RÉSUMÉ
Objective To explore the correlations of evaluations of right heart function parameters in patients with Ebstein anomaly(EA)using echocardiography and cardiac MRI.Methods Data of transthoracic echocardiography and cardiac MRI in 32 patients with EA confirmed by operation were retrospectively analyzed.The correlations of cardiac cavity size,right ventricular function and strain parameters obtained using echocardiography and the functional right ventricular(fRV)ejection fraction(EF)measured using MRI were explored.Results MRI fRV-EF in 32 cases of EA was(23.20± 7.61)％.Among echocardiographic parameters in 32 cases of EA,fractional area change(FAC)of fRV(r=0.347,P=0.015)was slightly,while global longitudinal strain(GLS)of fRV(r=0.801,P＜0.001)was highly positively correlated with MRI fRV-EF,respectively,whereas atrialized right ventricle(aRV)area/fRV area(r=-0.730,P=0.007)was highly negatively,aRV area/left ventricular area(r=-0.450,P=0.042)and right ventricular anterior-posterior diameter(r=-0.650,P=0.022)were both moderately negatively correlated with MRI fRV-EF.Both the left ventricular eccentricity index(r=-0.347,P=0.049)and Glasgow outcome scale extended(r=-0.336,P=0.024)obtained with echocardiography were slightly negatively correlated MRI fRV-EF.Conclusion Right heart function parameters in EA patients obtained with echocardiography were correlated with those of MRI fRV-GLS,among which aRV area/fRV area were highly positively correlated with MRI fRV-EF,hence having great value for evaluating right heart function in EA patients.
RÉSUMÉ
Objective:To evaluate the application value of conventional echocardiography and two-dimensional speckle tracking imaging (2D-STI) in assessing the left ventricular systolic and diastolic functions in patients with restrictive cardiomyopathy (RCM).Methods:Fifteen patients confirmed as RCM by cardiac magnetic resonance imaging or pathological biopsy in Fuwei Cardiovascular Hospital of Yunnan Province from September 2017 to June 2020 were selected. According to left ventricular ejection fraction(LVEF), they were divided into LVEF retention group(LVEF≥50%, 8 cases) and LVEF reduction group (LVEF<50%, 7 cases). Meanwhile, 20 healthy volunteers were selected as the control group. Conventional echocardiography and 2D-STI were used to evaluate left ventricular systolic and diastolic function, including left ventricular end-diastolic diameter (LVEDd), LVEF, mitral valve blood flow spectrum peak E/peak A, peak E deceleration time (EDT), tissue Doppler mitral valve ring average early diastolic peak velocity (e′), E/e′ ratio, isovolumetric relaxation time (IVRT), left atrial volume index (LAVI) and speed of tricuspid regurgitation (TVR), tricuspid annular plane systolic excursion (TAPSE), left ventricular longitudinal strain (LS) and circumferential strain (CS). Then the differences and similarities between the two RCM groups and the control group were compared.Results:There was no significant difference of LVEF between LVEF retention group and the control group ( P>0.05), and LVEF in LVEF reduction group was significantly lower than that in control group ( P<0.05). LVEDd in LVEF retention group was significantly smaller than that of LVEF reduction group ( P<0.05), but was not statistically different from the control group ( P>0.05). Values of E/A, E/e′, LAVI and TVR in LVEF retention group and LVEF reduction group were significantly greater than the control group (all P<0.05), and there was no statistically significant difference between the two RCM groups ( P<0.05). Values of e′, EDT, IVRT and TAPSE in LVEF retention group and LVEF reduction group were significantly lower than the control group (all P<0.05), and there was no statistically significant difference between the two RCM groups (all P>0.05). The global LS and LS of AP4, AP3, and AP2 showed significantly different among the 3 groups (all P<0.05). The global and basal, middle, apical segmental CS in LVEF retention group were significantly larger than those in LVEF reduction group (all P<0.05), but they were not significantly different from the control group (all P>0.05). Conclusions:All patients with RCM show left ventricular diastolic dysfunction in conventional echocardiography, and show gradually reduced left ventricular systolic function and left ventricular remodeling. RCM patients with normal LVEF demonstrate decreased myocardial systolic function, and left ventricular global LS could be used as a sensitive indicator to predict myocardial systolic function.