Résumé
Objective To quantitatively evaluate left ventricular ( LV ) systolic function in bicuspid aortic valve (BAV) using layer-specific strain ( LSS) . Methods Thirty BAV patients were divided into normal function (NF) group (10 cases) and non-normal function (N-NF) group (20 cases) based on aortic valvular lesion types ,and 20 healthy volunteers were taken as control group . Longitudinal strain( LS) and circumferential strain (CS) of three-layer myocardium and full thickness myocardium were assessed using layer-specific speckletracking imaging ,available by GE Vivid E9 and EchoPac workstation . Results There was no significant difference in left ventricular ejection fraction( LVEF) among the N-NF group ,NF group and control group ( P > 0 .05) ,all of them within the normal range[(63 .3 ± 7 .1)％ ,(64 .6 ± 6 .2)％ , ( 65 .3 ± 3 .9)％ ] . It showed a gradient decrease from the endocardium to the epicardium in both control and BAV group . LS of endocardium ( LSendo) and LS of epicardium ( LSepi) in N-NF group and NF group were significantly reduced compared with those in control group ( P <0 .05) [ LSendo :( -21 .19 ± 3 .12)％vs ( -23 .06 ± 2 .07 )％ vs ( -25 .53 ± 2 .51 )％ ;LSepi:( -16 .08 ± 2 .68 )％ vs ( -18 .85 ± 2 .12 )％ vs ( -20 .72 ± 2 .28)％ ] . Compared with control group ,there was no significant difference in NF group in CS of the three-layer myocardial and full-thickness myocardium as well as the LS of the whole medial myocardial layers and full-thickness ( P > 0 .05 ) . Compared with NF group [ CS :( -19 .57 ± 2 .9 )％ vs ( -13 .43 ± 2 .19)％ vs ( -20 .03 ± 3 .04)％ ;LS :( -21 .38 ± 2 .05)％ vs ( -18 .85 ± 2 .12)％ vs ( -21 .09 ± 2 .03)％ ] and control group[CS :( -21 .63 ± 3 .01)％ vs ( -14 .34 ± 2 .55)％ vs ( -21 .48 ± 2 .16)％ ;LS :( -22 .18 ± 2 .30 )％ vs ( -20 .72 ± 2 .28 )％ vs ( -22 .89 ± 2 .30 )％ ] , CS [ ( -16 .78 ± 3 .65 )％ vs ( -11 .40 ± 3 .78 )％ vs ( -15 .83 ± 2 .61 )％ ] and LS [ ( -18 .34 ± 2 .85 )％ vs ( -16 .08 ± 2 .68 )％ vs ( -18 .51 ± 2 .86)％ ] of middle myocardium ,epicardial myocardium and full-thickness myocardium in N-NF group were decreased significantly ( P < 0 .05) . Conclusions It is essential to maintain normal valvular function to prevent the progress of myocardial deterioration . LSendo and LSepi can be used to sensitively identify early left ventricular systolic dysfunction in BAV patients with normal LVEF .
Résumé
Objective To investigate the availability and usefulness of echocardiography in piglet of experimental carotid-jugular shunting pulmonary hypertension.Methods Fifty-one 1-month-old piglets were randomly divided into surgical shunt group(CA-JV,n =45) and sham group(n =6).In shunt group,left CA-JV shunt was esteblished by end-to-side vascular anastomosis from left carotid artery to jugular vein.Piglets in sham group received a sham operation.Periodic hemodynamic evaluation of the carotidjugular shunt and heart were performed by ultrasound examination post-surgery.Tricuspid regurgitation and pulmonary regurgitation were monitored for evaluating pulmonary systolic pressure and mean pressure.Results In CA-JV group,32 piglets survived to end point of experiment and 27 maintained a persistent shunting (success rate 60％).Tricuspid regurgitation and pulmonary regurgitation occurred increasingly and pulmonary pressure had risen gradually since 4 months post-surgery (P ＜ 0.05).Those were coincided with the results of right catheterization and pulmonary pathology.Conclusions Ultrasound can monitor experimental carotid-jugular shunting pulmonary hypertension that shows practical value for further study in the mechanism and treatment of pulmonary hypertension due to increased pulmonary blood flow.