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Assessment of Left Ventricular Systolic Function in Patients with Non-compaction Cardiomopathy by Speckle Tracking Imaging

Author: WangQiao
Tutor: XieMingXing；LiLing
School: Huazhong University of Science and Technology
Course: Medical Imaging and Nuclear Medicine
Keywords: Speckle Tracking Noncompaction of ventricular myocardium Systolic function Strain
CLC: R541.1
Type: Master's thesis
Year: 2011
Downloads: 10
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Abstract

Left ventricular noncompaction (noncompaction of the left ventricular myocardium, NVM) is a family of genetic background of congenital heart disease, due to the densification process of embryonic endomyocardial blocked, leading to a trabeculae can not be absorbed, the prominent feature significantly prominent trabeculae and trabecular communicating with the left ventricular cavity between the crypt. The true incidence of the disease is not yet clear, the literature reported adult incidence of 0.014% -0.26% and 3.7% of the incidence of clinical heart failure cases. The disease can exist alone, called isolated left ventricular noncompaction (isolated left ventricular non-compaction, IVNC). Heart failure, thrombosis, and the arrhythmia is IVNC the three clinical features. Despite heart failure is more common in IVNC patients, 17-40% of patients with cardiac function in the normal range the reported IVNC patients. Overall the normal IVNC patients with heart function, normal left ventricular regional myocardial contractile function IVNC patients with non-compact segment and dense segments overall left ventricular systolic function, there is a dispute. The myocardial strain technology plays a vital role in the evaluation of left ventricular systolic function reflect effective, sensitive indicators of left ventricular function. The newly developed ultrasound speckle tracking imaging (speckle tracking imaging, STI) by real-time tracking of the myocardium of the same location in a different frame rate trajectory accurately, non-invasive measurement of left ventricular longitudinal, circumferential and radial strain and strain rate degree of left ventricular myocardial deformation parameters such quantitative and qualitative analysis, to provide a new method for the evaluation of cardiac overall and local sports mechanics. The purpose of this study is to use the STI technology assessment IVNC patients with localized myocardial strain variation, and provide a new method for the accurate evaluation of patients IVNC regional myocardial systolic function. The first part of the ultrasound speckle tracking imaging evaluation of myocardial noncompaction in patients with left ventricular regional myocardial contractility the functional applications STI technical evaluation IVNC patients left ventricular regional myocardial systolic function. Selected IVNC 54 patients, divided into left ventricular ejection fraction (Ejection Fraction, EF) EF values ??reduce group (EF lt; 50%, 34 cases), EF the value normal range group (EF ≥ 50%, 20 Li ), normal control group (28 cases). Collected and stored transthoracic three cardiac cycles standard left ventricular fractional mitral papillary muscle and apex level and apical bit left ventricular long axis, apical four-chamber apical two-chamber view 2D image to use QLAB7.0 ultrasound workstation off-line analysis. Records of each section of each segment myocardial strain peak, and its quantitative analysis. The results showed: EF value of ① IVNC patients to reduce the group each segment myocardial Sc, Sr and ε measured values ??than those of EF value normal range IVNC group and normal control group reduced the difference was statistically significant (P lt; 0.05). ② The EF measured value normal IVNC group and the control group in the general clinical data and conventional ultrasound measurement parameter differences sex (P gt; 0.05), but the left ventricular apex level 6 section segment of Sr, Sc, ε measured value, papillary muscle level 4 segments of ε measured value and in addition to the anteroseptal outside Sr measured value is reduced compared to the normal control group, the difference was statistically significant (P lt; 0.05). The second part of the ultrasound speckle tracking imaging evaluation of myocardial noncompaction left ventricular the insufficiency of IVNC patients from patients with non-compact segment with dense segment myocardial contractile function applications STI technical evaluation of cardiac function myocardial contractile function of the non-compact segment and dense segment . The selected cardiac dysfunction IVNC 34 patients, normal control group of 28 patients, collection and storage of three cardiac cycle standard left ventricular fractional mitral papillary muscle and apex level and apical bit left ventricular long axis, apical transthoracic four-chamber apical two-chamber view two-dimensional image, to use QLAB7.0 ultrasound workstation for offline analysis. Record each section of each segment myocardial strain peak, and the involved segment and uninvolved segments and the control group to compare the same level as the corresponding segment, and its quantitative analysis. The results show that: the same level of left ventricular ① IVNC patients with non-compact segment and dense segment myocardial compared with the control group of the same level of myocardial Sr, Sc, ε are reduced, the difference was statistically significant (P lt; 0.05). The ② IVNC patients with non-dense segments of myocardium (papillary muscle and apex level) Sr, Sc, ε measured values ??compared to the same level as dense myocardial reduce difference was statistically significant (P lt; 0.05). The mitral level of non-compact segment myocardial Sr, Sc, ε measured values ??with the same level compact segment myocardial comparison, the difference was not statistically significant. The number of EF involved segment, the ③ IVNC patients with left ventricular, a negative correlation (r = -0.589, P lt; 0.05) and EDV, ESV, a positive correlation (r = 0.570 to 0.538, P lt; 0.05). Conclusion: ① EF measured values ??the normal IVNC group and normal control group in the general clinical data and conventional two-dimensional ultrasound measurement parameters no significant difference in sex (P gt; 0.05), but the six segments of the left ventricular apical level Sr, Sc, ε measured value, Sr, and in addition to the anteroseptal outside ε measured values ??of the four segments of the papillary muscle level is reduced compared to the normal control group, the difference was statistically significant (P lt; 0.05). ② IVNC patients with reduced EF value group each segment myocardial Sc, Sr and ε measured values ??than those of EF value normal range group and normal control group reduced the difference was statistically significant (P lt; 0.05). Myocardium and dense segment of the non-compact segment myocardial the the ③ heart dysfunction IVNC patients with left ventricular Sr, Sc, ε reduce than normal with the water control group, a statistically significant difference (P lt; 0.05), non-compact segment myocardial ( papillary muscle and apical level) compared with the same level of dense segmental myocardial reduce more obvious difference was statistically significant (P lt; 0.05). The ④ heart dysfunction IVNC patients with left ventricular involved segment number and EF was negatively correlated (r = -0.589, P lt; 0.05) and EDV, ESV, a positive correlation (r = 0.570 to 0.538, P lt; 0.05).

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