| Objective:1.To evaluate the regional myocardial motion and function of left ventricularshort-axis in heart failure patients with coronary artery disease（CAD）and dilatedcardiomyopath（DCM) by Omni-directional M-mode Echocardiograph (OME) withdifferent function parameters.2.To explore the application of assessing regional myocardial motion and functionbetween Omni-directional M-mode echocardiography(OME) and the two-dimensionalspeckle tissue imaging(STI).Methods:Object: Selected30healthy subjects(normal group)，30patients with DCM (DCMgroup) and30patients with CAD(CAD group) as the research subjects. Equipment:Using GE Vivid Seven Demision ultrasound system with Echo PAC work station andLEJ-2omni-directional M-mode echocardiography which was developed byBiomedical Engineering Institute of Fuzhou University in China. Measurement:1.Left ventricular image cine loops on three levels（including mitral level,middle leveland apical level） at the short-axis view were stored on station.2. The left ventricularshort-axis16segments’ curves of OME in every group were collected. Theparameters including the peak systolic epicardial motion velocity(Vepi), the peaksystolic endocardial velocity (Ven), the peak systolic endocardial accelerated (Aen),the wall mean heavy(MH) during the cardiac cycle, diastolic wallthickness(D),relatively force (F) were measured.The Strain Rate (SR) can beestimated as follows: SR=(Ven—Vepi)/D. Mean value of three cardiac cycle wererecorded of each parameter.Then compared DCM group and CAD group with normal group according to the records.3. Divided CAD into the non-ischemic segments andischemic segments according to the results of coronary angiography, Compared thevalue of different parameters respectively between two groups.4. SR were measuredby the two-dimensional speckle tissue imaging(STI) on the different groups inpapillary muscle level, then compared the difference between the two-dimensionalspeckle tissue imaging(STI) and omni-directional M-mode echocardiography(OME)Results:1. In normal group, the value of F was significantly lower in apical level than thecorresponding segments in mitral level and the middle level (p<0.05); And the valueof F of left ventricular free walls was higher than interventricular septums at thesame level of left ventricular short-axis, but the differences had no statisticalsignificance(p>0.05).2.The each parameter in DCM group was significantly lower than the corresponding16segments in normal group (p<0.05), compared the apical level with the mitral leveland middle level and compared the interventricular septums with the left ventricularfree walls, the value of F wasn’t lower, the differences had no statistical significance(p>0.05).3.Compared with corresponding16segments in normal group,the value of Ven inCAD group on lateral, inferior and posterior septum in mitral level, inferior andposterior septum in middle level and posterior septum in apical level had nosignificant decrease (p>0.05),the other segments had significant decrease(p<0.05),the value of SR of16segments in CAD group on posterior septum inmitral level and apical level had no significant decrease (p>0.05),the othersegments had significant decrease (p<0.05). While the value of Aen, F of16segmentswere significantly decreased (p<0.05). The F was not exactly equal in each segmentof CAD group, but the differences had no statistical significance.(p>0.05). Comparedwith non-ischemia segments, the value of each phase in the Ischemic-segment weresignificantly decreased (p<0.05).4.The SR in the middle level had good relation between the OME and STI in eachgroup. Conclusion:1.OME had higher accuracy in evaluating the regional myocardial function of leftventricular, and more quantitately and locally through applying different parametersto evaluate the movement between the heart failure patients with coronary arterydisease（CAD）and dilated cardiomyopath（DCM).Acceleration and the relativelyforce could be more sensitive than velocity and SR in evaluating the left ventricularabnormal regional systolic function. And the relatively force should be more sensitivethan acceleration in evaluating the abnormal regional systolic function in DCM andischemic segments in the CAD.2.The SR had good relation among each group between the OME and STI. So OMEcould also evaluate the regional myocardial motion and function in diverse functionstate as an effective method. |
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