| Viral myocarditis (VMC) is one of the most common pediatric cardiovascular diseases, the incidence is growing in recent years. According to the autopsy date, the incidence of the viral myocarditis had rised from 1%～9% to 5%～12%. Myocarditis can occur at any age of children, it was reported that the viral myocarditis mostly occurred in 1 year of age abroad, especially newborns, and it often caused epidemic in obstetric baby rooms. Nine provinces domestic investigating showed that the incidence of viral myocarditis in children less than 4 years of age was the most, accounted for 35.2% of all cases.The clinical manifestations of viral myocarditis are uneven, mild cases may be asymptomatic, easily overlooked. It may also be manifeste as symptoms of other systems disease, such as shortness of breath, nausea and vomiting, so it is easily misdiagnosed. Patients with severe myocarditis can occur heart failure, and be complicated by serious arrhythmias, cardiogenic shock, heart and brain syndrome, and even sudden death. It seriously damaged the health and lives of children. Calabrese F reported that myocarditis was the most common cause of heart failure in children who were previously healthy. With early treatment the prognosis is good, but without timely treatment, long-term healing can lead to dilated cardiomyopathy or become persistent or chronic process. Therefore early correct diagnosis is essential.Correct evaluation of cardiac function is a very important aspect of myocarditis diagnosis. Determine the status of cardiac function in clinical can assesse the extent of the heart damage, and is important for guiding clinical treatment and prognosisIn the evaluation of cardiac function, echocardiography is the most commonly used means. Echocardiographic quantitative assessment of overall cardiac function has many methods and parameters, but there was few technology in quantitative assessment of regional cardiac function, it has some limitations.A-SMA technology used in this study is a new ultrasound technology developing in recent years, it is used to detect cardiac function. It can be instant, intuitive, quantitative display the changes of the systolic and diastolic function on-line. It is especially has a unique advantage in the quantitative analysis of partial function of left ventricular.A-SMA is based on a"organization-blood interface"automatic detection technology, detecting and tracing the endocardial automati-cally. Add the endocardial border with color-coded, and display different time of endocardial changes by color (red, yellow, green) coding change gradely. Different section of left ventricular short axisis divided into a number of different wedge-shaped area equal,and detect fractional area change of systolic and diastolic of each cardiac cycle quantitative,the results is displated on the screen in histogram mode, curve pattern and form of data instantly. It is easy to distinguish the changes of the globle and segmental cardiac function by observing the change of color coding and fractional area change of left ventricular in a given period,it is fast and intuitive.In this study, we used Aloka SSD 5500 color ultrasound diagnostic apparatus with A-SMA analysis software,and detected 70 children with viral myocarditis.Start A-SMA system, and adjusted the size of region of interest surrounding the entire left ventricular cavity. Instrument automatically partition the left ventricular wall and the left ventricular short axis view were divided into 4 or 6 equal wedge-shaped region. The color distribution of segmental wall motion was showed in the A-SMA image. ECG R wave peak as the end-diastolic,and T wave end as the end-systolic, measurement of left ventricular regional fractional area change-systolic (FAC-S) fractional area change-diastolic (FAC-D) and fractional area change-total (FAC-T) of systolic and diastolic,result was displayed in histogram mode and form of data. Then took the apical four chamber view, turned on the left ventricular time-volume curve and its derivative curve, and detected the following parameters: normalization peak filling rate (nPFR) and normalization peak ejection rate(nPER); ejection fraction(EF); end diastolic volume(EDV) and end systolic volume(ESV).The test results were analysised contrasting with the cardiac function of normal children which were get in the first half of this issue.The result showed that:70 cases of myocarditis detected 1120 left ventricular wall segments, their color changes of segmental wall motion in systolic and diastolic were in a state of disorder and incomplete in children with myocarditis detecting with A-SMA technology. Ribbon-level was reducted or became thinner in 311 segments in systolic, the ribbon's color was mainly red, the detection rate was 27.8%; And 298segments in diastolic, the ribbon's color was mainly deep blue, the detection rate was 26.6%. It showed that the ventricular segmental wall motion were in different degrees of reduced in children with myocarditis. However, no obvious lacking of color was seen, it showed that no significant wall motion disappeared in children with myocarditis in this study. The motion abnormalities were most common seen in anterior and interventricular septum, and most of them are in the apical segments. The FAC of each segment were inequality in children with myocarditis, the FAC-S and FAC-D of most segments of left ventricular were lower than that of normal children, and the difference was statistically significant, but the change of inferior wall was not apparent. It showed that the systolic and diastolic function of most segments of children with myocardial were decreased compared with normal children.In this study, we examined children with ESV and EDV to reflect the changes in ventricular volume in children with myocarditis. The results showed that the ESV and EDV of all age groups of children with myocarditis were higher than normal children's. Two low-age children compared with normal children, the difference was significant; And it had no significant between the slightly higher age groups and normal children. It suggested that the left ventricular cavity enlargement and ventricular volume increasing was more pronounced in the low-age children with myocarditis.We detected FAC-T of systolic, EF and nPER by A-SMA technique to reflet global systolic function of children with myocarditis. The results showed that FAC-T of systolic, EF and nPER was declined in children with myocarditis than normal children, and the difference was significant, it suggested that the left ventricular systolic function was declined in patients.We detected FAC-T of diastolic and nPFR by A-SMA technique to reflet global diastolic function of children with myocarditis. The results showed that FAC-T of diastolic and nPFR was declined in children with myocarditis than normal children, and the difference was significant, it suggested that the left ventricular diastolic function was declined in patients.In this study, we used A-SMA technique detecting globle and segmental function of children with viral myocarditis, and got quantitative indices of globle and segmental function of children. Through this research we can conclude that application of A-SMA technology can evaluate left ventricular function intuitively and quantitatively. It has a distinct advantage particularly in the quantitative detection of regional left ventricular function. It can react lesion location and extent ore accurately. It provides objective and accurate diagnostic information for the clinical, and it has important value for assessment of condition and prognosis. This new technology is a non-invasive cardiovascular testing, it is practical in clinical, and suitable for clinical using widely.
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