Comparison Of Left Ventricular Opacication With Two-Dimensinal Echocardiography On Measurement Of Left Ventricular Systolic Function

BackgroundLeft ventricular systolic function is one of the major indexes for prognosing the heart diseases. Two dimensional echocardiography(2DE) is the most common way to measure the cardiac function. However, the poor acoustic window worsens the 2DE image and cardiac function measurement. Left ventricular opacification (LVO) could improve ednocardial border developing. It is important to study whether LVO can enhance the accuracy of measuring left ventricular systolic function by improving the endocardial border developing.ObjectiveTo evaluate the value of LVO in enhancing the accuracy of measuring the left ventricular systolic function by improving the endocardial border developing, and to provide an useful way to measure cardiac function accurately.Materials and Methods1. 58 cases with poor acoustic window were studied. Among them, male 17 cases, female 41 cases, age ranged 31 -70yrs old, the mean age 56.6±9.9 years old.2. Standard apical four chamber image is got and recorded in optical disk before and after injection of human albumin microspheres, injectable suspension octafluoropropane formulation.3. Simpson method is adopted for left ventricular systolic function, which include left ventricular end-diastolic volume(EDV), end-systolic volume(ESV), stroke volume(SV) and ejection fraction(EF).All the left ventricular systolic function data before and after injection were measured by 2 doctors separately and blindly. The data was measured again by one of the above 2 doctors 3 months later.4. Left ventricular endocardial border is divided into 6 segments. Score 0: absent segment, score 1: fuzzy segment, score 2: clear segment.Autoradiography improvement rate is used for evaluating the effect of LVO enhancing endocardial border developing.Improvement rate=(segments of 0→1 and (0→2 + segments of 1→2)/ (segments of score 0 + segments of score 1)Significant improvement rate= (segments of 0→2+ segments of 1→2)/(segments of score 0 + segments of score 1)5. Paired t test and linear correlation analysis are adopted.Results1. Autoradiography resultsBefore and after LVO, segments of score 0 are 3 and 0, for score 1: 96 and 3 . for score 2: 249 and 345.Segments of score0 before LVO is 99. Improvement rate is 100%, significant improvement rate is 96.97%. 2. Comparison of left ventricular systolic function before and after LVOThe differences of ESV,SV and EF were statistically significant (P<0.05); EDV was not statistically significant (P>0.05).ESV was smaller after LVO than before;SV and EF were greater after LVO than before. The two doctors got the same results as above.3. Repeatability TestNo matter before or after LVO, the difference of EDV,ESV,SV and EF were not statistically significant(P>0.05) and all parameters were correlative(P<0.05) both inter-observer and inner- observer.4. The standard deviations of parameters were all greater before LVO than after.Conclusions1. 2DE is a relative accurate method of measuring left ventricular systolic function, good consistency and reproducibility is in intra-observers and inter-observers.2. LVO can enhance the accuracy of 2DE in measuring left ventricular systolic function by improving left ventricular endocardial border developing; good consistency and reproducibility is in intra- observers and inter-observers.3. LVO improves end-systolic endocardial border developing better than end-diastole one.4. ESV values is less before LVO than after, however, SV and EF values are larger before LVO than after,which suggests that 2DE may underestimate the left ventricular systolic function.