Quantitative evaluation of left ventricular myocardium damage in patients with breast cancer after combined chemotherapy using velocity vector imaging / 中国医学影像技术

Objective: To investigate the value of velocity vector imaging (VVI) in quantitatively evaluating the degree of myocardial damage in breast cancer patients treated with combined chemotherapy. Methods Totally 65 patients with human epidermal growth factor receptor-2 (HER-2) positive breast cancer were divided into CETH group (combined chemotherapy with Herceptin) and CET group (combined chemotherapy). Routine echocardiography and VVI were performed before chemotherapy and at the end of the 5th and 7th chemotherapy cycles, respectively. The parameters of conventional echocardiography, systolic strain rate (SSR) and early diastolic strain rate (DSR) were analyzed. Results No significant difference of ultrasound parameters was found between CETH group and CET group before and at the end of the 5th, 7th cycles of chemotherapy (all P>0.05). In both CETH group and CET group, there were significant differences of SSR and DSR in 16 segments of left ventricle before and at the end of the 5th and 7th cycles of chemotherapy (all P<0.05). With the prolongation of chemotherapy time, SSR and DSR decreased gradually, and there were significant differences between each of the two time points (all P<0.05). At the end of the 7th cycle of chemotherapy, SSR and DSR of left ventricular segments in CETH group were lower than those in CET group (all P<0.05). Conclusion VVI is more sensitive than conventional echocardiography in detecting left ventricular myocardial damage, which can quantitatively assess myocardial damage of breast cancer patients with different chemotherapy regimens.

Velocity vector imaging in evaluation of impact of hemodialysis on left ventricular longitudinal strain of myocardium in uremia patients / 中国医学影像技术

Objective: To investigate the value of velocity vector imaging (VVI) technique in evaluation of the impact of hemodialysis on left ventricular longitudinal strain of myocardium in uremia patients. Methods: Echocardiography was performed in 35 uremia patients who underwent high flux hemodialysis before and 2 h after dialysis. The peak systolic longitudinal strain (LPS) of 3 layers at 17 segments of left ventricular were obtained using VVI software after conventional measurement. Results: The left atrial diameter, left ventricular end diastolic and end systolic diameter, left ventricular end diastolic and end systolic volume as well as stroke volume reduced after dialysis (all P0.05). Conclusion: VVI technique can sensitively and accurately evaluate the impact of hemodialysis on the global and local systolic function of left ventricular myocardium in uremic patients.

Study on carotid artery elasticity in elderly patients with metabolic syndrome / 中华老年医学杂志

Objective To analyze motion characteristics of the carotid artery wall and to evaluate changes of carotid artery elasticity in elderly patients with metabolic syndrome (MS)by using velocity vector imaging (VVI). Methods A total of 111 elderly patients with metabolic syndrome were continuously enrolled in this prospective study. Patients received a health questionnaire ,physical examinations ,blood biochemical indexes tests ,and carotid artery ultrasound examination. According to carotid intima-media thickness(IMT)and carotid plaques ,patients were divided into a group of MS with carotid plaques (n= 34) ,a group of MS without carotid plaques (n= 31)and a control group (n=46).Dynamic images of the short axial section at 1 cm from the bifurcation of the right common carotid artery were collected in all cases ,and the VVI offline software was used to detect and record the maximum radial velocity (V) ,maximum tangential strain(S)and maximum tangential strain(SR)of each segment as well as the average V(EV) ,average S(ES)and average SR(ESR)of the entire vessel. Results IMT was higher in the group of MS with carotid plaques than in the group of MS without carotid plaques and the control group(P＜0.01) ,and there was no statistical difference between the group of MS without carotid plaques and the control group(P＜0.05).V ,S ,SR ,EV ,ES and ESR in the two MS groups were lower than in the control group. There were statistically significant differences in V ,S ,SR ,EV ,ES and ESR between the MS groups (P＜ 0.01).EV was negatively correlated with hypertension ,hyperglycemia ,hypertriglyceridemia and low high-density lipoprotein cholesterol(r= -0.305 ,-0.625 ,-0.647 and -0.337 ,respectively ,P＜0.01).ES was negatively correlated with hypertension ,hyperglycemia ,hypertriglyceridemia and low high-density lipoprotein cholesterol(r= -0.252 ,-0.673 ,-0.528 and -0.273 ,respectively ,P＜ 0.01 or 0.05).ESR was negatively correlated with hypertension ,hyperglycemia ,hypertriglyceridemia and low high-density lipoprotein cholesterol(r= -0.315 ,-0.697 ,-0.609 and -0.385 ,respectively ,P＜0.01 or 0.05). Conclusions VVI technology can assess the motion characteristics of the carotid artery wall , evaluate changes of carotid artery elasticity earlier than conventional ultrasound in elderly MS patients , and therefore provide a theoretical basis for the early diagnosis of atherosclerosis.

Role of Quantitative Wall Motion Analysis in Patients with Acute Chest Pain at Emergency Department

BACKGROUND: Evaluation of acute chest pain in emergency department (ED), using limited resource and time, is still very difficult despite recent development of many diagnostic tools. In this study, we tried to determine the applicability of new semi-automated cardiac function analysis tool, velocity vector imaging (VVI), in the evaluation of the patients with acute chest pain in ED. METHODS: We prospectively enrolled 48 patients, who visited ED with acute chest pain, and store images to analyze VVI from July 2005 to July 2007. RESULTS: In 677 of 768 segments (88%), the analysis by VVI was feasible among 48 patients. Peak systolic radial velocity (V(peak)) and strain significantly decreased according to visual regional wall motion abnormality (V(peak), 3.50 ± 1.34 cm/s for normal vs. 3.46 ± 1.52 cm/s for hypokinesia, 2.51 ± 1.26 for akinesia, p < 0.01; peak systolic radial strain -31.74 ± 9.15% fornormal, -24.33 ± 6.28% for hypokinesia, -20.30 ± 7.78% for akinesia, p < 0.01). However, the velocity vectors at the time of mitral valve opening (MVO) were directed outward in the visually normal myocardium, inward velocity vectors were revealed in the visually akinetic area (V(MVO), -0.85 ± 1.65 cm/s for normal vs. 0.10 ± 1.46 cm/s for akinesia, p < 0.001). At coronary angiography, V(MVO) clearly increased in the ischemic area (V(MVO), -0.88+1.56 cm/s for normal vs. 0.70 + 2.04 cm/s for ischemic area, p < 0.01). CONCLUSION: Regional wall motion assessment using VVI showed could be used to detect significant ischemia in the patient with acute chest pain at ED.

Evaluation on the ventricular dyssynchrony in patients with pulmonary hypertension using velocity vector imaging / 中华超声影像学杂志

Objective To determine whether strain and strain rate derived from velocity vector imaging ( VVI) allowed assessment of regional and global right ventricular ( RV) dysfunction and intra‐and inter‐ventricular dyssynchrony in patients with pulmonary hypertension ( PHTN) . Methods Ninety‐nine patients were enrolled , including 35 controls and 64 PHTN patients . All participants underwent echocardiography examinations and off line strain/strain rate analysis . Bi‐ventricular regional peak systolic strain ,strain rate ,and the time‐to‐peak systolic variables were measured at the RV free wall ,inter‐ventricular septum ,and LV lateral wall in apical four chamber views . Standard deviations of the time‐to‐peak systolic strain (SD‐Ts) and strain rate (SD‐Tsr) at six RV and three left ventricular (LV) segments were calculated to define intra‐and inter‐ventricular dyssynchrony . Results Compared with the controls , segmental and global peak systolic strain and strain rate decreased in the PHTN patients . And intra‐right ventricular dyssynchrony was present in the PHTN patients [SD‐Ts:(28 ± 20)ms in controls vs (61 ± 62) ms in patients , P = 0 .003 ] . The difference between the time‐to‐peak systolic strain rate at the basal segment of RV free wall and LV lateral wall indicated earlier RV free wall contraction in PHTN patients , relativetoLVlateralwall,particularlyinthoseseverePHTNpatients[(13±13)msincontrolsvs( -49± 14) ms in patients , P < 0 .01] . Conclusions PHTN impairs RV myocardial contraction and induces to ventricular mechanical dyssynchrony .VVI could monitor RV function during the treatment of PHTN .

Application progress of velocity vector imaging in cardiovascular diseases / 心血管康复医学杂志

Velocity vector imaging (VVI) can quantitatively detect biomechanical characteristics of myocardium and vascular wall based on the principle of speckle tracking , getting rid of the angular dependence of tissue Doppler ima‐ging (TDI) .It can distinguish myocardial segment movements ,observe cardiac twisting motion and discover early e‐lastic changes of vascular wall and evaluate stability of atherosclerotic plaques ,which possesses important signifi‐cance for differential diagnosis of early heart and vascular diseases .The present article made a review on application progress of VVI in cardiovascular diseases .

Assessment of left ventricular torsion and untwisting in patients suffering from dilated cardiomyopathy by velocity vector imaging / 解放军医学杂志

Objective To evaluate the characteristics of left ventricular twisting (LVtw) and untwisting (LVuntw) in patients with dilated cardiomyopathy (DCM). MethodsNineteen DCM patients (aged 18-82 years, mean 50.52±17.52 years, 2 females) and 21 normal controls (aged 18-80 years, mean 49.05±16.94 years, 5 females) were enrolled in present study. Basal and apical short axis view of two-dimensional images of left ventricle were obtained to analyze LV rotation, and the LV rotation velocity was detected by velocity vector imaging (VVI). LVtw, LVtw velocity, untwisting velocity and untwisting rate (untwR) were calculated. ResultsThe rotated degree and velocity of the basal and apical parts of LV myocardium were irregularly changed along with the cardiac cycle in the DCM group. The rotation degree and rotation velocity at the basal and apex axis decreased in DCM group compared with that in normal group, while the peak of twisting (Ptw) [(6.49±1.82)°] and the peak of twisting velocity (PTV) [(67.84±15.60)°/s] decreased significantly in DCM group. The untwR and peak of untwisting velocity (PUV) were also decreased significantly in DCM patients. ConclusionThe Ptw, PTV and PUV decrease significantly, and the LV untwR, impacted by the preload, is also decreased significantly in DCM patients.

An evaluation of left ventricular function in NMT by velocity vector imaging / 预防医学

Objective To evaluate of velocity vector imaging technology in methadone maintenance treatment patients. Methods From June to December in 2011,78 cases of heroin addicts were selected as observation group,and 78 healthy persons who received physical examination at the same period were selected as the control group.Velocity vector imaging technology was measured for both groups.Results All of early diastolic peak velocity and early diastolic max strain rate of the basement,left ventricular interval before,left ventricular apex,left ventricular wall between basement,in the left ventricular wall,the left ventricular segmental wall apex in observation group were significantly lower than that in the control group (P <0.05).Conclusion The velocity vector imaging technology could be applied to evaluate left ventricular function among methadone maintenance treatment patients.

Evaluation of regional myocardial mechanics of right ventricle in patients with liver cirrhosis using velocity vector imaging combined with isometric stress test / 中华超声影像学杂志

Objective To study regional myocardial function of right ventricle at different stages of cirrhosis,using velocity vector imaging combined with standard isometric grip strength test to reveal the mechanical function in patients with liver cirrhosis at early stage further,and to benefit reliable quantitative evaluation and efficacy indicators for the establishment of the early diagnostic criteria of cirrhotic cardiomyopathy by echocardiography,and found myocardial mechanics basis for explicit pathogenesis of cirrhotic cardiomyopathy.Methods Accorded to Child-Pugh score,the cirrhosis experimental groups were divided into three groups:group A (42 patients),group B (28 patients) and group C (12 patients).There were 31 patients in group A to be conducted standard isometric grip strength test.While 34 healthy people were selected as the control group.The dynamic gray scale long-axis view images of the right ventricle were collected in 3 complete cardiac cycles in apical four-chamber view.Peak systolic longitudinal strain (Smax) and global ejection fraction of the right ventricle were derived from 6 myocardial segments with the Syngo VVI workstation off-line.Results 1)Compared with the control group,in group A,global ejection fraction of the right ventricle was normal,there were not significant change of Smax of each segment (P ＞0.05).In group B,there was not significant change of global ejection fraction of the right ventricle,the Smax of each segment were increased mainly (P ＜0.05-0.01).In group C,global ejection fraction of the right ventricle was significantly lower (P ＜ 0.01),the Smax of each segment reduced mainly (P ＜ 0.05-0.01).2)Compared with group A,in group B,there was no significant difference of blood pressure and global ejection fraction of the right ventricle,while including the Smax of each segment in systole and diastole.Compared with group A and group B,in group C,systolic and diastolic blood pressure and global ejection fraction of the right ventricle decreased significantly; the Smax of each segment were reduced mainly (P ＜ 0.05-0.01).3)Compared with the resting state,after the standard isometric grip strength test,the global ejection fraction of the right ventricle decreased significantly,there was a significant reduction mainly in Smax of each segment (P ＜ 0.01).Conclusions The regional myocardial function of right ventricle in patients with liver cirrhosis is abnormality even at early stage and could be revealed by standard isometric stress test.The right ventricular systolic dyfunction is related to the stages of liver cirrhosis disease.

Quantitative assessment of segmental ventricular wall motion abnormalities in patients with coronary artery heart disease / 中国医师进修杂志

Objective To assess segmental ventricular wall motion abnormalities in patients with coronary artery heart disease by velocity vector imaging (VVI).Methods Eight-six patients of chest pain having underwent coronary angiography were selected,and were divided into myocardial ischemia group (31 cases),myocardial infarction group(25 cases) and normal group (30 cases) according to test results.All the patients were checked with ultrasonic cardiogram in specified time.Systolic rotation angle and speed,diastolic rotation speed in the bottom and apex heart of each segment (anterior,anterior septum,posterior,lateral,inferior wall,interval) was analyzed by VVI.Results Rotary motion of the left ventricle was not consistent in different segment in myocardial infarction group,and the extent and form was different compared with that in normal group.Compared with that in normal group,bottom and apex heart angle of rotation of each segment in myocardial infarction group showed significant difference (P ＜ 0.01 or ＜ 0.05).The rotation angle of each segment in apex and bottom heart between myocardial ischemia group and normal group had no statistical significance (P ＞0.05).In bottom heart:the systolic rotation speed on anterior wall,anterior septum,posterior wall and lateral wall in myocardial infarction group was statistically lower than that in normal group (P ＜ 0.01 or ＜ 0.05),and the diastolic rotation speed on anterior wall,anterior septum,posterior wall,lateral wall,inferior wall was statistically lower than that in normal group (P ＜ 0.01 or ＜ 0.05).The systolic rotation angle between two groups was not statistically significant (P ＞ 0.05).The diastoic rotation speed on anterior interval septum in myocardial ischemia group was statistically lower than that in normal group (P ＜ 0.05),the systolic rotation angle and speed,diastolic rotation speed in other segment was not statistically significant compared with that in normal group (P ＞ 0.05).In apex heart,the systolic rotation speed in anterior wall,anterior septum,posterior wall in myocardial infarction group was statistically lower than that in normal group (P ＜ 0.01 or ＜ 0.05),and the diastolic rotation speed in anterior wall,posterior wall,lateral wall,inferior wall was statistically lower than that in normal group (P ＜ 0.01 or ＜ 0.05).The diastolic rotation speed on anterior and inferior wall in myocardial ischemia group was statistically lower than that in normal group (P ＜ 0.05),and the systolic rotation angle and speed,diastolic rotation speed in other segment was not statistically significant (P ＞ 0.05) compared with that in normal group.Conclusion VVI technique in ultrasonic cardiogram can check out difference between myocardial ischemia and myocardial infarction incipiently.

Determinationofleftventricularbiomechanicalparametersbyusing velocity vector imaging technology and its application in assessing coronary artery stenosis in coronary artery disease / 吉林大学学报(医学版)

Objective To determine the biomechanical parameters of left ventricular by using velocity vector imaging (VVI),and to indirectly assess the coronary artery stenosis with VVI in the patients with coronary artery disease (CAD).Methods 52 patients who had one coronary artery lesions at least diagnosed by coronary angiography (CAG)were divided into coronary artery mild stenosis group and severe stenosis group;2 1 patients in mild stenosis group had one coronary stenosis <75%;31 patients in severe stenosis group had one coronary artery stenosis ≥75% at least.At the same time,20 cases of normal people without coronary artery stenosis showed by CAG were selected as normal control group. VVI was used to detect the left ventricular wall segments of the overall longitudinal strain (GLS ), the overall circumferential strain (GCS ) and the overall radial strain (GRS ). Results The absolute values of GLS,GRS,GCS of the patients in mild and severe coronary artery stenosis groups were significantly decreased than those in normal control group(P<0.05),and the strain parameters in severe stenosis group were decreased more significantly, there were significant differences compared mild stenosis group (P<0.05 ). The distribution of the segments with decreased longitudinal strain matched the LV myocardial segment with the coronary stenosis rate ≥ 75%,and GLS had the most sensitivity.The GLS in normal control group,mild stenosis group and severe stenosis group were negatively correlated to left ventricular ejection fraction (LVEF)(r=-0.58,P<0.05;r=-0.51,P<0.05;r=-0.43,P<0.05).GLS-16.14 % was used to assess the severe coronary artery stenosis with requiring the implementation of PTCA treatment as the diagnostic cut-off point with sensitivity 96.8%, specificity of 70%, the highest Yuedden index 0.668. Conclusion The decreasing of left ventricular strain could be detected by VVI, which suggests that severe coronary artery stenosis exists in coronary artery;the distribution of the segments with significantly decreased strains can be used to assess the coronary lesions and stenosis degrees.

Application of velocity vector imaging and dobutamine stress echocardiography in evaluating the strain of left ventricular in the long axis views in diabetic patients with LVEF ＞50％ / 中华超声影像学杂志

Objective To assess the systolic strain of left ventricular(LV) in the long axis views in diabeties mellitus(DM) patients with LVEF value ＞ 50％ with velocity vector imaging (VVI) and dobutamine stress echocardiography (DSE).Methods Thirty DM patients,which were excluded from coronary artery disease,valvular heart diseases,congenital heart diseases,hypertension,and LVEF value ＞50％ by echocardiography,and 20 volunteers with age and sex matched were involved in the study.Two-dimensional VVI echocardiographic cine loops were stored at baseline and dobutamine stress in the apical four-chamber,two-chamber and long axis views of LV.The maximum long systolic velocity (Vs),strain (ε)and strain rate (SR) were obtained from sygno VVI software.Results The Vs,ε and SR decreased from basal to apical in the LV walls whether in the control group or in the DM group.At baseline,SR in 7 segments,ε in 4 segments and Vs in 3 segments in the DM group decreased significantly than those in the control group (P ＜0.05).After the maximum dobutamine stress,all parameters decreased significantly in the DM group than those in the control group (all P ＜0.05).In addition,67％ parameters in apical LV and 11％ parameters in middle LV in the DM group were lower than those in the control group.All parameters in basal LV were comparable between the two groups at baseline.Conclusions The Vs,ε and SR showed decreased tendency from basal to apical in the long axis of LV.The Vs,ε and SR impairment in the long axis of DM patients appeared first in apical tissue of LV.DSE could increase the sensitivity of VVI parameters in the earlier stage.

Quantitative Analysis of Longitudinal Strain and Strain Rate of Left Ventricle in Normal Infants and Young Children / 中国医学影像学杂志

Purpose To quantitatively evaluate longitudinal strain and strain rate (SR) of left ventricular (LV) in normal infants and young children using velocity vector imaging (VVI). Materials and Methods A total of 50 normal infants and young children were enrolled in the study. The longitudinal strain peaks and SR peaks in three sections of LV walls during systole period and relaxation period were measured by VVI from apical four-chamber view, apical two-chamber view and long axis view, respectively. Results Forty-one cases (82%) presented a smooth strain curve without incisures and a double peak in SR curve (systolic peak and single diastole peak). The strain in anterior septum and posterior septum, the systolic SRs and diastolic SRs decreased from basal to apical segments. However, only the strain in basal segment and that in apical segment in anterior septum showed statistic difference (t=1.79, P0.05). Conclusion Most normal infants and young children present a smooth diastolic strain curve and a double peak SR curve of LV, which can provide clinical guidance in the early diagnosis of myocardial abnormality for infants and young children.

Effects of age on left ventricular twist-displacement loop assessed by velocity vector imaging / 中南大学学报(医学版)

Objective:To assess effect of age on the characteristic of letf ventricular (LV) twist-displacement loop in health volunteers by velocity vector imaging (VVI) and to provide a new method for LV function evaluation in clinic. Methods:Atfer obtaining basal and apical LV short-axis images in 98 healthy volunteers (18-75 years old) by 2-dimensional echocardiography, we use VVI sotfware to analysis LV twist motion and radial displacement at each plane off-line. hTe peak LV twist (Ptw), the peak untwist velocity (PutwV), the proportion of untwist in isovolumetric relaxation period (Iutw%) and LV radial displacement (Dis) were measured and calculated. Then we constructed LV twist-displacement loop and compared the characteristic of them among different groups. Results:Ptw increased gradually with the increase in age. The biggest PutwV was in the group of 30-60 years old. Iutw%increased gradually before 60 years old, then decreased atfer that. Dis was not obviously different among the three groups. hTe characteristic of LV twist-displacement loop was like the configuration of 8. There was a linear relation between twist and displacement during systole, and the slope increased gradually with the increase in age. During early diastole, the relatively small radial expanding displacement displayed with untwisting, resulting in a much steeper twist-displacement relationship curve occurred in each group, which was getting smooth gradually when the radial expanding displacement increased during mid to late diastole. Conclusions:VVI can be used to effectively and noninvasively assess LV twist-displacement loop with change in age and provide important information for LV function. hTe effect of age must take into account when evaluate the LV function by the twist-displacement loop.

Assessment of left ventricular rotation in rheumatic mitral stenosis patients by velocity vector imaging / 中华超声影像学杂志

Objective To assess the regional left ventricular (LV) rotation motion in the patients with rheumatic mitral stenosis (MS) with velocity vector imaging (VVI).Methods This study included 38 patients with isolated MS (mild,moderate and severe) and 55 healthy control subjects.Short-axis parasternal views at the basal and apical level of LV were taken.Peak value of rotation angle and rotation velocity,as well as time to peak value were measured by VVI workplace offline respectively.Results ①In the healthy control subjects LV rotates clockwisely at the base and counterclockwisely at the apex,the same as the patients with MS.② In th patients with MS,rotaion angle and rotation velocity were significantly reduced at the apical level(P ＜0.001),rotation velocity were significantly reduced at some segments of basal level (anterior,lateral,septal) (P ＜ 0.05).③Compared with the healthy control,the difference of time to peak roation angle between base and apex was significantly longer in patients with MS (P ＜0.05).④ There were no significant differences among mild,moderate and severe MS (P ＞0.05).Conclusions The patients with MS may suffer from systolic dysfunctin even in the early stage identified by the alteration of LV rotation motion,which is independent of the hemodynamic severity of MS.

Evaluation of systolic function of left ventricular in the short axis views in diabetic patients with ejection fraction ＞50％ with velocity vector imaging and dobutamine stress echocardiography / 中华超声影像学杂志

Objective To evaluate the systolic function of left ventricle(LV) in the short axis views in diabetic patients with ejection fraction (EF) value ＞ 50％ with velocity vector imaging (VVI) and dobutamine stress echocardiography (DSE).Methods 30 diabetic patients,which were excluded from coronary artery disease,hypertension,valvular heart diseases,congenital heart diseases,and EF value ＞50 ％by echocardiography,and 20 volunteers with age and sex matched were involved in the study.Twodimensional VVI echocardiographic cine loops were stored at baseline and dobutamine stress (10,20,30 and 40 μg · kg-1 · min-1) in the basal,middle and apical short axis views of LV.The maximum systolic velocity (Vs),strain (ε) and strain rate (SR) were obtained from sygno VVI software.Results The Vs,ε and SR showed decrement tendency from basal to apical short axis view whether in the control group or in the DM group.At baseline,the SR in the apical view decreased significantly in the DM group than that in the control group (P ＜0.05),other parameters were comparable between the two groups.After 10 μg· kg-1 · min-1 dobutamine stress,the SR in the middle and apical views and Vs,ε in the apical view decreased significantly in the DM group than those in the control group (all P ＜ 0.05).After 20μg· kg-1 · min-1 dobutamine stress,the SR in the basal,middle and apical views and Vs,ε in the middle and apical views decreased significantly in the DM group than those in the control group (all P ＜0.05).After the maximum dobutamine stress,all parameters decreased significantly in the DM group than those in the control group (all P ＜0.05).Conclusions The systolic function impairment of DM patients appeared first in the apical tissue of LV,SR was more sensitive index than velocity arnd strain,DSE could increase the sensitivity of VVI parameters in detecting the myocardial systolic function impairment in the earlier stage.

Evaluation of regional myocardial mechanical dysfunction of left ventricle in female patients with ECG T-wave inversion using velocity vector imaging / 中华超声影像学杂志

Objective To evaluate regional myocardial mechanical dysfunction of left ventricle in patients with ECG T-wave inversion using echocardiographic velocity vector imaging.Methods One hundred nineteen female patients with T wave inversion divided into three groups:V1-6 T-wave inversion group(52 patients),V1-4 Twave inversion group (33 patients),V3-6 T-wave inversion group (34patients),while selected 44 healthy women in control group.Peak systolic radial strain (SRSmax) and strain rate (SRSrmax),peak systolic circumferential strain (SCSrmax) and strain rate (SCSmax) were derived and compared from three short-axis views of left ventricle at 18 wall segments using a dedicated Syngo VVI software and workstation,and the depth of T-wave inversion in different precordial lead was measured and correlated with mechanics parameters between four groups.Results In V1-6 T-wave inversion group,each mechanical variable of anteroseptal,anterior,anterolateral and inferolateral walls decreased (P ＜0.05-0.01).In V1-4 T-wave inversion group each mechanical variable of anteroseptal,anterior and inferoseptal walls declined (P ＜0.05-0.01).In V3-6 T-wave inversion group four mechanical variables(i.e.,SRSmax SRSr SCSmax and SCSrmax) of anteroseptal,anterior,anterolateral and inferolateral walls reduced,mainly at basal segment (P ＜0.05-0.01).The ventricular segments of reduced SRSmax,SRSrmax and SCSrmax in V1-6 T-wave inversion group and of SRSrmax in V3-6 T-wave inversion group were more than those in V1-4 T-wave inversion group (P ＜0.05-0.01).In V1-6 T-wave inversion group,negative correlationships between radial mechanical variables of anteroseptal wall and the depths of V4 and V5 lead T-wave inversion were found (r =-0.29--0.37,P ＜0.05-0.01).Otherwise a positive correlationships between SCSmax of anterolateral wall and the depth of V3 lead T-wave inversion were established (rs =0.44,P =0.01) in V1-4 T-wave inversion group.Conclusions There is a regional myocardial dysfunction of LV in female patients with ECG T-wave inversion.The extent of electrical repolarization abnormality is correlated to the severity of regional myocardial dysfunction.

Relationship between myocardial perfusion impairment and dysfunction in diabetic rats using myocardial contrast echocardiography and velocity vector imaging / 中华超声影像学杂志

Objective To investigate whether myocardial dysfunction and perfusion impairment had happened in diabetes mellitus(DM)rats,and to assess the relationship between them by using myocardial contrast echocardiography(MCE)and velocity vector imaging(VVI).Methods MCE and VVI were performed from the short-axis views of the mid-left ventricular level both at rest and after dipyridamole stress in control rats and DM rafs(12 weeks after induction with streptozotocin).MCE-derived myocardial blood flow(MBF)and myocardial flow reserve(MFR)and VVI-derived circumferential strain rate(SRc)and SRc reserve were obtained.Results SRc(absolute value)and MBF in the DM group were significantly lower than those in the control group at rest(P =0.03 for SRc and P =0.005 for MBF).SRc reserve and MFR in the DM group were significantly lower than those in the control group after dipyridamole stress (P =0.000 for SRc reserve and P =0.014 for MFR).There was no significant correlation between SRc and MBF at rest in the DM group(r =0.189,P =0.453).However,significant negative correlation existed between SRc reserve and MFR(r =-0.658,P =0.003).Conclusions Both myocardial systolic function and perfusion are impaired in DM rats.The decrease of MBF might not be the predominant determinant of myocardial systolic dysfunction at rest.However,the impairment of MFR could be an important contributor to the decrease of myocardial contractile reserve.

Evaluation of short axis systolic function of single left ventricles using velocity vector imaging / 中华超声影像学杂志

Objective To investigate the short axis systolic function of children with single-left ventricle(LV),and to appraise the clinical value of velocity vector imaging(VVI) on assessing it.Methods The study group consisted of 14 patients with single-LV.The control group consisited of 14 age-matched normal children.VVI was used to analyse the circumferential and radial strain and strain rate of regional single-LV at the level of papillary muscle.Results Compared with values in control group,single-LV circumferential strain values were significantly lower in anterior septum,posterior septum,anterior wall,lateral wall and inferior wall(all P ＜0.05).Single-LV circumferential strain rate values were significantly lower in anterior septum,posterior septum,anterior wall,lateral wall and posterior wall compared with controls(all P ＜0.05). In control group,circumferential strain and strain rate were higher in inferior septum and anterior septum compared with other segments( P ＜0.05).Single-LV radial strain values were significantly lower in all segments compared with values in control (P ＜ 0.05).In control group,radial strain and strain rate of papillary muscle level showed no significantly difference( P ＞0.05).Conclusions Circumferential and radial systolic ventricular function are impaired in children with single-LV.VVI can beused as a quantitative tool in evaluating the short axis systolic function of single-LV.

Assessment of ventricular function in children with single ventricle after cavopuimonary connection using velocity vector imaging / 中华超声影像学杂志

ObjectiveTo evaluate the feasibility and accuracy of velocity vector imaging (VVI) in assessing ventricular function in children with single ventricle after cavopulmonary connection.Methods Thirty children with single ventricle after cavopulmonary connection were enrolled in this study,30 agematched normal children were served as control group.The systolic peak velocity,displacement,strain and strain rate in this two groups measured in 6 segments by VVI were compared.dp/dt of single ventricle was estimated by atrioventricular regurgitation using simplified Bernoulli equation.Results Strain and strain rate were significantly lower in all 6 segments in children with single ventricle after cavopulmonary connection compared with values in normal children( P ＜0.05,respectively),strain rate of the basal segment at the rudimentary chamber correlated best with dp/dt (r =0.72,P ＜0.01).Conclusions Segmental ventricular dysfunction was observed in children with single ventricle after cavopulmonary connection,and could be assessed accurately using velocity vector imaging.