RESUMO
Objective To study the local morphology of post-infarction ventricular septal rupture (PI-VSR) and the left ventricular function before and after operation and to evaluate the relevant risk factors of death in patients with PI-VSR by using left ventricular opacification (LVO) combined with real-time three-dimensional echocardiography (RT-3DE).Methods Twenty-eight patients with PI-VSR and 19 patients undergoing surgical treatment were selected.The consistency of two-dimensional ultrasound,RT-3DE and the detection of LVO on the maximum diameter,location,number and shape of ventricular septal rupture (VSR) with the surgical results were compared.Through LVO combined with RT-3DE,the changes of left ventricular function indexes before and after surgery were compared.According to the general data and clinical data of patients,independent risk factors affecting survival and prognosis were explored.Results ①There was no significant difference between LVO and RT-3DE in detecting VSR maximum diameter and surgical results (all P ＞0.05).The location,number and shape of VSR detected by LVO were consistent with the surgical results (all P ＜0.05).RT-3DE had good consistency in detecting VSR location,shape and surgical results (all P ＜0.05).Among them,of LVO's detection of VSR location and shape and the Kappa values of consistence of the intraoperative results were 0.650 and 0.883 respectively.LVO had a sensitivity of 0.923,specificity of 1.000,accuracy of 0.947,positive predictive value of 1.000 and negative predictive value of 0.857 in observing VSR shape.② LVO combined with RT-3DE was used to evaluate the left ventricular function of postoperative patients.The parameters of left ventricular function improved significantly(all P ＜0.05).③The independent risk factors affecting the 30 d survival rate included:gender,Killips pump function classification,and whether or not surgery was performed.Conclusions LVO and RT-3DE can provide more accurate anatomical information such as VSR maximum diameter,location,number and shape,which provides the basis for the selection of treatment strategy.LVO combined with RT-3DE can evaluate the changes of left ventricular function before and after surgery,which can provide reference for clinical evaluation of prognosis.
RESUMO
Objective@#To study the local morphology of post-infarction ventricular septal rupture (PI-VSR) and the left ventricular function before and after operation and to evaluate the relevant risk factors of death in patients with PI-VSR by using left ventricular opacification (LVO) combined with real-time three-dimensional echocardiography (RT-3DE).@*Methods@#Twenty-eight patients with PI-VSR and 19 patients undergoing surgical treatment were selected. The consistency of two-dimensional ultrasound, RT-3DE and the detection of LVO on the maximum diameter, location, number and shape of ventricular septal rupture (VSR) with the surgical results were compared. Through LVO combined with RT-3DE, the changes of left ventricular function indexes before and after surgery were compared. According to the general data and clinical data of patients, independent risk factors affecting survival and prognosis were explored.@*Results@#①There was no significant difference between LVO and RT-3DE in detecting VSR maximum diameter and surgical results (all P>0.05). The location, number and shape of VSR detected by LVO were consistent with the surgical results (all P<0.05). RT-3DE had good consistency in detecting VSR location, shape and surgical results (all P<0.05). Among them, of LVO′s detection of VSR location and shape and the Kappa values of consistence of the intraoperative results were 0.650 and 0.883 respectively. LVO had a sensitivity of 0.923, specificity of 1.000, accuracy of 0.947, positive predictive value of 1.000 and negative predictive value of 0.857 in observing VSR shape. ②LVO combined with RT-3DE was used to evaluate the left ventricular function of postoperative patients. The parameters of left ventricular function improved significantly(all P<0.05). ③The independent risk factors affecting the 30 d survival rate included: gender, Killips pump function classification, and whether or not surgery was performed.@*Conclusions@#LVO and RT-3DE can provide more accurate anatomical information such as VSR maximum diameter, location, number and shape, which provides the basis for the selection of treatment strategy. LVO combined with RT-3DE can evaluate the changes of left ventricular function before and after surgery, which can provide reference for clinical evaluation of prognosis.
RESUMO
Contrast echocardiography is broadly described as a variety of techniques whereby the blood pool on cardiac ultrasound is enhanced with encapsulated gas-filled microbubbles or other acoustically active nano- or microparticles. The development of this technology has occurred primarily in response to the need improve current diagnostic applications of echocardiography such as the need to better define left ventricular cavity volumes, regional wall motion, or the presence or absence of masses and thrombi. A secondary reason for the development of contrast echocardiography has been to expand the capabilities of echocardiography. These new applications include myocardial perfusion imaging for detection of ischemia and viability, perfusion imaging of masses/tumors, and molecular imaging. The ability to fill all of these current and future clinical roles has been predicated on the ability to produce robust contrast signal which, in turn, has relied on technical innovation with regards to the microbubble contrast agents and the ultrasound imaging paradigms. In this review, we will discuss the basics of contrast echocardiography including the composition of microbubble contrast agents, the unique imaging methods used to optimize contrast signal-to-noise ratio, and the clinical applications of contrast echocardiography that have made a clinical impact.