Assessment Of Global And Regional Left Ventricular Systolic Function In Patients With Hypertrophic Cardiomyopathy By Real-Time Three-Dimensional Echocardiography

Part1：Assessment of global systolic function of left ventricular in patientswith hypertrophic cardiomyopathy by real-time three-dimensionalechocardiographyObjective To assess global systolic function of left ventricular using real-timethree-dimensional echocardiography (RT-3DE) in patients with hypertrophiccardiomyopathy (HCM), and to investigate the feasibility of RT-3DE in the evaluation ofglobal systolic function of left ventricular.Methods Twenty-five patients with HCM which is asymmetric septal hypertrophy, andtwenty healthy subjects were enrolled in the study. The apical four-chamber view of leftventricular was acquired by RT-3DE to analysis end-diastolic volume (EDV), end-systolicvolume (ESV), stroke volume (SV) and left ventricular ejection fraction (LVEF). Moreover,The apical four-chamber view and two-chamber view of left ventricular were store indynamic mode, and then we compared the values of LVEF which were measured by RT-3DE,two-dimensional echocardiography biplane simpson’s method and M-modeechocardiography.Results①There were no significant differences between the two groups in age, height,weight, body surface area and heart rate(P>0.05). However, LVDd in the HCM group was lower than that in the control group, while LVEF measured by two-dimensionalechocardiography biplane simpson’s method and M-mode echocardiography, LVWT andLVOTG were greater than those in the control group(P<0.05).②Compared with the control group, EDV, ESV and SV in the HCM group decreasedsignificantly, while LVEF increased in the HCM group(P<0.05).③The values of LVEF which were measured by two-dimensional echocardiography biplanesimpson’s method and M-mode echocardiography were greater than RT-3DE(P<0.05).④The intraclass correlation coefficient and Bland-Altman analysis demonstrated that therewere high repeatability and consistency of these parameters acquired by RT-3DE: EDV, ESV,SV and LVEF.Conclusions The left ventricular volume and SV decreased significantly, but the increasedLVEF couldn’t indicate that patients with HCM had presented the increased systolic function.RT-3DE can offer a convenient, comprehensive and accurate evaluation on the volume andsystolic function of left ventricular in patients with HCM. Part2：Assessment of regional left ventricular systolic function in patientswith hypertrophic cardiomyopathy by real-time three-dimensionalechocardiographyObjective To assess regional left ventricular systolic function in patients with hypertrophiccardiomyopathy (HCM) using real-time three-dimensional echocardiography (RT-3DE).Methods Object of study and image acquisition were the same with the first part. The leftventricular volume-time curves were recorded with Tomtec4D LV-Analysis3.0, theparameters analyzed quantitatively by RT-3DE included: regional left ventricularend-diastolic volume (rEDV), regional left ventricular end-systolic volume (rESV), the timeto minimum systolic volume (rESVT), regional stroke volume (rSV), regional ejectionfraction (rEF), regional-global ejection fraction (rgEF) and the parameters of left ventriculardyssynchrony.Results In the HCM group, the values of Tmsv16-Dif、Tmsv16-SD、Tmsv16-Dif%、Tmsv16-SD%were significantly lower compared with the control group (P<0.01), andrEDV, rSV, rEF and rgEF in hypertrophic segments were lower than those in non-thickeningand mild-thickening segments (P<0.05). In the control group, there were no significantdifference of those parameters among all segments (P>0.05). The values of rEDV, rSV andrgEF in hypertrophic segments decreased in the HCM group (P<0.05), at the basal level, rEFin hypertrophic segments decreased, at the apical level，it increased, but the differences at themid-ventricular level between the two groups were not significant; the values of rEF andrgEF in non-thickening and mild-thickening segments increased (P<0.05).Conclusions RT-3DE could sensitively detect left ventricular dyssynchrony in the systolicphase and accurately assess regional left ventricular volume and systolic function of differentsegments in patients with HCM.