Comparative Study Of Left Ventricular Hemodynamic Changes After Revivent Surgery By Dual-modality Imaging

Objective: 1.To investigate the hemodynamic changes after Revivent by two-dimensional transthoracic echocardiography(2D-TTE),three-dimensional transthoracic echocardiography(3D-TTE)and cardiac magnetic resonance imaging(CMR).2.CMR and Echo imaging techniques were compared to evaluate the characteristics of left ventricular function and their correlation.Methods: 1.Objects:22 consecutive patients diagnosed with old myocardial infarction(OMI)and left ventricular apical aneurysm in whom Revivent surgery had been successfully performed were enrolled between February 2017 and June 2018 inclusive.All patients were examined with 2D-TTE,3D-TTE and CMR one week before operation.Follow-up patients were divided into A and B groups,group A included 14 patients who completed 2-D TTE and 3-D TTE echocardiography one month after operation,group B consisted of 10 patients who completed Echo and CMR follow-up 1 year after operation.2.Equipment: 2D-TTE and 3D-TTE images were acquired using an EPIQ 7C(PHILIPS Healthcare)ultrasound system with a 1.0 ~ 5.0 MHz probe.Cardiac magnetic resonance examination used the US GE 750 w 3.0T scanner.3.Measurement: 2D-TTE,3D-TTE and CMR was performed one week before surgery,one month and one year after Revivent,to acquire the parameter of left ventricular end-diastolic volume(LVEDV)?left ventricular end-systolic volume(LVESV)?left ventricular end diastolic diameter(LVEDd)?left ventricular end systolic diameter(LVESd)?left ventricular ejection fraction(LVEF)?stroke volume(SV)?stroke output index(SVI)?cardiac output(CO)and cardiac output index(CI).To evaluate the changes of left ventricular hemodynamics after Revivent,and compare the correlation between CMR and Echo in evaluating left ventricular function.Results: 1.Echocardiographic imaging data shows that,LVEDV,LVESV were significantly smaller 1month and 12 months after the operation(P<0.01)and LVEF were increased after the operation(P<0.01).LVEDd and LVESd were significantly smaller 12 months after the operation(P<0.01).There was no significant difference in SV,SVI,CO and CI preoperative or postoperative(P>0.05).2.CMR data showed that,compared with preoperative,LVEDV,LVESV and LVEF were significantly improved 12 months after the operation(P<0.01).There was no significant difference in LVEDd(AP),SV,SVI,CO and CI pre-or post-operative(P>0.05).3.According to Bland-Altman's statistical analysis,echocardiography and CMR imaging data have good consistency.Conclusions: 1.Echo and CMR imaging techniques have good clinical applicability in evaluating left ventricular hemodynamic changes after Revivent in patients with left ventricular aneurysm.2.The left ventricular volume and LVEF of patients after Revivent were significantly reduced in comparison with pre-operation.3.Echo and CMR measurements have good consistency.Echo is more convenient and faster than CMR.It is a reliable technical method for evaluating left ventricular hemodynamic changes before and after surgery.