To evaluate the possibility and accuracy of Doppler tissue image (DTI) on assessment of normal and abnormal ventricular activation and contraction sequence, 9 open chest canine hearts were analyzed by acceleration mode, M-mode, and spectrum mode DTI. Our results showed that: (1) Acceleration mode DTI could show the origin of activation and conduction sequence on line; (2) M-mode DTI revealed that the activation in mid-interventricular septum was earlier than that in mid-left ventricular posterior wall at sinus activation; (3) Spectrum DTI showed the ventricular endocardium was activated earlier than the ventricular epicardium in all segments at sinus rhythm. The earliest site of activation of the normal ventricular wall was at middle interventricular septum; the latest site was at basal-posterior wall; the contraction sequence was different at the different walls; (4) During abnormal ventricular activation, mid-left ventricular posterior wall was activated earliest in accordance with the pacing sites. Abnormal ventricular activation was slower than sinus activation, and the contraction sequence varied at different sites of ventricular wall. It is concluded that DTI can be used to localize the origin of normal or abnormal myocardial activation and to assess the contraction sequence conveniently, accurately and non-invasively.
Echocardiography, Doppler/instrumentation ; Echocardiography, Doppler/*methods ; Heart Ventricles/*ultrasonography ; Myocardial Contraction/*physiology ; Sinoatrial Node/physiology ; Tachycardia/physiopathology ; Tachycardia/ultrasonography

Transthoracic echocardiographic characteristics of 17 cases of cardiac amyloidosis (CA), a rare disease in China, were analyzed in order to improve the understanding of the disease. Seventeen cases of biopsy-proven CA, admitted to Wuhan Union Hospital from June 1994 to September 2008 were retrospectively reviewed. Twenty normal volunteers served as control group. Left atrial and ventricular functions and mitral inflow velocity were measured by two-dimensional, and Doppler echocardiography, and tissue Doppler imaging (TDI)-derived peak systolic wall motion velocities (Sv), peak early diastolic wall motion velocities (Ev), and peak late diastolic wall motion (Av) were measured at the septum, lateral, inferior and anterior corners of mitral annulus from the apical 4- and 2 chamber views. Compared with the control group, the interventricular septal thickness (IVSd), the left ventricular posterior wall (LVPWd), right ventricular transverse diameter (RVTDd) near the end of diastole and the interauricular septum thickness (IASs), left atrial anteroposterior diameter (LAADs), right atrial transverse diameter (RATDs) near the end of systole were increased significantly (all P<0.05) and left ventricular ejection fraction (LVEF) decreased (P<0.05) in the CA group. Compared with the control group, Sv, Ev at each wall and Av at almost all walls were significantly decreased in the CA group. In the CA group, Myocardial echoes of interventricular septum and free wall of left ventricle were enhanced evidently and distributed unevenly. The echoes presented as ground glass-like images, with some spotty hyper echoes. Both atria were enlarged, and LVEF decreased, with diastolic function impaired, and mild-moderate hydropericardium found in the CA group. It was concluded that echocardiography was a relatively sensitive and highly specific non-invasive method for the diagnosis of CA.
Amyloidosis/*ultrasonography ; Cardiomyopathies/*ultrasonography ; Case-Control Studies ; Echocardiography ; Echocardiography, Doppler/*methods ; Retrospective Studies ; Sensitivity and Specificity

BACKGROUND: The diagnosis and estimation of severity of infundibular pulmonic stenosis (PS) is difficult by two-dimensional or M-mode echocardiography. In continuous wave(CW) Doppler signal valvular PS is seen as a parabolic velocity profile but infundibular PS is seen as a velocity signal with its peak in late systole. The purpose of this study is that Doppler echocardiography can discriminate valvular PS from infundibular PS and assess the severity of infundibular obstruction. METHOD: Six patients with valvular and infundibular PS by Doppler echocardiography and cardiac catheterization were studied. All had been undergone surgery. We compared their Doppler echocardiographic and cardiac catheterization finding with surgical finding. RESULT: 1) CW Doppler signal of infundibular PS had lesser peak velocity(2.84m/sec vs 4.33m/sec, p < 0.05) and later systolic peak in velocity(AT/ET ratio : 0.73 vs 0.51, p < 0.05) than that of valvular PS. 2) Pressure gradient across the infundibular obstruction measured by Doppler echocardiography correlated well with that by cardiac catheterization(r=0.89, p < 0.05). 3) Operation finding showed infundibular PS in 5 case but not one and coexisting other anomaly such as ASD in 4 case, TOF in 1 case, PAPVR in 1 case. CONCLUSION: Doppler echocardiography is a useful noninvasive method for the diagnosis and the estimation of severity of infundibular obstruction in patient with PS.
Cardiac Catheterization ; Cardiac Catheters ; Diagnosis ; Echocardiography ; Echocardiography, Doppler ; Humans ; Methods ; Pulmonary Valve Stenosis ; Systole

OBJECTIVES: To define the differnce in echocardiographic features between hypertrophic cardiomyopathy(HCM) and severe left ventricular hypertrophy(LVH) accompanying hypertension. METHOD: Two-dimensional, M-mode and Doppler echocardiography were performed in both 16 subjects with typical HCM(Group 1) and 22 subjects with severe LVH accompanying hypertension(Group 2). We andalyzed the echocardiographic features such as distribution of LV hypertrophy, systolic anterior motion of mitral valve(SAM), LV outflow Doppler pressure gradient, interventricular septal thickness(IVST), LV posterior wall thickness(LVPWT). systolic IVS excursion (IVSa) and LVPW excursion (LVPWa), LVPWa/IVSa, LV end-diastolic (LVEDD) and end-systolic dimension (LVESD), fractional shortening(% FS), isovolumic relaxation time(IVRT), peak mitral early filling velocity(peak E), peak atrial filling velocity(peak A) and diastolic deceleration time(DT) from the videotape recordings. RESULTS: 1) There were no definite clinical or electrocardiographic difference between two groups of the subject, except high blood pressure in group 2. 2) By echocardiography, mean LVPWT wa larger in group 2 compared with the HCM group(14±2 vs 11±2mm, p < 0.001), but asymmetric septal hypertrophy(ASH) was more frequent(IVST/LVPWT, 1.7±0.5 vs 1.2±0.2, p < 0.001) in HCM group than in LVH group. 3) IVSa was reduced(6±2 vs 8±2mm). but LVPWa/IVSa ratio was higher(2.3±1.2 vs 1.7±0.4, p < 0.05) in HCM group than in LVH group. CONCLUSION: We conclude that echocardiographic differentiaton between HCM and LVH accompanying hypertension is very difficult, but LVPWT, IVSa from M-mode echocardiography and LVPWa/IVSa ratio seem to be helpful indices, complementary to SAM or ASH, to differentiate each other.
Cardiomyopathy, Hypertrophic ; Deceleration ; Echocardiography ; Echocardiography, Doppler ; Electrocardiography ; Hypertension ; Hypertrophy ; Hypertrophy, Left Ventricular ; Methods ; Relaxation ; Videotape Recording

BACKGROUND: Radiofrequecy(RF) catheter ablation is the choice of treatment of refractory supraventricular tachycardia. Althogh catheter ablation is invasive, it is well-known that this procedure is safe. However RF catheter ablation may provoke some adverse conditions. The purpose of this study was to assess functional and morphologic changes shortly after radiofrequency catheter ablation in patients with supraventricular tachycardia by means of two-dimensional echocardiography. METHOD: Echocardiogram underwent 1 day before and within 3 days after RF catheter ablation. Cardiac chamber size, wall thickness, and valve motion in the M-mode were Measured. Left ventricular volume, area, dimension, pericardial effusion and segmental wall motion were measured by means of two-dimensional echocardiography and valve incompetence were also measured with color Doppler echocardiography. RESULTS: New echocardiographic abnormalities were observed in 4(5.4%) among 73 patients. One mild aortic regurgitation,one increase in severity of tricuspid imcompetence, one increase in severity of mitral regurgitation and one mild pericardial effusion were found. CONCLUSION: We concluded that echocardiographic changes after radiofrequency ablation are rate and of minor significance.
Catheter Ablation ; Echocardiography ; Echocardiography, Doppler, Color ; Humans ; Methods ; Mitral Valve Insufficiency ; Pericardial Effusion ; Tachycardia, Supraventricular

BACKGROUND: In latent type of hypertrophic obstructive cardiomyopathy, there is no pressure gradient at rest in left ventricular outflow tract(LVOT), but it develops with provocation. Dobutamine increase myocardial contractility and may inducce outflow tract obstruction. To evaluate the usefulness of dobutamine induced outflow tract obstruction as a provocation test, nine patients with latent obstructive cardiomyopathy were studied. METHOD: 680 cases of dobutamine stress echocardiography were reviewed. Nine patients developed late peaking outflow velocity pattern in response to dobutamine infusion(inducible group). Ten patients developed early peaking velocity pattern were included as control group. Left ventricular dimension, outflow tract diameter were measured, and pattern of septal hypertrophy was classified. Changes of peak velocity and acceleration time/ejection time ratio (AT/ET) were measured at rest and peak dose dobutamine. RESULTS: The peak outflow velocity at rest was not different in both groups(1.49±0.45, 1.18±0.11m/sec). Peak velocity and AT/ET ratio were significantly increased in inducible group(4.2±0.9m/sec, 0.66±0.17), but no significant changes were noted in control group. Patients with inducible group had greater septal thickness, smaller outflow tract diameter and greater prevalence of septal bulge morphology. CONCLUSION: These results suggest that dobutamine stress Doppler echocardiography could be a useful provocation test to diagnosis of latent obstructive cardiogyopathy.
Acceleration ; Cardiomyopathies ; Cardiomyopathy, Hypertrophic ; Diagnosis ; Dobutamine ; Echocardiography, Doppler ; Echocardiography, Stress ; Humans ; Hypertrophy ; Methods ; Prevalence

Now real-time three-dimensional echocardiography (RT3DE) is an important tool to diagnose the complex congenital heart malformation. However, searching the cross-sections to view the cardiac anomalies in a three-dimensional ultrasound image of the heart by hand on the RT3DE system is time consuming, not repeatable, and easy to miss some places. In order to improve the existing diagnostic tool, we adopted the methods based on template matching for automatically finding the best cross-sections which are defined by Sun Kun et al. to view the cardiac anomalies in RT3DE's full-volume data. Among the methods is the entropy correlation coefficient which measured the similarity of the best cross-sections with the highest accuracy. The automatic search for these cross-sections is much quicker than the manual search. And with good repeatability it will make good preparation for the subsequent computer-aided diagnosis such as measure and registration, which is significant for the diagnosis of the complex congenital heart malformation.
Algorithms ; Echocardiography, Doppler, Color ; methods ; Echocardiography, Three-Dimensional ; Heart Defects, Congenital ; diagnostic imaging ; Humans ; Image Processing, Computer-Assisted ; methods

BACKGROUND: Mitral valve prolapse(MVP) is now recognized as noe of the most common cardiovascular disorders, particularly in young women with a slender body habitus. However, there is little clinical information about young men with mitral valve prolapse. The purpose of this study was to evaluate the physical and echocardiographic characteristics of young men about 20 years old with mitral valve prolapse. METHOD: Twenty young men with mitral valve prolapse(MVP graoup, mean age ; 19.9±2.4 years) and twenty healthy volunteers(control group, mean age ; 19.9±3.2 years) were examined using physical examination, chest X-ray, computed thoracic tomography and two dimensional and Doppler echocardiography. RESULTS: Compared with control group, MVP group had a smaller chest circumference(p < 0.001), a larger height-arm span difference(p < 0.01), smaller anteroposterior chest diameters(by chest X-ray ; p < 0.001 and computed tomography ; p < 0.01) and smaller anteroposterior/transverse chest diameter ratio(chet X-ray ; p < 0.01 and computed tomography ; p < 0.05). In MVP group, mitral regurgitation was noted 15 men(75%), those had posteriorly directed jets suggesting anterior mitral leaflet anomalies. CONCLUSION: Healthy young men having mitral valve prolapse had narrow chest and slender physical characteristics and anterior mitral leaflet abnormalities.
Clinical Study ; Echocardiography ; Echocardiography, Doppler ; Female ; Humans ; Male ; Methods ; Mitral Valve Insufficiency ; Mitral Valve Prolapse ; Mitral Valve ; Physical Examination ; Thorax

BACKGROUND/AIMS: The aim of this study was to investigate atrial conduction times and left atrial mechanical functions, the noninvasive predictors of atrial fibrillation, in prediabetic patients with impaired fasting glucose (IFG) and impaired glucose tolerance (IGT). METHODS: Study included 59 patients (23 males, 36 females; mean age 52.5 ± 10.6 years) diagnosed with IFG or IGT by the American Diabetes Association criteria, and 43 healthy adults (22 males, 21 females; mean age 48.5 ± 12.1 years). Conventional and tissue Doppler echocardiography were performed. The electromechanical delay parameters were measured from the onset of the P wave on the surface electrocardiogram to the onset of the atrial systolic wave on tissue Doppler imaging from septum, lateral, and right ventricular annuli. The left atrial volumes were calculated by the disk method. Left atrial mechanical functions were calculated. RESULTS: The mitral E/A and E′/A′ ratios measured from the lateral and septal annuli were significantly lower in the prediabetics compared to the controls. The interatrial and left atrial electromechanical delay were significantly longer in prediabetic group compared to the controls. Left atrial active emptying volume (LAAEV) and fraction (LAAEF) were significantly higher in the prediabetics than the controls. LAAEV and LAAEF were significantly correlated with E/A, lateral and septal E′/A′. CONCLUSIONS: In the prediabetic patients, the atrial conduction times and P wave dispersion on surface electrocardiographic were longer before the development of overt diabetes. In addition, the left atrial mechanical functions were impaired secondary to a deterioration in the diastolic functions in the prediabetic patients.
Adult ; Atrial Fibrillation ; Echocardiography, Doppler ; Electrocardiography ; Fasting ; Female ; Glucose ; Humans ; Male ; Methods ; Prediabetic State

BACKGROUNDSince the size of ischemic myocardium is closely related with both global and regional function of the myocardium, it is of great significance to measure the size of ischemic myocardium with non-invasive methods.

METHODSEleven mongrel dogs were subjected to occlusion of the left anterior descending coronary artery for acute ischemia. Strain rate imaging had M-mode of strain-rate (CAMM) curve pointed from the basal segment of the anterior wall to the basal segment of the inferior wall to detect the border of ischemia size. The strain rate (SR) defined the cut-off value of ischemic myocardium in a two-chamber apical view, and marked by the anterior and inferior wall on two-dimensional images respectively. Along the endocardium and epicardium, the ischemic size was curved on two-dimensional images by the trackball method and then compared with the pathologically ischemic size. And then longitudinal strain rates were compared in the cut-off value, adjacent non-ischemic and ischemic segments at which the cut-off point was defined by changing the curve M-mode of strain rate after ischemia.

RESULTSLinear correlation existed between pathology and strain rate ischemic size (r = 0.884, P < 0.001). The SR parameters were lower in ischemia and cut-off point than in non-ischemic segments. The peak SRs of systole (S(SR)), early diastole (E(SR)), late diastole (A(SR)), strain during ejection time (epsilon(et)), and the maximum length change during the entire heart cycle (epsilon(max)) in ischemic segments lowered (P < 0.05). Time to onset of regional relaxation (T(R)) was prolonged (P = 0.012).

CONCLUSIONSR imaging can accurately assess the size of ischemic myocardium.

Animals ; Dogs ; Echocardiography, Doppler ; methods ; Female ; Male ; Myocardial Ischemia ; diagnostic imaging ; pathology ; Ventricular Function, Left ; physiology