Objective To evaluate blood flow structure and quantify the variation of the flow within left ventricle,assess the impact of chronic heart failure(CHF) by vector flow mapping(VFM).Methods Twenty-seven patients with chronic heart failure and thirty controls were involved.The flow vector images on the section plane of the flow within the left ventricle were acquired by VFM.Time-flow(T-F) curve and all other peak systolic and diastolic flow curve include normal velocity profile,parallel velocity profile,vector profile,flow profile were analyzed by DSA-RS1 program.Results Ventricular ejection peak S,rapid ventricular filling peak E and atrial systole peak A were relatively lower at basal and middle segments in CHF group than normal control group.Normal velocity profile,velocity profile,flow profile at peak S and E were lower at basal and middle segments in CHF group than normal control group.Conclusions VFM technology could provide quantitative and intuitive information to demonstrate the flow structure of the ventricle and evaluate the cardiac function in patients with CHF.

Objective To evaluate the right ventricular function in patients with congestive heart failure (CHF) after cardiac resynchronization therapy (CRT) by 2-dimensional speckle imaging (2D-STI).Methods 46 patients with CHF were divided into responders to CRT and non-responders to CRT according the standard of a decline in LV end-systolic volume ≥ 10％.All the patients received echocardiography examination 1-3 days before CRT and 6 month after CRT.Tissue Doppler imaging (TDI) indices included SD of time to peak velocity in systole (Ts-SD) among 12 segments.Right ventricular diameters included RV basal transverse diameter (D1),RV middle transverse diameter (D2) and RV longitudinal diameter (D3) in apical four views.2D-STI indices included systolic strain (S) and stain rate (SR) of basal or middle segment of RV free wall.Results Compared with before CRT,LVEDd,LVEDV,LVESV and Ts-SD significantly decreased,LVEF significantly increased in responders 6 months after CRT.Before CRT,compared with nonresponders,there was no significant difference of D1,D2 and D3 in responders,while S and SR in basal or middle segment of RV free wall were higher than non-responders.Compared with before CRT,D1,D2 and D3 in responders decreased significantly,S and SR in basal or middle segment of RV free wall increased significantly,while there was no difference in non-responders.There were significant negative correlation between S and SR in basal or middle segment of RV free wall and Ts-SD in responders.Conclusions The remodeling and systolic function of RV are improved after CRT.It may help for improving the efficacy of CRT when takes RV function data into account before CRT.

Objective To evaluate the diastolic function in patients with congestive heart failure (CHF) after cardiac resynchronization therapy (CRT) by conventional echocardiography or Doppler tissue imaging (TDI).Methods 31 patients with CHF were divided into responders to CRT (group R) and nonresponders to CRT (group N) according the standard of a decline in left ventricular(LV) end-systolic volume ≥10％.All the patients received echocardiography examination 1-3 days before CRT and 6 month after CRT.Color M-mode echocardiography indices included Vp,E/Vp.TDI indices included the peak velocity in early diastole (e) at 4 sites of mitral annulus,E/e,time to peak velocity in systole (Ts),Ts-SD and maximum difference of Ts (Ts-Dif) among 12 segments.Results Compared with before CRT,Ts-SD and Ts-Dif significantly shortened in group R;Vp increased significantly,E/e at each 4 site and mean value at 4 sites of mitral annulus,E/Vp decreased significantly; but there were no significant difference in group N.There were significant positive correlation between mean value at 4 sites of E/e,E/Vp and Ts-SD in group R.Conclusions The diastolic function in responders to CRT improved after CRT,which was associated with the decreased LV filling pressure and improved LV relaxation.

ObjectiveTo investigate the relationship between carotid intima-media thickness (IMT)and plaque extent of carotid artery with coronary heart disease (CHD).Methods 131 inpatients were divided into 3 groups,in which 54 cases of coronary heart disease group,46 cases of risk group with coronary heart disease,31 cases of control group.The carotid wall IMT,plaque length and thickness was measured by Color Doppler ultrasound.The obtained data using SPSS 17.0 software for statistical processing.ResultsCarotid intimal thickening and the incidence had no significant difference between the group of coronary heart disease and risk group with coronary heart disease risk( all P ＞ 0.05),carotid artery IMT and incidence rate between the above two groups and the control group had statistical differene( t =3.26,3.48,all P ＜ 0.05 ),and the three groups of carotid artery plaque score and plaque classification were statistically significant( F =4.28,P ＜ 0.05 ).ConclusionCarotid IMT and plaque formation was the independent risk factor of CHD,and it could predict the occurrence and development of CHD,especially in carotid artery plaque specificity is higher,in the primary hospital could be used as the auxiliary examination method of CHD.

Objective To evaluate left atrial systolic function and synchronization by two dimensional speckle tracking imaging(2D-STI) measuring the strain in healthy subjects.Methods Thirty-two healthy subjects were studied.The peak velocity(Vmax),the peak amplitude of longitudinal and radial strain (Am-LS and Am-RS),the peak time of both longitudinal and radial strain(T-LS and T-RS) were acquired in each left atrial wall(anterior,inferior,posterior,lateral and septal) at three levels (basal,middle and apical)during left atrial active contraction by 2D-STI.Results ① No significant differences were found at theVmax,Am-LS,Am-RS,T-LS and T-RS among all left atrial walls in the same level ( P ＞ 0.05).②The Vmax,Am-LS and Am-RS were decreased progressively from basal to apical,and there were significant differences( P ＜0.05) except the Am-RS at anterior,posterior and septal( P =0.218,0.258 and 0.238,separately).③Compared all levels in each left atrial wall,the T-LS and T-RS showed no significant differences( P ＞0.05),except the T-LS at posterior( P =0.002) and the T-RS at lateral( P =0.026).④The standard deviation of the T-LS,T-RS and T-globe were 37.38 ms,48.25 ms and 43.85 ms,respectively.There were no significant correlation between T-LS and T-RS in the same segment with r =0.014 and P =0.885.Conclusions There were some regularity during left atrial active contraction.On the whole,the peak velocity and the peak amplitude were decreased progressively from basal to apical in each atrial wall,and the peak time of strain showed no significant difference in the same level of each left atrial wall.The 2D-STI may paly important roles in the evaluation of left atrial systolic function and synchronization.

Objective To evaluate the function and synchronization of left atrial in patients with chronic heart failure(CHF) by real-time three dimensional echocardiography (RT-3DE).MethodsThirty healthy controls and thirty-two patients with CHF were studied.The CHF were divided into group CHF1 with the normal of left ventricular filling pressure and group CHF2 with the elevated of that.From the volume-time curve of RT-3DE workstation,the maximum volume (LAVmax),the minimum volume (LAVmin),the volume before contraction (LAVp) of left atrial were acquired.Accordingly,the total,passive and active ejection fraction could be calculated.The synchronization parameters derived from RT3DE were the dispersion and maximum difference of time to minimum volume for left atrial segments (Tmsv- 16-SD,Tmsv 12-SD,Tmsv-6-SD,Tmsv- 16-Dif,Tmsv 12-Dif,Tmsv-6 Dif).The index of volume and time were corrected by the body surface area and interval of R-R,respectively.The correlation were analysed in them.Results ① All the index of volume before and after correction were gradually increasing from control to CHF2 group,but the LATEF,LAPEF and LAAEF were just the reverse,with all parameters had significant difference among total groups( P ＜0.01 ).②The synchronization parameters were significantly higher from control to CHF2 group( P ＜0.01 ).Comparing between two groups,no significant difference of the synchronization parameters were found between CHF1 group and CHF2 group ( P ＞ 0.05),except Tmsv-16-SD％ and Tmsv-16-Dif％ ( P ＜0.01 ).③The Tmsv-16-SD％ and Tmsv-16-Dif％ had a positive correlation with the index of volume and a negative correlation with the ejection fraction.The most significantly correlation parameters was LAVmaxI,with r =0.75 and P ＜0.01.ConclusionsThe function of left atrium are reduced in patients of CHF,there are dyssynchronization.The higher of the filling pressure of left ventricle,the lager of the dyssynchronization of left atrium.RT-3DE may paly important roles in the evaluation of function and synchronization of left atrium.

Objective To evaluate left atrial function in patients with ischemic cardiomyopathy(ICM)and dilated cardiomyopathy(DCM)by two dimensional-speckle tracking imaging(2D-STI).Methods Twenty-two patients with ICM,twenty-six with DCM and thirty-two healthy subjects were studied.The maximum volume(LAVmax),minimum volume(LAVmin)and volume before the systole(LAVp)of left atria were acquired using biplane area-length method,and calculated the total emptying volume(LATV),expansion index(AEI),active emptying volume(LAEV)and fraction(LAEF)of left atria.The strain and strain rate during systole and late of diastole(Ss,SRs,Sa and SRa)were measured at each left atrial wall (septal,lateral,anterior and inferior).The average of them were worked out.The correlation of left atrial function and strain rate were analysed.Results ①No significant differences were found at the age,sex,heart rate and the E wave between the mitral leaflet tips during all the groups.Compared with the control group,the peak of A wave,the deceleration time of E wave and LVEF decreased in ICM and DCM groups,while the LAD,LVEDD and E/A increased significantly in the two groups(P＜0.05).There were no significant differences between ICM and DCM.②Compared with the controls,the LAVmax increased,AEI and LAEF decreased significantly in patients with ICM and DCM,even lower in DCM(p＜0.05).③Compared with the controls,the Ss,SRs,Sa and SRa reduced significantly in patients with ICM and DCM(P＜0.05),and the DCM showed much significant differences than ICM(P＜0.05).④The AEI had a positive correlation with SRs(r =0.765,P＜0.01).The LAEF had a significant correlation with SRa(r =0.830,P＜0.01).Conclusions The accumulation during systole and active emptying function during late of diastole are both lower in ICM and DCM,even worse in the latter.The 2D-STI may paly an important role in the evaluation of left atrial function.

Objective To evaluate the function and synchronization of left atrial in patients with chronic heart failure(CHF) by two dimensional-speckle tracking imaging (2D-STI) and real-time threedimensional echocardiography(RT-3DE).Methods Thirty-two healthy controls and twenty-nine patients with CHF were studied.The mean strain and strain rate during systole,early and late of diastole(mSs,mSe and mSa,mSRs,mSRe and mSRa) were measured at each left atrial wall by 2D-STI.From the volume-time curve of RT-3DE workstation,the maximum volume (LAVmax),the minimum volume(LAVmin),the volume before contraction(LAVp) of left atrial were acquired.Accordingly,the total,passive and active ejection fraction could be calculated.The synchronization parameters derived from 2D-STI and RT-3DE were the dispersion of time to peak strain and time to the minimum volume (T-SD and Tmsv-16-SD).The index of volume and time were corrected by the body surface area and interval of R-R,respectively.The correlation were analysed betwee them.Results () Comparing between two groups,the mSs,mSe and mSa were shortened and the mSRs,mSRe and mSRa were slower in CHF group (P ＜ 0.05).② All the index of volume were gradually increasing from control to CHF group,but the LATEF,LAPEF and LAAEF were just the reverse,with all parameters had significant difference between two groups (P ＜0.05).③ The synchronization parameters were significantly higher from control to CHF group by the two kinds of skills (P ＜0.05).Comparing with 2D-STI,the indexes of synchronization were bigger and the asynchronization rate of CHF group were higher by RT-3DE.④The indexes of synchronization had a negative correlation with the strain rate and the ejection fraction,but had a positive correlation with the index of volume.Conclusions The function of left atrial are reduced in patients of CHF,there are asynchronization.2D-STI and RT 3DE may paly important roles in the evaluation of function and synchronization of left atrial.The relevance ratio of the left atrial asynchronization are higher from the RT-3DE than 2D-STI.

Objective To evaluate intra-and interatrial synchronization in patients with paroxysmal atrial fibrillation (PAF) by dual gate Doppler and discuss the predictive value of atrial asynchrony for detecting PAF.Methods Twenty-nine patients with PAF as AF group and 24 healthy volunteers as control group underwent echocardiography.The time interval of the onset of a'wave between mitral annular septal and lateral site was T1 by dual gate Doppler,which was used to evaluate left atrial synchronization.The time intervals from the onset of a'wave at tricuspid annular right ventricular free wall site to a'wave at tricuspid annular septal site and mitral annular lateral site were T2 and T3,which were respectively used to evaluate right atrial and interatrial synchronization.The greater time interval predicted the worse synchronization.Compared these indexes between two groups,the most valuable index was obtained and combined with left atrial volume index (LAVI) to predict PAF,its optimal values were found out by ROC curve.Results ①There were no significant differences in many other basic indexes between two groups (P ＞0.05).However,compared with control group,the ratio of early diastolic transmitral flow velocity (E) and mitral annular velocity of septal site (e'),the diameters and volume indexes of atria were significantly increased in AF group.②T1,T2 and T3 (standardized before and after) increased significantly in AF group (P ＜0.01).Standardized T1 had the largest area under curve (AUC) for detecting PAF.The AUC of standardized T1 and LAVI were 76.6％ and 84.1％.Standardized T1 ≥29.55 ms and LAVI≥ 21.60 ml/m2 were combined for detecting PAF (sensitivity 82.8 ％,specificity 79.2％,AUC 87.1％).③ Standardized T1 was positively correlated with age,left atrial systolic diameter,LAVI,RAVI and E/e'(P＜ 0.05).Conclusions Patients with PAF have worse intra-and interatrial synchronization and left atrial asynchrony can provide predictive value for detecting PAF.Dual gate Doppler is expected to be a new technique for evaluating intra-and interatrial synchronization accurately and detecting the risk of AF.

Objective To assess left ventricular function early and late improvement of patients with acute myocardial infarction (AMI) treated by percutaneous coronary intervention (PCI) by speckle tracking imaging (STI).The clinical values of the assessment of STI for the prognosis and heart function improvement of AMI patients treated by PCI were discussed.Methods 73 AMI patients who had AMI for the first time and had been treated by primary PCI from September 2010 to July 2011 and were examined in the follow-ups from December 2010 to February 2012 in our hospital were enrolled.Dynamic images were acquired before PCI,at 3 months and 6 months after PCI and analyzed by STI.Dynamic images were analyzed for longitudinal peak systolic strain (LPSS),radial peak systolic strain (RPSS) and circumferential peak systolic strain (CPSS) values by STI.According to the comparison of left ventricular ejection fraction (LVEF) before PCI and 6 months after PCI,patients were divided into left ventricular function improved group (ΔLVEF6＞5％) and not-improved group.According to the comparison of LVEF before PCI and 3 months after PCI,improved group were divided into left ventricular function early-improved group (ΔLVEF3 ＞5％) and late-improved group.Results The values of all STI parameters before PCI,3 months and 6 months after PCI in improved group were higher than those in not-improved group (P ＜0.001,all).LPSS before PCI and at the follow-ups and RPSS at 3 months after PCI in early-improved group were higher than those in late-improved group (LPSS at 3 months after PCI:P＜0.001;Other parameters:P ＜0.05).There were significant correlations between all STI parameters and both ΔLVEF3 and ΔLVEF6.LPSS before PCI was more closely related to ΔLVEF3 (r =-0.781,P ＜0.001).CPSS at 6 months after PCI was more closely related to ΔLVEF6 (r =-0.834,P ＜ 0.001).Conclusions Early and late function improvement of left ventricle in AMI patients who is treated by PCI are accurately assessed by STI.The precise analyses of longitudinal and circumferential movements in STI are important for clinical diagnosis.