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Objective@#To compare the distribution characteristics of left ventricular configuration in Chinese adult patients with hypertension under Chinese and international standard using echocardiography.@*Methods@#A total of 201 patients with primary hypertension were included in the study.Left ventricular end systolic left atrial diameter (LAD), ascending aortic diameter (AO), left ventricular end diastolic diameter (LVDd), left ventricular posterior wall thickness (PWTd) and ventricular septal thickness (IVSd) were measured and then relative wall thickness (RWT), left ventricular mass (LVM), left ventricular mass index (LVMI) were calculated. Left ventricular systolic left atrial volume (LAV) was measured by Simpson′s biplane method and left atrial volume index (LAVI) was then calculated. Ganau classification was done according to Chinese and international standard respectively. The differences of left ventricular configuration in hypertension were compared.@*Results@#According to the Chinese standard, the analytic results of left ventricular configuration showed that there were 103 cases (51.2%) in normal configuration (NG) group, 28 cases (13.9%) in concentric remodeling (CR) group, 52 cases (25.9%) in eccentric hypertrophy (EH) group and 18 patients (9.0%) in hypertrophic (CH) group, respectively. Whereas, according to the international standard, there were 47 cases (23.4%) in NG group, 93 cases (46.3%) in CR group, 18 cases (8.9%) in EH group and 43 cases (21.4%) in CH group.Each group in the configuration analysis had significant difference between Chinese and international standard (P<0.01). Patients with left atrial enlargement according to the Chinese and international standard had statistical difference in the EH and CH groups (P<0.05).@*Conclusions@#Analysis of left ventricular configuration according to the Chinese and international standard has significant difference. According to Chinese standard, it may be more accurate to reflect the changes of left ventricular configuration in Chinese hypertensive population, so as to evaluate the changes of left heart structure and function more accurately.
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Objective To investigate the heterogeneity of the left ventricular reference value in echocardiography mesurements by Meta analysis. Methods A literature retrieval in PubMed,Embase, Medline and other databases from January 2005 to September 2017 related to left ventricular normal reference value in healthy adults was performed. Cohrane′s Q test was used to test the heterogeneity,and I2 was used as a statistic for the description of heterogeneity. Subgroup analysis,sensitivity analysis and Meta regression were used to analyze the sources of heterogeneity. Results The Meta analysis enrolled 9 studies including 5 933 normal cases. The heterogeneity test showed that the left ventricular normal reference value of echocardiography was highly heterogeneous among the studies. In subgroup analysis, some measurements′ heterogeneity were significantly reduced. Meta regression analysis showed that the contribution of racial specificity to heterogeneity was relatively high in some measurements. Conclusions The heterogeneity of left ventricle is mainly related to racial specificity,but it cannot fully explain the heterogeneity between studies. Further studies are needed to demonstrate the involved factors of heterogeneity of left ventricular normal reference values.
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w biomarker to predict the presence of vulnerable plaque.
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In this paper is presented the research and development of a new myocardial contrast echocardiography (MCE)-based quantitative analysis system for myocardial microcirculation. The system can measure the values of A, beta, A x beta, A-EER (endo-epi ratio of A), beta-EER and A x beta-EER from the signal intensity of real-time 2-D grayscale images and power Doppler images; it can draw the time-intensity curves to indicate the variation of the intensity of microbubbles scattering in subendocardial layer and subepicardial layer with the varying of myocardial segments; and it can estimate the hemodynamic parameters by nonlinear regression analysis. So the MCE software system has brought the quantitative analysis of real-time MCE to success.
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Humanos , Circulação Coronária , Doença das Coronárias , Diagnóstico por Imagem , Ecocardiografia , Métodos , Processamento de Imagem Assistida por Computador , Métodos , Microbolhas , Microcirculação , Dinâmica não Linear , SoftwareRESUMO
This article reports a quantitative analysis software system for myocardial contrast echocardiography (MCE). It can measure the signal intensity of grayscale images and power Doppler images, draw the time-intensity curves of variations on the intensity of microbubbles scattering in subendocardial layer and subepicardial layer with the pulsing intervals, and estimate the hemodynamic parameters by nonlinear regression analysis. This system has been applied to a study on 20 healthy volunteers, and the results suggest that the software has the capacity for bringing the quantitative analysis of MCE to success. The MCE software system conforms to the DICOM standard and can be integrated into PACS.
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Adulto , Feminino , Humanos , Masculino , Meios de Contraste , Ecocardiografia , Métodos , Endocárdio , Diagnóstico por Imagem , Aumento da Imagem , Métodos , Interpretação de Imagem Assistida por Computador , Métodos , Microbolhas , Design de SoftwareRESUMO
Objective To explore the diagnostic value of color Doppler echocardiography in the patients with anomalous origin of coronary artery.Methods Six patients were studied using color Doppler echocardiography.The origin sites,running courses,blood flow directions of coronary arteries, other accompanied cardiovascular abnormalities and valvular regurgitations were investigated.The diameters of coronary artery trunks and left ventricular ejection fraction (LVEF) were measured.And the results were compared with those of coronary angiography and surgery.Results Left coronary artery(LCA) originated from pulmonary artery(PA) in 4 cases,left anterior descending(LAD) branch originated from PA in 1 case,and accessory coronary artery originated from PA in 1 case.The main accompanied cardiovascular abnormalities included ventricular septum defect,atrial septum defect,complete endocardial cushion defect,and so on.For all the patients,the diagnostic results by echocardiography were consistent with catheterization and surgery.High correlations existed between echocardiographic and catheterization measurements for left and right coronary artery diameter and LVEF (r= 0.94 , 0.96 , 0.89 ,respectively,all P 0.05 ).Conclusions Color Doppler echocardiography can accurately diagnose the patients with anomalous origin of coronary artery, provide reliable information for surgical treatment.
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Objective To explore the value of quantitative tissue velocity imaging (QTVI) in quantitatively evaluating segmental systolic function of left ventricle. Methods Fifteen healthy volunteers(group A) and fifteen myocardial infarction patients (group B) were studied at apical four-chamber view, two-chamber view and apical longitudinal view using QTVI. Septal, lateral, anterior, inferior, ante-septal and posterior walls were divided into basal, middle and apical segments respectively, in total 18 segments. The systolic peak velocity (Vp), systolic peak displacement (D), systolic peak strain rate (SR) and strain (S) were measured respectively for each segment of both groups. Results For abnormal wall motion segments in group B, the value of Vp showed significant lower in 16(16/18) segments, D in 15(15/18) segments, SR in 17(17/18) segments and S in 16(16/18) segments than those in the corresponding segments of group A (all P
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Objective To explore the practicability of real-time myocardial contrast echocardiography (MCE) in assessing the transmural distribution of myocardial perfusion. Methods Three grades of left anterior descending coronary artery(LAD) stenoses were created in 6 open-chest dogs. Stenoses reduced LAD flow by 50%, 75% and 90% of hyperemia guided by flow probe. Low-energy MCE were performed at baseline, hyperemia reduced by dipyridamole, three different stenoses, reperfusion and complete occlusion, respectively, during continuously infusion of SonoVue. Regions of interest(ROI) were placed individually within endocardial and epicardial layers and myocardial signal intensity-versus-time plots just after high-energy FLASH frames were fitted to an exponential function to obtain values of A, ?, A??. The corresponding transmural gradients, defined as endocardial-epicardial ratios of A (A-EER),?(?-EER) and A??(A??-EER) were also calculated. Results The transmural distributions of A,? and A?? were more or less homogeneous at baseline,hyperemia and 50% reduced LAD flow, with their transmural gradients near 1. When LAD flow was reduced by 75%,? and A?? from endocardial layer decreased (P
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0.05). ④ High correlations were also found between 2-DE, RT-3DE derived LVEDV and TV (r= 0.80- 0.88), but 2-DE and RT-3DE 2-plane methods underestimated TV significantly (P
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0.05 ). After once injection both observers considered the number of clearly recognized endocardial border segments increased significantly. The number evaluated by observers A increased from 2.68 ? 0.95 to 5.99 ? 0.10 while from 2.82 ? 1.03 to 5.99 ? 0.11 by observers B( P 0.05 ). The average contrast enhancement rate of LV endocardial border was 99.7 %. Perfluoropropane-albumin microsphere injection had no significant effection on vital signs such as blood prssure, heart rate and respiration. Electrocardiogram didn′t change markedly and the variance of the laboratory findings like blood and urine routine examination, hepatic and renal function was in normal range. Only one case( 0.33 %) had slight side-effects who suffered from mild nausea and diarrhea, which suggested the clinical safety of this contrast agent. Conclusions Perfluoropropane-albumin microsphere injection could enhance the resolution of LV endocardial borders and make the judgement of regional myocardial movement easier. It has little side-effects and will be appropriate for clinical use.
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ObjectiveTo determine the possibility of r eal-time perfusion imaging in the quantitative evaluation of myocardial perfusion in various segments of left ventricle. MethodsImages of ten anesthetized dogs were obtained at the mid-papillary muscle short-axis view with a real-time imaging system. Mechanical index (MI) was adjusted to 0.1 , 0.2 and 0.4 respectively, and frame rate was set at 20 Hz. Optison was infused intravenously at a rate of 0.1 , 0.2 and 0.5 ml/min, respectively. Images were recorded for 150 real-time frames commencing immediately after a couple of Doppler bursts. Myocardial opacification was assessed both visually and quantitatively for six segments of left ventricle (antero- and infero-septum, inferior, posterior, lateral and anterior wall). Myocardial signal intensity versus real-time frame curves were made and fitted to an exponential function: Y=A(1-e -?t ). ResultsUsing low MI (MI= 0.1 or 0.2 ) and with continuously infusion of Optison at a rate of 0.2 or 0.5 ml/min, real-time imaging resulted in sufficient myocardial opacification and left ventricular endocardial border definition, and displayed myocardial thickening and wall motion simultaneously. ConclusionsReal-time imaging has a potential in the quantitative assessment of myocardial perfusion, and allows simultaneous assessment of perfusion and myocardial function.