Standard for monitoring and evaluation of two-dimensional- and three-dimensional-transesophageal echocardiography during transcatheter tricuspid valve replacement / 中华超声影像学杂志

Transcatheter tricuspid valve intervention is the new frontier of interventional cardiology. The LuX-Valve is a radial force-independent orthotopic tricuspid valve replacement device developed in China. The LuX-Valve Plus transcatheter tricuspid valve replacement (TTVR) system is changed from the trans-atrial to the transjugular approach, which further reduces trauma and pulmonary complications compared with the first generation LuX-Valve. The first-in-human study has been completed at Zhongshan Hospital, Fudan University and an exploratory multicentre clinical study is underway. Echocardiography plays an important role in pre-TTVR screening, intraoperative guidance and postoperative evaluation and follow-up, especially two-dimensional transoesophageal echocardiography (2D-TEE) and three-dimensional transoesophageal echocardiography (3D-TEE). However, there is a lack of appropriate intraoperative guidance and assessment protocols. In this study, we briefly described the protocols and imaging considerations for intraoperative 2D-TEE and 3D-TEE to ensure the successful implantation of TTVR.

Ecocardiografia sob estresse usando imagem tridimensional em tempo real / Stress echocardiography using real-time 3d imaging

A necessidade de examinar o coração com uma ferramenta tridimensional não é nova na ecocardiografia. O órgão complexo e dinâmico em estudo sempre exigiu o entendimento em três dimensões e em tempo real. Sem o recurso, o examinador precisa transformar as imagens em bidimensional para uma compreensão de volume que exige complexa interação de conhecimentos e aproximações. A invenção da tridimensão já contabiliza três décadas, e seu aprimoramento levou a produtos comerciais no início do século. Estudos demonstram, no mínimo, equivalência da tridimensão com ganhos no manuseio do tempo necessário. Utilizamos as modalidades Tri Plano na rotina com ganho de tempo e menor estresse do membro superior do examinador. A tridimensão pode responder perguntas mais complexas e auxilia em nossa abordagem mais geométrica da contração, sendo o espessamento analisado em segundo plano.(AU)

The need to examine the heart using a three-dimensional (3D) tool is not new. This complex and dynamic organ has always required 3D and real-time understanding. Without this feature, the examiner has to transform two-dimensional images to understand its volume, which requires complex knowledge and approximation interactions. Echocardiography was invented three decades ago, and its improvements resulted in commercial products at the beginning of the century. Some studies demonstrate 3D equivalence with gains in handling the necessary time. We use triplane modalities in our routine, with time gain and less stress on the examiner's upper limb. Thus, 3D examinations can answer more complex questions and provide a more geometric approach to contraction, with thickening being analyzed in the background. (AU)

Ecocardiografia Tridimensional na avaliação de endocardite de válvula nativa: um relato de caso e semelhança entre achados ecocardiográficos e cirúrgicos / Three-Dimensional transesophageal echocardiography in native valve endocarditis: a case report and similarities between echocardiography and surgical findings

A endocardite de valva nativa é uma doença incomum, complexa, e de alta morbimortalidade. Requer tratamento clínico prolongado, com várias complicações possíveis, e o seu tratamento cirúrgico é complexo e tecnicamente difícil. O ecocardiograma transtorácico e transesofágico são fundamentais na avaliação da doença, inclusive seus achados são parte dos critérios diagnósticos de endocardite. Adicionalmente, o ecocardiograma tridimensional (3D) contribui com detalhamento anatômico na avaliação das estruturas cardíacas acometidas pela doença. Mostramos um caso em que é ilustrado o papel da ecocardiografia no diagnóstico e avaliação de complicações da endocardite, comparando as imagens do ecocardiograma 3D pré-operatórias, com os achados durante o ato cirúrgico. (AU)

Native valve bacterial endocarditis is an uncommon, complex, and highly morbid disease that requires prolonged clinical treatment and challenging surgical interventions. Transthoracic and transesophageal echocardiography are paramount assessment tools whose findings are included in the diagnostic criteria. Three-dimensional echocardiography shows further realistic imaging details. Here we present a case demonstrating the role of echocardiography in the diagnosis of endocarditis and the identification of its complications to show how advanced imaging techniques may have a remarkable resemblance with in vivo surgical findings. (AU)

Dynamic evaluation of left ventricular systolic function in patients with pregnancy-induced hypertension by three-dimensional speckle tracking imaging / 中国基层医药

Objective:To investigate the clinical efficacy of three-dimensional speckle tracking imaging in the dynamic evaluation of left ventricular systolic function in patients with pregnancy-induced hypertension.Methods:50 patients with pregnancy-induced hypertension, who received prenatal examination in Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from July 2019 to June 2020 and finally gave birth, were included in the observation group. An additional 50 healthy pregnant women who concurrently received prenatal examination were included as controls. All participants underwent routine echocardiography and three-dimensional speckle tracking imaging examinations. Parameters related to left ventricular systolic function were recorded. Routine echocardiography parameters and three-dimensional speckle tracking imaging parameters were compared between the observation and control groups.Results:There were no significant differences in routine echocardiography parameters (including heart rate, left ventricular end-diastolic diameter, interventricular septum thickness in end-diastole, left ventricular posterior wall thickness in diastole, and left ventricular ejection fraction) between before treatment, after treatment, and 3 months after delivery in the observation group, and between observation and control groups before treatment (all P > 0.05). The absolute values of left ventricular global longitudinal strain (LVGLS) [(-18.41 ± 2.23)% vs. (-26.03 ± 2.79)%], left ventricular global circumferential strain (LVGCS) [(31.29 ± 3.09)% vs. (37.45 ± 3.68)%], left ventricular global radial strain (LVGRS) [(-19.37 ± 2.19)% vs. (-24.59 ± 2.74)%], and left ventricular global area peak systolic strain (LVGAS) [(-26.61 ± 3.18)% vs. (-39.23 ± 3.96)%] measured before treatment were significantly lower in the observation group than in the control group ( t = 6.31 -14.87, all P < 0.05). The absolute values of LVGLS, LVGCS, LVGRS, and LVGAS in the observation group were significantly higher after treatment [(-24.79 ± 2.68)%, (35.94 ± 3.25)%, (-22.48 ± 2.41)%, (-37.54 ± 3.38)%] and 3 months after delivery [(-25.64 ± 2.72)%, (36.63 ± 3.47)%, (-23.91 ± 2.69)%, (-38.49 ± 3.64)%] than before treatment ( t = 4.08 - 10.59, P < 0.05). There were no significant differences in LVGLS, LVGCS, LVGRS, and LVGAS between observation group and control groups at each time point studied ( t = 0.47 - 1.19, P = 0.182 - 0.652 > 0.05). The absolute svalues of LVGLS, LVGCS, LVGRS and LVGAS in patients with pregnancy-induced hypertension were positively correlated with left ventricular ejection fraction values ( r = 0.638 - 0.775, P = 0.009 - 0.041 < 0.05). Conclusion:Three-dimensional speckle tracking imaging can be used to dynamically evaluate the impairment of left ventricular systolic function in patients with pregnancy-induced hypertension. This technique helps guide early intervention and prognosis evaluation and has a high clinical application value.

Quantitative evaluation of the dynamic changes of mitral annulus in patients with degenerative mitral regurgitation by three-dimensional echocardiography / 中华超声影像学杂志

Objective:To quantitatively analyze the static geometric structure and dynamic changes of the mitral annulus(MA) in patients with degenerative mitral regurgitation (DMR) by three-dimensional transthoracic echocardiography.Methods:Thirty-five patients with DMR (both mitral valve prolapse and Barlow) were collected as DMR group in Yunnan Fuwai Cardiovascular Disease Hospital from August 2019 to March 2021, and 42 healthy volunteers were selected as control group during the same period. The mitral annulus area (MAA), mitral annulus perimeter (MAP), mitral annulus anterolateral-posteromedial diameter (DALPM), anteroposterior diameter (DAP), non-planar angle (NPA), mitral annulus height (AH), and the ratio of height to intercommissural diameter (AHCWR) were measured during the late-diastole, early-systole, mid-systole and late-systole, and the systolic change fractions of the above parameters were calculated. The differences of static structure and dynamic change of MA between the two groups were compared, and the characteristics of dynamic change of MA in the whole cardiac cycle were analyzed.Results:Static structure: MAA, MAP, DAP and DALPM in DMR group were higher than those in control group during the whole cardiac cycle, and the differences were statistically significant (all P<0.05). Compared with the control group, the saddle structure in DMR group were flattened in the middle and late contraction stages (AHCWR: 0.17±0.01 vs 0.21±0.01 and 0.15±0.01 vs 0.23±0.01, both P<0.05), while the saddle structure was relatively preserved in the rest of the contraction stage. Dynamic changes: Presystole contraction (MAA, MAP, DAP, DALPM decreased, all P<0.05) were appeared durng the late-diastole and early-systole in the control group, and saddle shape deepened (NPA decreased, AH and AHCWR increased, all P<0.05). Compared with the control group, presystole MA contraction and saddle deepening disappeared in DMR group (there were no significant differences in all MA parameters between late-diastole and early-systole, all P>0.05). The systolic dynamic changes were weaker and impaired when compared with the control group, which showed that the systolic change scores of DALPM, NPA and AHCWR were lower than those of the control group (all P<0.05). There were no statistical differences in the 4 time phases of MA parameters except DAP (all P>0.05). Conclusions:The saddle-shape structure of MA in normal subjects is obvious, and the dynamic change of MA in the cardiac cycle is significant, with obvious contraction before contraction and saddle-shape deepening. The saddle structure of DMR patient is flattened in the middle and late systolic period, and the MA kinetic energy of DMR patient is weakened throughout the cardiac cycle, the contraction phenomenon disappeared before contraction, and the dynamic change of systolic period is impaired to varying degrees.

Value of three-dimensional speckle tracking echocardiography in evaluation of left ventricular diastolic function in elderly patients with heart failure / 中国医师杂志

Objective:To analyze the value of three-dimensional speckle tracking echocardiography (3D-STE) in evaluation of left ventricular diastolic function in elderly patients with heart failure (HF).Methods:130 elderly patients with heart failure (HF pEF) with preserved left ventricular ejection fraction in Gulou Hospital Affiliated to Medical College of Nanjing University from January 2018 to October 2019 were studied. All of them were examined by conventional ultrasound, 3D-STE and left-heart catheterization. Their cardiac three-dimensional full-volume dynamic images were collected and then analyzed with three-dimensional speckle tracking technique. The global longitudinal strain (GLS), global radial strain (GRS), global circumferential strain (GCS), and global area strain (GAS) were measured. According to the detected left ventricular end diastolic pressure (LVEDP), the patients were divided into the normal left ventricular diastolic function group (LVEDP≤15 mmHg) and the left ventricular diastolic dysfunction group (LVEDP>15 mmHg). The GLS, GRS, GCS and GAS of the two groups were compared. Pearson correlation analysis was performed to analyze the correlation between GLS, GRS, GCS, GAS and LVEDP, and ROC curves were used to analyze efficiencies of GLS, GRS, GCS and GAS in prediction of left ventricular diastolic dysfunction.Results:The absolute values of GLS, GRS, GCS and GAS of the left ventricular diastolic dysfunction group were lower than those of the normal left ventricular diastolic function group ( P<0.05). The GLS, GCS and GAS were positively correlated with LVEDP ( P<0.05), while GRS was negatively correlated with LVEDP ( P<0.05). The AUC values of GLS, GRS, GCS and GAS for predicting left ventricular diastolic dysfunction were 0.667, 0.775, 0.762 and 0.840, respectively. The sensitivities were 79.17%, 72.22%, 69.44% and 80.56%, specificities were 48.28%, 70.69%, 82.76% and 77.59%, accuracy rates were 65.38%, 71.54%, 75.38% and 79.23%, respectively. Conclusions:The 3D-STE-related strain parameters GLS, GRS, GCS and GAS can be used as ultrasound indexes for assessment of left ventricular diastolic function in elderly patients with HF pEF, which is helpful for early detection of changes in left ventricular diastolic function in elderly patients with HF.

Assessment of left atrial function in elderly patients with ischemic mitral regurgitation by real-time three-dimensional speckle tracking imaging / 中华老年医学杂志

Objective@#To assess left atrial(LA)function by evaluating changes of LA wall movement and volume detected by real-time three-dimensional speckle tracking imaging(RT3D-STI)in elderly patients with ischemic mitral regurgitation(IMR).@*Methods@#Eighty-six elderly patients with coronary heart disease(CHD)were enrolled in this study.According to whether or not to have IMR, the patients were divided into the pure CHD group(n=32)and the CHD-induced ischemic mitral regurgitation(IMR)group(n=54, including 20 cases of mild IMR, 18 cases of moderate IMR and 16 cases of severe IMR). Thirty-two healthy elderly volunteers were considered as control group.RT3D-STI was used to evaluate the global atrial longitudinal strain(GLS), global circumferential strain(GCS), global radial strain(GRS)and LA maximal, minimal and pre-systolic volumes(LAVmax, LAVmin, and LAVp). LA ejection fraction(LAEF), LA passive ejection fraction(LApEF)and LA active ejection fraction(LAaEF)were calculated.The relationship of LA volume changes and myocardial strain with LA function was analyzed.@*Results@#The left ventricular ejection fraction(LVEF)and LAEF were reduced in CHD group and IMR group as compared with the control group, and were lower in IMR group than in CHD group(P<0.05). Compared with the control group, the LAVmin was increased, and the LAaEF was decreased in the IMR group(P<0.05). Compared with the control group, the GLS, GCS, GRS were declined in the CHD and IMR groups, and were lower in IMR group than in control group(P<0.05). Along with the increased severity of regurgitation, GLS, GCS, and GRS were decreased in varying degrees.The standard deviations of time to peak longitudinal strains(TLS-SD), of time to peak circumferential strains(TCS-SD), and of time to peak radial strain(TRS-SD)rose in the IMR group as compared with the control group(P<0.05). The myocardial motion indicators(GLS, GCS, GRS)had a quite strong correlation with LAEF in the CHD and IMR groups(CHD group: r=-0.745, -0.718 and 0.627, P=0.006, 0.007 and 0.009; IMR group: r=-0.785, -0.781, 0.643, P=0.006, 0.007 and 0.008). The receiver operating characteristic(ROC)curves analysis showed that the sensitivity and specificity of TLS-SD, TCS-SD and TRS-SD were 89.7% and 81.8%, 78.6% and 84.8%, 85.7% and 72.1%, respectively in the evaluation of LA function changes.@*Conclusions@#RT3D-STI can precisely and objectively assess the LA function changes by measuring the volume changes and tracing the myocardial motion in elderly IMR patients.

Three-dimensional speckle tracking imaging combined with SYNTAX score in evaluating complex coronary artery disease / 中国医学影像技术

Objective: To explore the value of three-dimensional speckle tracking imaging (3D-STI) combined with coronary artery SYNTAX scores (SS) in evaluating the left ventricular function of patients with complex coronary artery disease (CAD). Methods: Totally 78 patients with complex CAD were divided into low score subgroup (SS<23, n=26), medium score subgroup (23≤SS<33, n=25) and high score subgroup (SS≥33, n=27) according to SS. The global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS), global three-dimensional strain (G3DS) and longitudinal strain (LS), radial strain (RS), circumferential strain (CS) as well as three-dimensional strain (3DS) of segments were obtained with 3D-STI. Then LS, RS, CS, 3DS of basal segment, middle segment and apical segment were further calculated. The above indexes were compared among groups. Results: ①GLS, GRS, GCS and G3DS all decreased in turn among low score, medium score and high score subgroups (all P<0.05). LS, 3DS of basal segment, LS, RS, CS and 3DS of middle segment and apical segment also decreased gradually (all P<0.05). ②ROC curve showed that GLS, GRS, GCS and G3DS had a certain value in detecting degrees of complex CAD, and GLS and G3DS had larger AUC. ③GLS, GRS, GCS and G3DS were negatively correlated with SS in the group of complex CAD (r=-0.548, -0.366, -0.411, -0.556, all P<0.05). 3D-STI had good interobserver and intraobserver consistency. Conclusion: 3D-STI can reflect the complexity of coronary artery lesions, which has a certain guiding significance combined with SS in diagnosis and treatment of complex CAD.

3-Dimensional Echocardiography and 2-D Strain Analysis of Left Ventricular, Left Atrial and Right Ventricular Function in Healthy Brazilian Volunteers / Análise da Função Ventricular Esquerda e Direita e Atrial Esquerda pelo Ecocardiograma Tridimensional e Análise da Deformação Bidimensional em Voluntários Saudáveis Brasileiros

Abstract Background: New echocardiographic techniques are used in the diagnosis and prognosis of many heart diseases. However, reference values in different populations are still needed for several of these new indexes. We studied these new echocardiographic parameters in a group of Brazilians with no known cardiovascular disease. Objective: To study values for new echocardiographic indexes in Brazilians without known cardiovascular disease and their correlation with age. Methods: Cross-sectional study that included healthy individuals who underwent three-dimensional echocardiography (3DE) and two-dimensional speckle tracking echocardiography (STE) strain (e) analysis. Left atrial (LA) and left ventricular (LV) function were analyzed by 3DE and STE, and right ventricular (RV) function by STE. P values < 0.05 were considered significant. Results: Seventy-seven subjects (46.7% men; 40.4 ± 10.4 years) were included. Maximum, minimum and pre-atrial contraction (pre-A) LA volumes (ml/m2) were 21.2 ± 5.5, 7.8 ± 2.5, and 11.0 ± 3.1, respectively. Peak positive global LA e (LAScd), peak negative global LA e and total global LA e (LASr) were 17.4 ± 5.2%, -13.2 ± 2.0% and 30.5 ± 5.9%, respectively. LV end-diastolic and end-systolic volumes (ml/m2) measured 57 ± 12 and 24 ± 6, and 3D LV ejection fraction measured 58 ± 6%. Global LV longitudinal, circumferential and radial e were -19 ± 2%, -19 ± 3%, and 46 ± 12%, respectively. LV torsion measured 1.6 ± 0.70 /cm. Global longitudinal RV e (RV-GLS) and RV free wall strain were -22 ± 3% and -24 ± 5%. Minimum LA and pre-A volumes, LV apical rotation, torsion and RV-GLS increased with age, while total and passive LA emptying fractions, LAScd, LASr, LV end-diastolic and end-systolic volumes decreased with age. Conclusion: Values for new echocardiographic indexes in Brazilians without known cardiovascular disease and their correlation with age are presented.

Resumo Fundamentos: Novas técnicas ecocardiográficas são utilizadas no diagnóstico e prognóstico de diversas cardiopatias. No entanto, muitos desses novos índices ainda carecem de valores de referência em diferentes populações. Estudamos esses novos parâmetros ecocardiográficos em um grupo de brasileiros sem doença cardiovascular conhecida. Objetivo: Estudar valores dos novos índices ecocardiográficos em brasileiros sem doença cardiovascular conhecida e sua correlação com a idade. Métodos: Estudo transversal composto por indivíduos saudáveis que realizaram ecocardiograma tridimensional (E3D) e ecocardiograma bidimensional com análise de deformação (e) por speckle tracking (EST). Foram analisadas as funções atrial esquerda (AE) e ventricular esquerda (VE) por E3D e EST, e a função ventricular direita (VD) por EST. Valores de p < 0,05 foram considerados significantes. Resultados: Foram incluídos setenta e sete indivíduos (46,7% homens; 40,4 ± 10,4 anos). Os volumes AE máximo, mínimo e pré-contração atrial (pré-A) (ml/m2) foram 21,2 ± 5,5, 7,8 ± 2,5 e 11,0 ± 3,1, respectivamente. O pico da e global positiva do AE (LAScd), pico da e global negativa do AE e e global total do AE (LASr) foram 17,4±5,2%, -13,2 ± 2,0% e 30,5 ± 5,9%, respectivamente. Os volumes diastólico final e sistólico final do VE (ml/m2) mediram 57 ± 12 e 24 ± 6 e a fração de ejeção tridimensional do VE mediu 58 ± 6%. A e longitudinal, circunferencial e radial global do VE foi de -19 ± 2%, -19 ± 3% e 46 ± 12%, respectivamente. A torção do VE mediu 1,6 ± 0,7(0)/cm. A e longitudinal global do VD (SLG-VD) e a deformação da parede livre do VD foram de -22 ± 3% e -24 ± 5%. Os volumes mínimo e pré-A do AE, rotação apical do VE, torção e SLG-VD aumentaram com a idade, enquanto as frações de esvaziamento total e passivo do LA, LAScd, LASr, volumes diastólico final e sistólico final do VE diminuíram com a idade. Conclusão: Apresentam-se os valores para os novos índices ecocardiográficos em brasileiros sem doença cardiovascular conhecida e sua correlação com a idade.

The feasibility of 3D printing aortic root model by three dimensional transesophageal echocardiography data: a preliminary study compared with CT / 中华超声影像学杂志

Objective@#To preliminary explore the feasibility of three-dimensional transesophageal echocardiography (3D-TEE) as images data source for 3D printing model by comparing the 3D-TEE with CT of the aortic root Digital Imaging and Communications in Medicine(DICOM) data into 3D printing models respectively.@*Methods@#Fifteen patients who underwent surgical aortic valve replacement in the hospital were enrolled, and the aortic root 3D-TEE and CT DICOM data were obtained in perioperative. The images were imported into Mimics software to generate digital model standard tessellation language file, and to print the aortic root models by 3D printer. The structural morphology of both 3D-TEE and CT models were qualitatively evaluated respectively. The aortic annular area, perimeter, maximal diameter and minimal diameter of the original data, digital model, model and aortic valve replacement were quantitatively evaluated, and the consistency of each parameter value were analyzed. The mean diameter of 3D-TEE and CT model were calculated. The correlation of mean diameter with the number of replacement was analyzed.@*Results@#①Both 3D-TEE and CT images data were successfully printed into 3D models, and the positive rate of aortic valve structure were 93.3% (14/15) and 80.0% (12/15) respectively. ②The measured values of the aortic annular 3D-TEE and digital model were smaller than CT, CTdigital model and replacement (P<0.05), and the measurement consistency among groups was high. ③The parameter values of 3D-TEE model were smaller than CT model (P<0.05), and the measured values were all within the consistency range. The mean diameters were highly correlated with the replacement values (r>0.95, P<0.05).@*Conclusions@#3D printing aortic root model based on 3D-TEE image data is of high feasibility.

Research progress of three-dimensional speckle tracking imaging in evaluation of left atrial structure and function / 中国介入影像与治疗学

Three-dimensional speckle tracking imaging (3D-STI) is a new ultrasonic technology developed in recent years, which is based on gray-scale imaging. 3D-STI can accurately quantify the global and regional myocardial function by tracking trajectory of the spot signal myocardial echo in three-dimensional space. Recently, 3D-STI has been used to assess the structure and function of left atrium. The relative advancements were reviewed in this article.

Three-dimensional speckle tracking echocardiography in evaluation on left ventricular function in type 2 diabetes mellitus patients with non-alcoholic fatty liver disease / 中国医学影像技术

Objective: To evaluate the feasibility of three-dimensional speckle tracking echocardiography (3D-STE) in evaluating left ventricular (LV) function in type 2 diabetes mellitus (T2DM) patients with non-alcoholic fatty liver disease (NAFLD). Methods: Totally 30 T2DM patients without NAFLD (group A), 32 T2DM patients with mild NAFLD (group B) and 35 T2DM patients with moderate to severe NAFLD (group C) underwent 3D-STE. Echocardiographic parameters were obtained, including conventional parameters of the ratio of transmitral peak early to late diastolic velocity (E/A), interventricular septum thickness diastolic (IVSTd), posterior wall thickness diastolic (PWTd), LV end-diastolic diameter (LVDd) and LV end-systolic diameter (LVDs), as well as LV function parameters including end-systolic left atrial volume (LAV), LV mass (LVM), LV end-diastolic volume (LVEDV), LV end-systolic volume (LVESV), LV mass index (LVMI) and LV ejection fraction (LVEF), also 3D-STE parameters including global longitudinal strain (GLS), global area strain (GAS), global radial strain (GRS) and global circumferential strain (GCS). The correlation of 3D-STE parameters and glycosylated hemoglobin (HbA1c), body mass index (BMI) were analyzed with Pearson linear correlation analysis. Results: There was no difference of E/A, IVSTd, PWTd, LVDd, LVDs, LVMI, LVEF, LVEDV nor LVESV among the 3 groups (all P>0.05), but patients in groups B and A had higher GCS, GRS, GLS and GAS than in group C (all P0.05). Conclusion: 3D-STE can be used to assess LV function in T2DM patients with NAFLD.

Three-dimensional echocardiography combined with myocardial contrast echocardiography for assessment of myocardial dysfunction in patients with type 2 diabetes mellitus / 中国医学影像技术

Objective: To explore the value of real-time three-dimensional echocardiography (RT-3DE) combined with myocardial contrast echocardiography (MCE) in evaluating myocardial dysfunction in type 2 diabetes mellitus (T2DM) patients. Methods: Totally 58 T2DM patients were divided into group (T2DM isolated ) and group Ⅱ (T2DM associated with microvascular complications, each n=29). Group C included 32 normal individuals. The standard deviation (Tmsv16-SD, Tmsv12-SD, Tmsv6-SD) and the maximum time difference (Tmsv16-Dif, Tmsv12-Dif, Tmsv6-Dif) of the time to the minimum systolic volume of left ventricle were measured with RT-3DE. MCE was performed to obtain perfusion measurement of each segment of ventricular wall, including the acoustic intensity (A), microvascular flow velocity (β) and A•β. Results: There were statistically significant differences in all synchronize measurements except Tmsv6-Dif between group Ⅱ and group C (all P0.05). Conclusion: Left ventricular desynchrony can be observed in T2DM patients with or without microvascular complications. Myocardial perfusion reduce in T2DM patients presenting as diffuse damage, which aggravated with microvascular complications in other organs.