RESUMO
Objective: To investigate the clinical value of transthoracic echocardiography (TTE) measured pulmonary artery parameters and pulmonary valve annulus Z scores for choosing the type of operation in complete repair of pediatric tetralogy of Fallot (TOF) Methods: A total of 143 patients received complete repair of pediatric TOF in our hospital were retrospectively studied. The patient's median age was 8 (1-171) months. Based on the type of operation, patients were divided into 2 groups: Trans-annular patch group, n=100 and Valve sparing repair group, n=43. Conventional TTE parameters, right ventricular outflow parameters and pulmonary valve annulus Z scores were compared between 2 groups; pulmonary valve annulus diameters measured by TTE and surgery were studied by correlation analysis. Results: Compared with Valve sparing repair group, Trans-annular patch group had decreased left ventricular end diastolic diameter (23.14±3.82) mm vs (25.23±4.56) mm, pulmonary valve annulus diameter (8.52±2.18) mm vs (10.01±2.61) mm and main pulmonary artery diameter (67.31 vs 82.91) all P<0.05. With reduced value of pulmonary valve annulus Z scores, the constituent ratio in Trans-annular patch group was gradually increasing and in Valve sparing repair group was gradually decreasing, all P<0.05. Correlation analysis indicated that pulmonary valve diameters measured by TTE and surgery had moderate agreement (r=0.581, P<0.001). Conclusion: TTE measured pulmonary valve annulus diameter, main pulmonary artery diameter and pulmonary valve annulus Z scores were the objective parameters provided to surgeon at pre-operation, which had clear clinical value.
RESUMO
<p><b>BACKGROUND</b>Strain and strain-rate imaging (SRI) have been found clinically useful in the assessment of cardiac systolic and diastolic function as well as providing new insights in deciphering cardiac physiology and mechanics in cardiomyopathies, and identifying early subclinical changes in various pathologies. The aim of this study was to evaluate the regional and global left ventricular (LV) myocardial function in metabolic syndrome (MS) with SRI so that we can provide more myocardial small lesions in patients with MS, which is robust and reliable basis for early detection of LV function.</p><p><b>METHODS</b>Thirty-nine adults with MS were enrolled in the study. There was a control group of 39 healthy adults. In addition to classic echocardiographic assessment of LV global functional changes, SRI was used to evaluate regional and global LV function. Including: Peak systolic strain (S), peak systolic strain-rate (SR-s), peak diastolic strain-rate (SR-e).</p><p><b>RESULTS</b>There were no statistically significant differences between MS and controls in all traditional parameters of LV systolic function. On the other hand, significant differences were observed between MS and the control group in most of the parameters of S, SR-s, SR-e in regional LV function. Multiple stepwise regression analyses revealed that S and SR significantly were negatively correlated with blood pressure, waist circumference, fasting plasma glucose, uric acid, suggesting that risk factories were relevant to regional systolic dysfunction.</p><p><b>CONCLUSION</b>In MS with normal LV ejection fraction, there was regional myocardial dysfunction, risk factors contributed to the impairment of systolic and diastolic function of the regional myocardium. Assessment of myocardial function using SRI could be more accurate in MS patient evaluation than conventional echocardiography alone.</p>