longitudinal. Con el objetivo de estudiar el valor del DTP en la ECh fueron evaluados con ecocardiograma y Doppler 49 pacientes con serología positiva para ECh (49 ± 12 años) y 20 individuos normales, (45 ± 15 años) como grupo control (C). De acuerdo al patrón del flujo mitral y de vena pulmonar los pacientes con ECh fueron divididos en 4 grupos: función diastólica normal (N), relajación prolongada (RP), pseudonormal (PN) y restrictivo (R). La velocidad pico de la onda E del anillo lateral mitral (Ea) estuvo disminuida en las pacientes con patrón de RP, PN y R (0.11 ± 0.02 m/seg, 0.10 ± 0.02 m/seg y 0.12 ± 0.06 m/seg respectivamente) con respecto al grupo C (0.18 ± 0.07 m/seg, p < 0.01) pero no en los pacientes con patrón N (0.15 ± 0.03 m/seg N.S.). En este último grupo de pacientes sólo la relación velocidad pico de la onda E del flujo transmitral/Ea permitió detectar anormalidades de la función diastólica con respecto al grupo control (4.92 ± 0.98 vs 4.14 ± 1.26, p < 0.05). El DTP permite objetivar alteraciones de la función diastólica en pacientes con ECh, incluso en aquellos que presentan patrón del flujo mitral y de vena pulmonar normal.
Diastolic function is involved early during the undetermined form of Chagas'disease (Ch). Pulsed Doppler tissue imaging (DTI) is a new technique to evaluate diastolic function recording myocardial velocities in the longitudinal axis. To evaluate the relevance of DTI in patients with Ch, we studied, with Doppler and echocardiography, 49 patients (average age 49 ± 12 years) and 20 normal subjects (average age 45 ± 15 years) as a control group (C). Patients were divided in four groups according to the pattern of their mitral and pulmonary vein flows: Normal diastolic function (N), prolonged relaxation (PR), pseudonormal (PN) and restrictive (R). Peak velocity of the E wave of the lateral mitral annulus (Ea) was diminished in PR, PN, and R patients (0.11 ± 0.02 m/s, 0.10 ± 0.02 m/s and 0.12 ± 0.06 m/s, respectively) as compared to group C (0.18 ± 0.07 m/s, p < 0.01) but not with respect to group N (0.15 ± 0.03 m/s, N.S.). In this latter group only peak E velocity of transmitral flow/Ea ratio was useful to detect diastolic abnormalities as compared to group C (4.92 ± 0.98 vs 4.14 ± 1.26, p < 0.05). DTI was useful in the assessment of diastolic function in Ch, including those patients in whom mitral and pulmonary vein flows were normal. (Arch Cardiol Mex 2004; 74:31-38).
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Adult , Female , Humans , Male , Middle Aged , Chagas Cardiomyopathy , Echocardiography, Doppler, Pulsed/methods , Heart Ventricles , Ventricular Function/physiology , Case-Control Studies , Chagas Cardiomyopathy/physiopathology , Diastole/physiology , Heart Ventricles/physiopathology , Prospective StudiesABSTRACT
BACKGROUND AND OBJECTIVES: Mitral annulus velocity profile during diastole may provide additional information about left ventricular diastolic function. This study assessed the change of mitral annulus velocity profile during diastole with aging and the differences between septal and lateral annulus. SUBJECTS AND METHODS: Simultaneous measurements of annular velocity at both septal and lateral annulus were performed in 171 consecutive patients who had no evidence of hypertension, diabetes, other heart diseases and rhythm disturbances. RESULTS: The mean age of the subjects was 44.6+/-15.2 years (range:16-74) and male 93, female 68. The Em and Em/Am were well correlated with age negatively, irrespective of the position of sample volume (Em(septum):r=-0.75, p<0.0001, Emlateral:r=-0.78, p<0.0001;Em/Am(septum):r=-0.72, p<0.0001, Em/Am(lateral):r=-0.71, p<0.0001). The Em and Em/Am were significantly decreased in septum compared with lateral annulus (Em:9.9+/-3.1 vs. 13.5+/-4.1, p<0.0001;Em/Am:1.15+/-0.57 vs. 1.53+/-0.75, p<0.0001). CONCLUSION: The indices of mitral annular velocity were well correlated with aging negatively. And the mitral annular velocity was decreased significantly at the septum compared with lateral annulus.
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Female , Humans , Male , Aging , Diastole , Heart Diseases , HypertensionABSTRACT
Objective To assess the changes of the cardiac function of the patients with myocardial infarction(MI) after the coronary revascularization(CRV) by 2D echocardiography and Doppler tissue imaging(DTI).The effects of CRV on cardiac function were explored.Methods The global and regional wall functions were quantitatively analyzed in 49 patients with MI by 2D echocardiography and DTI(Aspen imaging systems).Results The regional function was improved prior to the global function in patients with MI after successful CRV.Conclusions CRV is one of the important factors for the cardiac function improvement in patients with MI.
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Objective: To establish porcine chronic ischemic myocardium model and to evaluate ultrasonic integrated backscatter(IBS) and Doppler tissue imaging(DTI) in detecting this model. Methods: An Ameroid constrictor was placed around the porcine proximal left circumflex artery. The calibrated average image intensity (%AⅡ), cyclic variation of IBS (CVIB), the subendo-epicardical gradient index (TGI) and the spectrum of left ventricular papillary muscle level short axis view (LVPM-SAM) and apical four chamber view (AP-4CV) were measured at normal state, 2 w, 4 w, 6 w and 8 w after Ameroid placement. Results: Normal %AⅡ, CVIB and TGI were 2.29?0.32,(9.69?2.22)dB and 0.22? 0.08 respectively. After Ameroid placement, the %AII increased gradually, the CVIB decreased gradually, and the decrease was higher in subepicardium than that in subendocardium. The most obvious decrease of TGI occurred from 2 w to 4 w after Ameroid placement and became zero at 8 w(P
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Objective To observe longitudinal motion characteristics of regional myocardium in left bundle branch block(LBBB) patients. Methods Left ventricular regional myocardium of 15 LBBB patients and 15 normal subjects were assessed by tissue Doppler imaging(TDI). Peak velocities(V_S,V_E,V_A) during isovolumic contraction, ejection, isovolumic relaxation, early relaxation, atrial systole phases and maximum time velocity integral(TVI_(max)), displacement(D_(max)) in mitral(tricuspidal) annulets of different walls were measured. Furthermore, the different parameters from the beginning of electrocardiogram QRS wave to the beginning of S wave(Q-Sb),to the tip of S wave(TTP), the acceleration time of IVC wave(IVA), the acceleration time of the E wave(Eac),the durations of different phases(IVC,S,IVR,D)and IVC/S and others were acquired. Results Peak velocities(V_S,V_E)and TVI_(max) in left ventricular septal, inferior, anterior, posterior walls were lower in LBBB group than control group; those parameters in different segments of left and right ventricular lateral myocardium were not significantly lower in LBBB group than control group. What is more, D_(max) of mitral annular sites in LBBB group were lower than control group. Q-Sb, TTP and IVC in left ventricular septal, inferior, anterior, posterior walls were longer in LBBB group than in control group; IVA lengthened, Eac and Edc shortened in left ventricular septal, inferior walls; IVR lengthened, diastole shortened, IVC/S increased in left ventricular septal, inferior, and posterior walls. Conclusions Abnormal left ventricular activation sequence during LBBB caused obvious impairment in total and regional systolic and diastolic function. And delayed contraction with different degrees were resulted from different walls of left ventricle with intraventricular dyssynchrony; but contraction in right ventricle was not significantly delayed, with interventricular dyssynchrony.