Assessment Of Left Ventricular Systolic Synchrony In Patients With Non-cardiac Chest Operation Preoperative And Postoperative Subjects By Real-time Three-dimensional Echocardiography

Thoracic surgery is an invasive surgery,the degree of injury to thebody depends on the part,nature and severity of the disease.Cardiaccomplications,such as arrhythmia,myocardial ischemia is a commoncomplication of chest operation.Intraoperative traction and long operativetime,intraoperative anesthesia is not smooth,low blood pressure,low bodytemperature,early postoperative pain and so is the risk factors of heartcomplications.First,the above factors can cause the increase in myocardialoxygen consumption,lead to postoperative myocardial hypoxia.When theincrease in myocardial oxygen consumption exceeding coronary reservecapacity,relative myocardial ischemia appeared.Second,surgery operationpull lung tissue caused lung ventilation/perfusion ratio decreased and early postoperative pain can also increase the body’s stress response,causing the release of neuroendocrine hormones, increased irritability ofthe heart,leading to arrhythmia cause myocardial hypoxia.In addition,surgery affect the autonomic nervous system,causing coronary arteryspasm,that makes the myocardial regions it dominated appear severeischemic,leading to decline in myocardial function.Therefore,in clinicalthoracic surgerys should minimize the pulling and squeezing of thehilar,heart and aorta,minimize bleeding,smooth anesthesia,full oxygen inorder to prevent the occurrence of cardiovascular complications.Showsthat the assessment of non-cardiac thoracic surgery on the heart functionis particularly important to the clinical monitoring and prevention of theoccurrence of cardiac complications.Real-time three-dimensional echo-cardiography is a recently developed technology for research the changeof cardiac volume and the cardiac function,RT-3DE can collect the wholeheart,and can not be impacted by the cardiac geometry assumptions andthe shape of the cardiac chambers,visually display the three-dimensionalstructure of the heart and cardiac wall motion,reflect the change of overall left ventricular and the regional ventricular in the different cardiac cycleheart.RT-3DE can overcome the deficiencies of the two-dimensionalultrasound,the accuracy and the repeatability of evaluat left ventricularvolumes and ejection fraction,and its correlation with cardiac magneticresonance imaging technology are higher than the two-dimensional echo-cardiography.Objective: Apply the real-time three-dimensional echocardiographyevaluat the left ventricular systolic synchrony of the patients withnon-cardiac thoracic surgery in peri operation period,and investigate itsclinical value.Methods: Select the30cases of non-cardiac thoracic surgerypatients and do real-time three-dimensional echocardiography in the perioperation period.Record the preoperative and postoperative leftventricular end-systolic volume (ESV),end-diastolic volume(EDV),ejection fraction (LVEF) and left ventricular systolic synchronyindex,and contrast the parameters of the preoperative group with thepostoperative group. Results:①The comparison of left ventricular systolic function:contrast the postoperative group ESV,EDV,LVEF with the preoperativegroup,the difference was not statistically significant(P>0.05).②Thecomparison of17segment volume-time curve shape:the left ventricular17segment volume-time curves’shape of the preoperative group isregular,the wave valley time is similar.The17segment volume-timecurves’shape of postoperative group is irregular, the wave valley time isinconsistent and the trough positions are far away.③Left ventricularsystolic synchrony indexes: The Tmsv16-SD,Tmsv16-SD%,Tmsv12-SD,Tmsv12-SD%,Tmsv6-SD,Tmsv6-SD%,Tmsv16-Dif,Tmsv16-Dif%,Tmsv12-Dif,Tmsv12-Dif%,Tmsv6-Dif,Tmsv6-Dif%in the postoperativegroup increased,compared with those in the preoperative group,thedifference was statistically significant (P <0.05).Conclusion: Real-time three-dimensional echocardiography17segment volume-time curve parameters can accurately evaluate leftventricular systolic synchrony change of the the patients with non-cardiacthoracic surgery in peri operation period,using RT-3DE analysis of changes in left ventricular segmental volume-time curves be able toobjectively assess peri operation left ventricular systolic synchrony andprovide a reliable basis for clinical prevention and treatment of perioperation cardiac complications of patients with non-cardiac thoracicsurgery.RT-3DE technology is a reliable method to evaluate left ventricularsystolic function, through the detection of left ventricular segmentalvolume with the heartbeat cycle changes, it can accurate assessment theleft ventricular whole systolic function and regional systolic function.RT-3DE technology can be found regional left ventricular systolicdysfunction early. The parameters of left ventricular systolic synchronyof non-cardiac chest operation patients during operation period reduce.Using RT-3DE analysis of changes in left ventricular segmentalvolume-time curves are able to objectively assess left ventricular systolicsynchrony during peri operation period and provide a reliable basis forclinical prevention and treatment of cardiac complications of patientswith non-cardiac thoracic surgery during peri operation period.