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Objective To study the characteristics of blood flow in isovolumic systole(IVC)of left ventric-ular(LV)in patients with dilated cardiomyopathy by flow-vector imaging(VFM). Methods Color flow Doppler imaging was performed from the apical long-axis view in 58 patients with dilated cardiomyopathy who was admitted in our hospital from October 2015 to November 2016 and 56 healthy volunteers as control. Doppler flow data ob-tained during IVC were analyzed offline with vector flow mapping.Results At the beginning of IVC,the swirl area (15 ± 3)cm2and flow(36 ± 8)cm2/s in the control group were significantly less than those in the observation group (27 ± 8)cm2,(45 ± 12)cm2/s,all P=0.000.At the end of IVC,the vortex flow was similar in both groups[(28 ± 4)cm2/s vs.(29 ± 11)cm2/s,P=0.617)],and the vortex area in the control group was significantly smaller than that in the observation group[(16 ± 3)cm2vs.(24 ± 9)cm2,P=0.000)].During the IVC,the area of the vortex in the control group increased slightly but not significantly(P = 0.073),but the flow rate decreased significantly (10 ± 27%). The area and volume of the vortex in the observation group decreased significantly with the flow de-creased by 29 ± 54%(P=0.000 vs.the control group).When the aortic valve was open,the average blood flow veloc-ity in the middle and basal parts of the LV compartment in the observation group was significantly lower than that in the control group(P<0.05).In multivariate models,a decreased LV ejection fraction was the only independent pre-dictor of the percentage decrease in area of the vortex during the IVC(P < 0.001),and a larger QRS width(P =0.026)and LV end-systolic long diameter(P = 0.004)were independent predictors of the percentage decrease in flow volume of the vortex. Conclusion The VFM technique enables a better assessment of the pathophysiological state of LV lumen energy loss during IVC in patients with dilated cardiomyopathy by vortex imaging.
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Purpose To evaluate clinical value oftransesophageal echocardiography (TEE) on total correction of tetralogy of Fallot (TOF) through preoperative and postoperative monitoring of TEE in paediatrics total correction of TOF and comparison with preoperative and postoperative transthoracic echocardiography (TTE).Materials and Methods Thirty-two children patients receiving total correction of TOF were retrospectively analyzed.TEE was adopted to measure atrial and ventricular cavity size,diameter of right ventricular outflow tract,residual shunt surrounding ventricular septum,diameter of pulmonary artery trunk,orifices flow rate and differential pressure of pulmonary artery and differential pressure of right ventricular outflow tract for all patients preoperative and intraoperative.Meanwhile,all these were compared with value measured by TTE before and after the surgery.Results Among the 32 TOF patients,preoperative TEE figured out one revised diagnosis (3％) of TTE and one supplementary diagnosis (3％).Coincidence rate of disease diagnosis of preoperative TEE and surgical outcome of the 32 patients was 100％ (32/32).Intraoperative TEE examination found out 7 (21.9％) with residual surgical issues.Differential pressure of right ventricular outflow tract measured by preoperative and intraoperative TEE and value measured by preoperative and postoperative TTE was of statistical significance (P＜0.05).Right ventricular outflow tract measured by intraoperative TEE was obviously reduced by approximately 28％ compared with the value measured by postoperative TTE.Correlation of atrial and ventricular cavity size,diameter of right ventricular outflow tract and orifices flow rate of pulmonary artery measured by intraoperative TEE and value measured by postoperative TTE were well (r=0.75-0.87,P＜0.05).Differential pressure of right ventricular outflow rate measured by intraoperative TEE was positively correlated with value measured by postoperative TTE (r=0.518,P＜0.05).Difference of atrial and ventricular cavity size,diameter of right ventricular outflow tract orifices flow rate and differential pressure of pulmonary artery and differential pressure of right ventricular outflow rate measured by intraoperative TEE and consistency scattergram of value measured by postoperative TTE was of no statistical significance (P＞0.05).Conclusion Application of TEE for total correction of TOF monitoring is of important practical value in correction and supplement of preoperative diagnosis and immediate postoperative surgical efficacy assessment.
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Objective To explore the clinical value of two-dimensional speckle tracking imaging (2DE-STI) by measuring global longitudinal strain (GLS) in normal children.Methods Totally 176 normal children underwent cardiac ultrasound examination,the left ventricular GLS were measured,and the difference of GLS between gender was analyzed.And the changes of GLS with body surface area (BSA) and age were discussed.Results GLS had no significant difference between male and female ([-24.90 ± 2.06]％ vs [-24.93 ± 2.01]％,t =0.83,P =0.934).GLS had significant differences among different BSA groups (F=3.84,P =0.003),and the differences of GLS in BSA＞ 1.0 group and the other five groups were statistically significant (all P＜0.05).GLS had statistically significant differences among different age groups (F=4.81,P=0.001),and the differences of GLS in ＞9 years old group and the other four groups were statistically significant (all P＜0.05).Conclusion Left ventricular GLS presents certain regularity with children's growth.