Traditional2D Echocardiography And Full Volume Real-time Three-dimensional Echocardiography Evaluate Cardiac Function Thoracic Radiotherapy

With the development of human life and natural environment worse, aswell as the influence of people’s social pressure, cancer became the first killerwhich leads people to mortality increased year by year.But with thedevelopment of science and technology, part of the tumor cure rate alsoincreased year by year, While we investigate its root node to give symptomatictreatment, we should pay more attention to the quality of tumorpatients’life.Chest tumors, including lung cancer, esophageal cancer, mediastinaltumor and breast cancer, the most treatment is radiotherapy, progress ofradiation treatment also makes more and more cancer patients of long-termsurvival, radioactive therapy complications are absorbed more and moremedical professionals and scientists attention, and we especially need to payattention to the damage of radioactive treatment of thoracic malignant tumors’heart, we should research and explore the new technology of radiotherapyaccording to it.Before that the heart is not sensitive to radiation organ, neglectto protect the heart during radiotherapy, But with the extension of observationtime, this year at home and abroad, there are many report of a radioactiveheart injury, including pericardial disease, myocardial fibrosis, coronary arterydisease, heart valve disease and cardiac conduction system damage, the harmcan not be ignored.Now the three-dimensional conformal radiotherapy for newtechnology development and long-term since all scholars to study theradiotherapy complication with this new technology not only improves thetarget area of conformal and selectivity, but also reduce the volume and doseof normal tissue involvement, the radiation side effects than early radiotherapymethods to a minimum. Full volume real-time three-dimensional echocardiography (Full volumeRT-3DE) is an important ultrasound technology innovation on developmenthistory of heart ultrasound, the technology and the traditional2Dechocardiography has very big difference, it’s not only through thethree-dimensional structure and dynamic changes of noninvasive method ofpresenting normal heart and lesion, but also can improve the irregularventricular and dyssynchrony ventricular cardiac function measurementprecision.In this study, traditional2D echocardiography and Full volume RT-3DEwas used to evaluate the left ventricular function in early thoracicradiotherapy.There are two parts in this study.the first part is to evaluate theleft ventricular function in early thoracic radiotherapy by traditional2Dechocardiography.The second part is to evaluate the left ventricular functionin early thoracic radiotherapy by Full volume RT-3DE.Objective:To evaluate the changes of left ventricular function of patientsin early thoracic radiotherapy by traditional2D echocardiography andRT-3DE,and to investigate the sensitive index of the left ventricular functionin early thoracic radiotherapy,using traditional2D echocardiography and Fullvolume RT-3DE.Methods:34patients who with thoracic cancer were enrolled in thisstudy,including14patients with lung cancer and20patients with esophagealcancer,to obtain a series of their single cardiac cycle2D and RT-3D imagesrecords of left ventricular function.Such as left ventricular end-diastolicdiameter (LVDd),interventricular septal thickness(IVSd),left ventricularposterior wall thickness (LVPWd),ejection fraction (EF),fractional shorteningof the left ventricular minor semi axis(FS), stroke volume (SV),heart rate(HR),left ventricular minute output (CO)and E/A In2D echocardiography.Allthe RT-3DE images were analyzed quantitatively to generate series of LVparameters, such as left ventricle volumetric parameters, systolic synchronyparameters and diastolic synchrony parameters. Left ventricle volumetricparameters including end systolic volume (ESV), end diastolic volume (EDV), ejection fraction (EF), stroke volume (SV), end-systolic sphericityindex(ESSI), end-diastolic sphericity index(EDSI). Systolic synchronyparameters including systolic dyssynchrony index (the16-segment model)(SDI16), dispersion end-systole (the16-segment model)(DISPES16),pre-contraction time volume (the16-segment model)(PreContr16), andpost-contraction time volume (the16-segment model)(PostContr16) andmean end-systolic time (the16-segment model)(MES16). Diastolic synchronyparameters including diastolic dyssynchrony index (the16-segment model)(DDI16), dispersion end-diastole (the16-segment model)(DISPED16),pre-relaxaction time volume (the16-segment model)(PreRelax16),post-relaxaction time volume (the16-segment model)(PostRelax16) and mean end-diastolic time (the16-segment model)(MED16).Results:1In the traditional2D echocardiography:LVDd、IVSd、LVPWd、EF、FS、SV、HR、CO has no significant difference between the two groups（allP>0.05）.E/A were significantly lower after radiotherapy(P<0.05).2In the Full volume RT-3DE echocardiography:LVESV、LVEDV、LVSV、LVEF、ESSI、EDSI、SDI16、DISPES16、PreContr16、PostContr16、MES16、DISPED16、PreRelax16、PostRelax16had no significantdifference before and after radiotherapy（all P>0.05）.MED16and DDI16islager than before radiotherapy(all P<0.05).Conclusions: In the case of Radiation damage in tumor growing, moreand more attention, radioactive heart injury is the priority among priorities, inorder to identify the early abnormal heart function and take timely interventionon clinical, early examination of the heart is particularly important.Ultrasonic heartbeat graph can be intuitive, accurate display of cardiacstructure, function and blood flow status, power radiation pericardium,myocardium, conduction system of heart valve and coronary artery can beinvolved, especially the radiotherapy can cause cell injury induced bymyocardial cell vacuolar degeneration, further development of irreversiblemyocardial lesions, myocardial cell loss of myofibrillar lysis collagen content increased, and myocardial fibrosis, the serious development of dilatedcardiomyopathy and congestive heart failure. according to the results of thisstudy, E/A is slight decrease in the2D echocardiography.Tips frome theoverall aspect that the left ventricular is reduce. MED16and DDI16is lightincrease in the real-time full volume three-dimensional echocardiography.It isreflected that the left ventricular is reduce frome the local area. the traditionaltwo-dimensional ultrasound heartbeat graph in the monitoring of thoracicradiotherapy induced early impairment of cardiac function is effective,compared to conventional radiotherapy technology, three-dimensionalconformal and intensity-modulated radiotherapy greatly improved on the earlydamage of heart, it shows that there is no impaired diastolic situation on themajority of patients ’ systolic function, a small number of patients withdiastolic heart function is decreased very slightly. The first, and weak. Onlywhen severe myocardial damage or the overall function of heart damage,theabnormal changes of left ventricular systolic function indexes of LVEF will behappened.