Abstract: Objective To investigate changes of left ventricularregional systolic function after surgical treatment of left ventricular aneurysm (LVA) by realtime threedimensional echocardiography (RT-3DE). Methods From February 2009 to February 2010, 14 consecutive patients who were diagnosed to have coronary artery diseases with LVA underwent surgical repair and coronary artery bypass grafting (LVA group) in our hospital. All patients of the LVA group were followed up for a mean period of 4 months. Twodimensional echocardiography (2DE) and RT-3DE were performed before operation and during the follow-up. Left ventricular regional ejection fraction (EF) was acquired by Qlab software analysis. At the same time, 12 healthy persons were included as controls (control group). Statistical analyses were carried out to compare left ventricular regional EF between the LVA group (before operation and 4 months after operation) and the control group. Results Contrary to the control group, preoperative regional EF of the LVA group increased from apex to base. In addition to the inferior basal segment, lateralinferior basal segment and anteriorinferior basal segment, regional EF in the remaining 14 segments were significantly lower than that of the control group (P＜0.05). At postoperative followup, regional EF recovered the increase from base to apex, and there was no significant difference between anteriorinferior segment and lateral segment regional EF of the LVA group and those of the control group (P＞0.05), while regional EF of other segments in the LVA group was lower than that in the control group (P＜0.05). Conclusion RT-3DE is an effective method to assess left ventricular regional systolic function in patients with LVA. After LVA repair and coronary artery bypass grafting, regional systolic function will restore to the normal direction of progressive increase, and some nonaneurysm segments systolic function will go back to normal.
The present study aimed to investigate the impact of hypothyroidism on left ventricular systolic function using real-time three-dimensional speckle tracking imaging (RT3D-STI). Thirty hypothyroidism patients and forty healthy volunteers were recruited and received RT3D-STI measurement of global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS), and global area strain (GAS). A comparison of differences between the hypothyroidism patients and those in the healthy group was carried out and we obtained the results as followings. The values of GLS were (-18.93°3.89) vs. (-21.44°1.99), with P<0.01, GRS were (51.13°11.95) vs. (56.10°5.76), with P<0.0; and GAS were (-31.63°5.38) vs. (-34.40°2.32), with P<0.01, i.e. they were lower in hypothyroidism group than those in the health group. While GCS were (-17.75°1.92) vs. (-17.03°3.45), with P>0.05, which were not significantly different between the two groups. In linear regression, GLS showed significant correlation with both TSH (b=-0.69, P<0.01) and FT3(b=0.71, P<0.01). Meanwhile, the GRS (b=2.98, P<0.05) and GAS (b=3.11, P<0.05) linearly correlated with FT3 level. In conclusion, the present study shows that the global longitudinal and radial moves of left ventricular are weaker in patients with hypothyroidism than healthy controls. And the impairment of left ventricular function would aggravate as FSH rises or FT3 declines.
ObjectiveTo investigate the clinical significance of cardiac function index (CFI) and global ejection fraction (GEF), derived from single-indicator transpulmonary thermodilution technique, in assessment of cardiac function in critically ill patients. MethodsA prospective clinical observational study was conducted in the Intensive Care Unit of the First Affiliated Hospital of Guangzhou Medical University. Between January 2012 and December 2012, 39 patients who underwent PiCCO monitoring were recruited, including 18 cases with left ventricular systolic dysfunction and 21 cases without left ventricular systolic dysfunction. Both groups underwent transpulmonary thermodilution measurements and transthoracic cardiac ultrasonography. Pearson correlation analysis was conduced to assess the correlation between left ventricular ejection fraction (LVEF) and CFI and GEF. ROC curve was established to calculate the predicted threshold of CFI and GEF for diagnosing cardiac insufficiency. ResultsLVEF was significantly correlated with CFI and GEF (r=0.553, P < 0.005; r=0.468, P < 0.005). The area under ROC curve of CFI, GEF and LVEF for diagnosing cardiac insufficiency was 0.885, 0.862 and 0.903, respectively (P > 0.05 for comparison). The cut-off value of CFI for predicting cardiac insufficiency was 4.25/min, with a sensitivity of 77.8% and a specificity of 88.9%. The cut-off value of GEF for predicting cardiac dysfunction was 19.5/min, with a sensitivity of 88.9% and a specificity of 66.7%. ConclusionCFI and GEF measured by transpulmonary thermodilution correlate well with LVEF assessed by transthoracic echocardiography, both can be used for assessment of left ventricular systolic function.