| Objective:The quantification of left ventricular(LV) size, shape, and function have important meanings for patient evaluation and management in Cardiovascular disease(CVD). LV size and myocardial mass are the most common indication for conventional echocardiography in the study of LV remodeling, while it is rarely in shape. Clinical studies have confirmed that left ventricular remodeling is characterized by shape changed in part of CVD patients, but the size and mass have no obvious changed. In our study, we use the single-beat real-time three-dimensional echocardiography(s RT-3DE) to measure left ventricular spherical index(LVSI) of large number of different age and gender healthy adults, to investigate the normal reference range of LVSI and its variation, in order to provide quantitative reference basis for clinical diagnosis, curative effect evaluation and prognosis judge of CVD in LV remodeling.Methods:313 healthy volunteers were recruited from Tai Gang hospital physical examination center. All of them have no history of lung or cardiovascular disease, and normal results on physical examination, laboratory text, conventional chest X-plain film and electrocardiography. 18kg/m2<BMI<28kg/m2.22 cases were excluded by poor apical acoustic window of two-dimensional echocardiography or three-dimensional echocardiography which can not display LV endocardial border. 291 of them were undergone the study and the analysis by two-dimensional echocardiography(2DE) and s RT-3DE. They were divided into 2 groups(137 of male and 154 of female, 18-80 years old, the average age of 48.7±13.2) based on the gender. And according to the age into 6groups(<30 years old, 30-39 years old, 40-49 years old, 50-59 years old, 60-69 years old and ≥70 years old). Using the SC2000 ultrasound machine(Siemens Acuson) which analyze the data by e Sie LVA system and equipped with 4Zlc probe(1.75-4.25MHz).LVSI were measured to investigate the normal reference range, to study the different in gender,age, body mass index, and body surface area, to analyze the correlation and difference Compared by 2DE.And to study the correlation between LVSI and left ventricular volume which involve left ventricular end diastolic volume(LVEDV) and left ventricular end systolic volume(LVESV).Then we analyze the agreement of LVSI between intra-observation and inter-observation by Bland-Altman.Results:1.The LVSI of healthy adults measured by of s RT-3DE were(43.05±6.47)% at the end of diastolic and(35.90±7.70)% at the end of systolic,respectively.2.There were positive correlations between LVSI and left ventricular volume both on the end of diastolic and the end of systolic no matter whether normalization by BSA, and the correlations were higher at the end of diastolic than systolic(r 0.528 at the end of diastolic, and r 0.460 at the end of systolic).3.The LVSI measured by s RT-3DE do not depend on geometric assumption, and overcome the foreshortening errors acquired by 2DE, the difference of LVSI between s RT-3DE and 2DE were statistically significant(p<0.05).4.There were no difference of LVSI in gender, age, body mass index, and body surface area(p>0.05).5. LVSI measured by s RT-3DE have better agreement between intra-observer and inter-observer.Conclusion:1.The normal reference range of LVSI in healthy adults were preliminarily established by s RT-3DE in different sex and age.2.s RT-3DE was superior to 2DE.3.The LVSI at the end of diastolic were not affected by different of gender, age, body mass index, and the surface area.4.It has provided a basis for further investagation and clinical application of LV remodeling in CVD. |
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