Study Of The Motion On Myocardial Hypertrophy By Omni-directional M-mode Echocardiography

Objective:1.Using the Omni-directional M-mode echocardiography to assess the normal myocardial velocity gradient (MVG); 2.Measure the parameters on normal group and control group, including hypertrophic cardiomyopathy(HCM)and left ventricular hypertrophy(LVH), to assessing regional myocardial hypertrophic motion and function; 3.To explore the application of assessing regional myocardial motion and function between Omni-directional M-mode echocardiography and the two-dimensional strain echocardiography.Methods:Object: 36 normal subjects, 32 hypertrophic cardiomyopathy (HCM) patients and 20 essential hypertention with left ventricular hypertrophic myocardium(LVH). Equipment: Using GE Vivid Seven Demision ultrasound system with Echo PAC work staion and LEJ-2 ominidirectional M-mode echocardiography which was developed by Biomedical Engineering Institute of Fuzhou University in China.Measurement: 1. Left ventricular image cine loops on three levels at the short-axis view were stored on station. 2. M-mode sections were done in each segment by LEJ-2 omni-directional M-mode echocardiography, this equipment can measure some parameters respectively, including systolic velocity, diastolic velocity and velocity difference between endocardium and epicardium, wall thickness. Mean value of three cardiac cycle were recorded. MVG can be estimated as follows: MVG=(Ven—Vep)/D. Compared identical segments on apical levels and mitral levels with middle levels. Tow detectors in double-blind conditions repetitively test MVG of the mitral level. Compared MVG on each segment with different group. 3. SR wre measured by two-dimensional strain echocardiography on normal subjects and hypertrophic cardiomyopathy (HCM) patients, compared the difference between the two-dimensional strain echocardiography and omni-directional M-mode echocardiography.Results:1.The MVG were lower form mitral level to apex level on left ventricular short-axis view, the MVG of left ventricular free walls were higher than interventricular septums at the same level of left ventricular short-axis, the lateral walls were highest, the deference between interventricular septums were indistinctive. The two reproducible test results detected no statistically significant difference.2.The MVG of the most segments except posterior wall and inferior wall were significantly lower in HCM patients than in normal subjects; the most segements on systolic period were significantly lower in LVH patients than in normal subjects, the difference were indistinctively on diastolic period. The velocity differences uncorrelated with wall thickness in normal subjects; but the velocity differences negative correlated well with wall thickness in HCM patients; The velocity differences uncorrelated with wall thickness at the most segements except interventricular septums in LVH patients.3.The MVG by LEJ-2 omni-directional M-mode echocardiography were lower than SR by two-dimensional strain echocardiography, consistency check shows that most parts of the data between two technologies in the normal ang HCM groups are statistically significant, and the MVG correlated well with SR in normal and HCM groups.Conclusions:1.The myocardial velocity gradients were not equation to each segment in normal subjects. LEJ-2 omni-directional M-mode echocardiography can quantitative analysis regional myocardial motion.2.The MVG measured by LEJ-2 omni-directional M-mode echocardiography in HCM group were significantly lower than in normal group on systolic and diastolic period, negative corellected well with wall thickness. The defference showed more inconspicuous at diastolic period than systolic period, uncorrelated with wall thickness. LEJ-2 omni-directional M-mode echocardiography could quantify the motion and function with regional myocardial hypertrophy. It might be a new method for diagnosising lower range cardiac function when whole function was in normal.3.The MVG correlated well with the SR, LEJ-2 omni-directional M-mode echocardiography might be a novel method to quantify regional myocardial function.