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Evaluation of the Left Ventricular Systolic Synchronyin the Patients with Hypertrophic Cardiomyopathy by Tissue Synchronization Imaging

Author: JiHuanChun
Tutor: WangZuo
School: Dalian Medical University
Course: Internal Medicine
Keywords: Hypertrophic cardiomyopathy Echocardiographic Tissue synchronization imaging Left ventricular systolic coordination
CLC: R542.21
Type: Master's thesis
Year: 2009
Downloads: 30
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Abstract


Objective: The application of ultrasonic tissue synchronization imaging techniques (tissue synchronization imaging, TSI) Hypertrophic Cardiomyopathy (Hypertrophic cardiomyopathy, HCM) patients with left ventricular systolic coordination and its accuracy. Methods: treatment history, clinical presentation, ECG and echocardiography and other related inspection, diagnosis of hypertrophic cardiomyopathy (HCM) based in septal lesions in 16 patients from July 2005 to March 2009, including 11 cases of non-obstructive HCM (HCM) patients, 6 males and 5 females; obstructive HCM (HOCM) 5 patients, 3 males and 2 females; aged 22 to 69 years old, on average (52.9 ± 12.9) years old. Control group of 20 patients, 11 males and 9 females, aged 47 to 76 years old, the average age (58.8 ± 10.4) years of age, without diabetes, hypertension, coronary heart disease, valvular disease, history of cardiovascular disease, ECG and heart Color Doppler ultrasound examination results were normal. Experiments using the configure tissue synchronization imaging technology software the GE Vivid7 ultrasound diagnostic equipment, real-time access to the apical four-chamber view, left ventricular apical two-chamber view, the apical long axis view, acquisition heart rate stable cardiac cycle 3 to 5, the record The image is saved to disk for offline analysis. A record of the results of routine ultrasound, converted TSI mode by green, yellow or red semi-quantitative regional myocardial systolic time to peak (TTP) and quantitative measurement of the HCM group and the normal group 6 12 myocardial segments of the wall to the longitudinal axis regional myocardial contraction peak Time (TTP). TSI determination of TTP is reflected on the ECG R-wave, the ventricular muscle began to shrink to ventricular contraction reached the peak value of the elapsed time, the start time generally provided in a position equivalent to the aortic valve opening, and the end time set in the aorta valve closure 200ms, which is equivalent to the rapid ejection phase (E wave start). Statistical Methods SPSS16.0 package for statistical analysis of measurement data to mean ± standard deviation (x_ ± s) measurement data between the two sample groups, unpaired t-test group results statistically p <0.05 significance. Results: 1. Routine ultrasound data comparison with the normal control group, the HCM group end-diastolic interventricular septum thickness and end-diastolic ventricular septal thickness / end-diastolic left ventricular wall thickness (IVSd / LVPWd), respectively, 20.1 ± 3.5mm, 1.8 ± 0.3 mm, compared to the control group were significantly increased (p lt; 0.01), left ventricular end-diastolic diameter, left ventricular end-diastolic wall thickness, LVEF, mitral diastolic early and late flow spectrum (peak E and peak A) and E / A was no significant difference between the two groups. 2.HCM group ventricular septal basal and middle segments TTP (273.1 ± 57.6ms, 281.2 ± 69.1ms) than the normal group interventricular septum the TTP (100.5 ± 13.9 ms, 103.5 ± 18.9 ms) was significantly delayed (p lt; 0.01); HCM left ventricular posterior wall of the left ventricular posterior wall base and middle segments TTP (161.3 ± 27.8ms, 169.4 ± 28.6ms) than the normal group TTP (78.5 ± 13.9 ms, 82.5 ± 16.8 ms) delay (p lt; 0.05), while interventricular septum, compared with HCM patients, ventricular septal contraction delay (p lt; 0.05); simultaneously TSI have delayed the yellow visible on the semi-quantitative HCM patients the interventricular septum offices wall visible, visible delay segment, consistent with the above results. Conclusion: HCM group presence of left ventricular systolic movement coordination disorder hypertrophic myocardial tissue synchronization imaging technology can be an accurate evaluation.

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CLC: > Medicine, health > Internal Medicine > Heart, blood vessels ( circulatory ) disease > Heart disease > Myocardial diseases > Myocarditis
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