The Study Of TTE And QTVI On Observation Of Effect Of Ventricular Septal Defect Neoplasty

Objective:To evaluate the changes of hemodynamics,cardiac chamber load and systolic and diastolic function and after ventricular septal defect(VSD)neoplasty by using transthoracic echocardiography(TTE)and Quantitative Tissue Velocity Imaging(QTVI).Methods:TTE and QTVI were performed in 30 patients with the VSD successfully neoplasty from April,2007 to October,2007 before neoplasty and three days,one month and three months after neoplasty.The spectriam of tricuspid and mitral valves were recorded by placing sample volume of pulsed wave Doppler on orifice of tricuspid and mitral valves on apical four chamber view,and spectrium of pulmonary artery was recorded through pulmonary orifice on short axis view of great artery.E peak and A peak velocities of tricuspid and mitral valves,and maximal,mean velocities and velocity-time integral of pulmonary artery were measured.The anterior-posterior diameters,left-right diameters and long diameters of left ventricle both in systole and diastole were respectively measured on short axis view of left ventricle in tendon cordal level and apical four chamber view.The long diameter of left ventricle in diastole and systole,the long and traverse diameters of left and right atrium in systole were measured on four chamber view.The antieror-postieror diameter of right ventricular in diastole Antieror-postieror diameter of left atrium in systole were measured on parasternal long axis view.The diameter of pulmonary artery was measured on short axis of great vessel by using two-dimensional echocardiography.The volume of left ventriculer in end-systolic and end-diastolic period were also measured by using Simpson's equation with tracing endocardium on apical four chamber view.With QTVI, the velocities on annular and middle parts of left and right ventricular lateral wall and ventricular septum were measured on apical four chamber view.Take all the mearsures above about 30 normal persons.Results:Involved change after VSD neoplasty on third day,third month and sixth month①Hemodynamic change:Left to right shunt in ventricular level disappeared after neoplasty.Compared with the data before neoplasty,E and A peak velocities of mitral valve and maximal and mean velocities,velocity-time integral of pulmonary artery were remarkably decreased(P＜0.001),Compared with the data normal persons,the above data decreased(P＜0.05).②The change of chamber load:Left-right diameter of fight ventricle was significantly reduced on 3 days,1 months and 3 months after neoplasty(P＜0.05).Antieror-postieror diameter of left atrium in systole antieror-postieror diameter and left-right diameter as well as end-diastolc volume of left ventricle were significantly markedly decresed on 3 days after neoplasty(P＜0.05).All diameters of left atrium and left ventricle,and end-systolic volumes of left ventricle were significantly reduced on 1 and 3 months(P＜0.05).③The change of cardiac function measured by TDI:E' velocity on middle part of left ventricular lateral wall on 1 and 3 months and A' velocity on middle part of left ventricular lateral wall on 3 months were significantly increased(P＜0.05).But,there were no significantly change on all the other wall velocity.Conclusion:TTE and QTVI are simple and valuable methods to observe on the effect of VSD neoplasty,which may provide useful information for clinical doctors.They are on observing hemodynamic,cardiac chamber and function changes before and after neoplasty.This study shows that abnormal hemodynamics,increased preload and it's morphological abnormality,as well as systolic and diastolic function of right ventricle observed by the use of TTE and QTVI after VSD neoplasty.