OBJECTIVES: To study the application of three-dimensional speckle-tracking imaging in evaluating left ventricular systolic function and its correlation with peripheral arterial elasticity in children with simple obesity. METHODS: Random sampling combined with convenience sampling was used to obtain research samples, and then the samples were divided into an obesity group (23 cases), an overweight group (21 cases), and a normal group (24 cases). Three-dimensional speckle-tracking imaging was used to measure the global longitudinal strain (GLS), global radial strain (GRS), and global circumferential strain (GCS) of the left ventricle. An automatic arteriosclerosis tester was used to measure ankle-brachial index (ABI) and brachial-ankle pulse wave velocity (baPWV). These parameters were compared among the three groups. The correlation of three-dimensional speckle-tracking parameters with ABI and baPWV was evaluated. RESULTS: There were no significant differences in GLS, GRS, and GCS between the obesity and normal groups (P>0.05). The overweight group had a significantly higher GLS than the normal group [(-24±7) vs (-19±12), P<0.05]. The obesity and overweight groups had a significantly lower ABI than the normal group [(1.00±0.09)/(1.09±0.13) vs (2.25±0.13), P<0.05). The obesity group had a significantly higher baPWV than the normal group [(978±109) vs (905±22), P<0.05]. In the children with obesity, GLS was positively correlated with baPWV (r=0.516, P<0.05) , but not correlated with ABI (P>0.05), and GCS and GRS had no significant correlation with ABI or baPWV (P>0.05). CONCLUSIONS There are varying degrees of changes in left ventricular systolic function and peripheral arterial elasticity in children with simple obesity, and there is a certain correlation between them.
Ankle Brachial Index ; Child ; Echocardiography, Three-Dimensional/methods* ; Elasticity ; Humans ; Obesity ; Overweight ; Prospective Studies ; Pulse Wave Analysis

BACKGROUND: Pulmonary vein (PV) occlusion generally depends on repetitive contrast agent injection when cryoballoon ablation for atrial fibrillation (AF). The present study was to compare the effect of cryoballoon ablation for AF guided by transesophageal echocardiography (TEE) vs. contrast agent injection. METHODS: Eighty patients with paroxysmal AF (PAF) were enrolled in the study. About 40 patients underwent cryoballoon ablation without TEE (non-TEE group) and the other 40 underwent cryoballoon ablation with TEE for PV occlusion (TEE group). In the TEE group during the procedure, PVs were displayed in 3-dimensional images to guide the balloon to achieve PV occlusion. The patients were followed up at regularly scheduled visits every 2 months. RESULTS: No differences were identified between the groups in regard to the procedure time and cryoablation time for each PV. The fluoroscopy time (6.7 ± 4.2 min vs. 17.9 ± 5.9 min, P < 0.05) and the amount of contrast agent (3.0 ± 5.1 mL vs.18.1 ± 3.4 mL, P < 0.05) in the TEE group were both less than the non-TEE group. At a mean of 13.0 ± 3.3 mon follow-up, success rates were similar between the TEE group and non-TEE group (77.5% vs. 80.0%, P = 0.88). CONCLUSIONS Cryoballoon ablation with TEE for occlusion of the PV is both safe and effective. Less fluoroscopy time and a lower contrast agent load can be achieved with the help of TEE for PV occlusion during procedure.
Aged ; Atrial Fibrillation ; diagnostic imaging ; surgery ; Contrast Media ; Cryosurgery ; methods ; Echocardiography, Three-Dimensional ; methods ; Echocardiography, Transesophageal ; methods ; Female ; Humans ; Male ; Middle Aged ; Pulmonary Veins ; diagnostic imaging ; surgery ; Treatment Outcome

BACKGROUND: Evaluation of left ventricular (LV) size and function is one of the important reasons for performing echocardiography. Real time three dimensional echocardiography (RT3DE) is now available for a precise non-invasive ventricular volumetry. Aim of work was to validate RT3DE as a non-invasive cardiac imaging method for measurement of LV volumes using cardiac angiography as the reference technique. METHODS: Prospective study on 40 consecutive patients with tetralogy of Fallot (TOF) referred for cardiac catheterization for preoperative assessment. Biplane cineangiography, conventional 2 dimensional echocardiography (2DE) and RT3DE were performed for the patients. A control group of 18 age and sex matched children was included and 2DE and RT3DE were performed for them. RESULTS: The mean LV end diastolic volume (LVEDV) and LVEDV index (LVEDVI) measured by RT3DE of patients were lower than controls (p value = 0.004, 0.01, respectively). There was strong correlation between the mean value of the LVEDV and the LVEDVI measured by RT3DE and angiography (r = 0.97, p < 0.001). The mean value of LV ejection fraction measured by RT3DE was lower than that assessed by 2DE (50 ± 6.2%, 65 ± 4.6%, respectively, p value < 0.001) in the studied TOF cases. There was good intra- and inter-observer reliability for all measurements. CONCLUSION: RT3DE is a noninvasive and feasible tool for measurement of LV volumes that strongly correlates with LV volumetry done by angiography in very young infants and children, and further studies needed.
Angiocardiography* ; Angiography ; Cardiac Catheterization ; Cardiac Catheters ; Child* ; Cineangiography ; Echocardiography ; Echocardiography, Three-Dimensional* ; Humans ; Infant ; Methods ; Prospective Studies ; Tetralogy of Fallot*

OBJECTIVETo evaluate the clinical significance of full volume real-time three-dimensional echocardiography (RT-3DE) in the assessment of general and local systolic functions of the left ventricle in children with Kawasaki disease (KD).

METHODSA total of 73 KD children (40 with and 33 without coronary artery lesions) and 35 healthy control children were recruited. Left ventricular ejection fraction (LVEF) was measured by M-mode ultrasound and full volume RT-3DE imaging. A left ventricular volume-time curve and a segmental speed-time curve were generated. Differences between control subjects and patients with and without coronary artery lesions were analyzed.

RESULTSThe M-mode ultrasound measurements of LVEF in KD patients with coronary artery lesions were significantly lower than in KD patients without coronary artery lesions and control children (P<0.05), while there was no significant difference between KD patients without coronary artery lesions and control children. RT-3DE measurements of LVEF were significantly different between the three groups analyzed (P<0.05): coronary artery lesion group < no coronary artery lesion group < control group. RT-3DE-based segmental ventricular wall analysis revealed that Tmsv16-SD and Tmsv12-SD in KD patients with coronary artery lesions were significantly higher than other two groups and Tmsv6-SD was also significantly higher than in the normal control group (P<0.05) and that Tmsv16-SD in KD patients without coronary artery lesions increased significantly compared with the normal control group (P<0.05).

CONCLUSIONSRT-3DE can be used in the quantitative evaluation of the left ventricular function and therefore has significant clinical implications.

Child ; Child, Preschool ; Echocardiography, Three-Dimensional ; methods ; Female ; Humans ; Infant ; Male ; Mucocutaneous Lymph Node Syndrome ; diagnostic imaging ; physiopathology ; Ventricular Function, Left

BACKGROUNDLeft atrial (LA) maximum volume is becoming a prognostic biomarker for left ventricular (LV) diastolic dysfunction. However, we assessed LV diastolic function by measuring LA phasic volumes using real-time threedimensional echocardiography (RT3DE) in patients with stable coronary artery disease (CAD).

METHODSSixty-five stable CAD patients with normal LV ejection fraction (LVEF) were divided into three groups according to degree of coronary stenosis: control (n = 15) with <50% stenosis as control group, mildS (n = 25) with mild stenosis (50%-70%) and severeS (n = 25) with >70% stenosis. LA phasic volumes and function were evaluated and compared using RT3DE and two dimensional echocardiography (2DE). N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels were examined. The correlations of RT3DE-derived parameters with other conventional indices were analyzed.

RESULTSSignificant correlations between RT3DE and 2DE for LA volume measurements were: control, r = 0.93; mildS, r = 0.94; severeS, r = 0.90 (all P < 0.05). Patients with severe coronary stenosis presented higher NT-proBNP level, indices of LA minimum volume and volume before atrial contraction, but lower LA total emptying fraction (LAEF) and LAEFpassive. Significant correlations of RT3DE derived LA volume indices with E/E' (r = 0.695) and NF-proBNP (r = 0.630) level were found.

CONCLUSIONSRT3DE derived, LA indices correlate well with NT-proBNP level and may be superior to 2DE measurements for the evaluation of LV diastolic dysfunction. Enlargement of LA minimum volume in stable CAD patients without systolic dysfunction appears earlier and may be better correlated with LV diastolic function than that of LA maximum volume.

Echocardiography ; Echocardiography, Three-Dimensional ; methods ; Female ; Humans ; Male ; Middle Aged ; Ventricular Dysfunction, Left ; diagnosis

Three-dimensional speckle tracking echocardiography was employed to evaluate the changes of left ventricular systolic strain in 23 heart transplant recipients at 1st, 3rd, 6th and 12th month after heart transplantation, and 23 healthy subjects served as controls. The three-dimensional full-volume echocardiographic images of left ventricle were recorded and then were analyzed using EchoPAC software. The strain curves and peak systolic strain values for each segment and overall left ventricular wall were obtained. Left ventricular global peak longitudinal strain (GPSL), global peak radial strain (GPSR), global peak circumferential strain (GPSC) and global peak area strain (GPSA) were measured and then statistically analyzed. There were no significant differences in left ventricular ejection fraction (LVEF) and cardiac output (CO) between heart transplant recipients and controls. The GPSL in heart transplant recipients at 1st month after surgery was significantly lower than that in controls, but close to the normal value at 3rd month after surgery and later. The GPSC, GPSA and GPSR were significantly lower in heart transplant recipients at 1st, 3rd, 6th and 12th month after surgery than those in controls. It is suggested that three-dimensional speckle tracking echocardiography can be used for monitoring changes of left ventricular systolic strains and evaluating left ventricular systolic function in cardiac allograft.
Adolescent ; Adult ; Allografts ; Echocardiography, Three-Dimensional ; methods ; Female ; Heart Function Tests ; methods ; Heart Transplantation ; methods ; Humans ; Male ; Middle Aged ; Reproducibility of Results ; Sensitivity and Specificity ; Systole ; Time Factors ; Ventricular Dysfunction, Left ; diagnosis ; diagnostic imaging ; Ventricular Function, Left ; Young Adult

Our study was aimed to evaluate the left ventricular (LV) global longitudinal systolic function of patients with diabetes mellitus (DM) using real-time three-plane speckle tracking imaging (RT-3P STI). The case group was the patients of type 2 DM with normal LV ejection fraction (EF). Then according to glycated hemoglobin (HbAlc) control level, the case group was divided into two groups, including DM1 (HbAlc<7%, n=31) and DM2 (HbAlc >or=7%, n= 37); 63 matched volunteers were chosen as control group. Conventional measurements of the LV size and function were performed. We then applied the automatic function imaging to analyze the global longitudinal systolic peak strain (GLPS) of the three apical views online, including the GLPS of apical four chamber view (GLPS-A4C), the GLPS of apical two chamber view (GLPS-A2C), the GLPS of apical long axis view (GLPS-LAX), and then generating the average GLPS (GLPS-Avg). The experimental results showed that there was no statistical difference in clinical baseline characteristics among the three groups (P>0.05). However, there were statistical differences in the ventricular wall thickness and the LV mass index of the DM1 and DM2 groups compared with that of the control (P<0. 05). No significant differences were found in LV diameters, volumes, LVEF among the three studied groups (P>0. 05). We also found significant differences in GLPS-LAX, GLPS-A2C, GLPS-Avg when we compared DM2 group with those of the DM1 group or the control (P<0. 05). We found a statistical difference in GLPS-A4C only when we compared the DM2 group with the control(P<0. 05), and no statistical difference in the strains of the three views between DM1 group and control (P>0. 05). RT-3P STI could not only accurately be used to evaluate the LV global longitudinal systolic function, but could also reflect the reduction of sub-clilical systolic function in DM patients with poor blood glucose control in the early stage.
Aged ; Case-Control Studies ; Diabetes Mellitus, Type 2 ; complications ; diagnostic imaging ; physiopathology ; Echocardiography, Three-Dimensional ; methods ; Female ; Heart Ventricles ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Myocardial Contraction ; physiology ; Stroke Volume ; Systole ; Ventricular Dysfunction, Left ; diagnostic imaging ; etiology ; Ventricular Function, Left

We sought to explore the feasibility of global area strain to assess left ventricular global systolic function in patients with essential hypertension and normal ventricular geometry. Thirty-five essential hypertensive patients with normal ventricular geometry and 30 normally healthy persons as controls were enrolled in this study. The two groups were comparable for age, sex ratio, height, weight, body mass index (BMI), and heart rate. Blood pressures (BPs) were significantly higher in the hypertension group than the control group. Two-dimensional echocardiography and three-dimensional speckle tracking imaging were performed. Left ventricular global area strain (GAS), global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS), LV volumes, ejection fraction (EF), sphericity index (SPI), left ventricular end-diastolic and end-systolic mass (EDmass and ESmass) and LV mass index (EDmassI and ESmassI) were obtained. Compared with those of the controls, GAS, GLS, GCS, GRS were significantly reduced in hypertensive patients Call P < 0.001). GAS (r = 0.672, P < 0. 001), GLS (r = 0.587, P < 0.001), GCS (r = 0.639, P < 0.001) and GRS (r = 0.685, P < 0.001) were correlated with EF in the pooled population. GAS showed an excellent correlation with GCS (r = 0.905, P < 0.001), GLS (r = 0.892, P < 0.001) and GRS (r = 0.990, P < 0.001). EF measured with 3D-STI was significantly lower in group of hypertension (P < 0.001) than that in the controls. There were no significant differences between the two groups in cardiac output, sphericity index, EDmass and ESmass, LV mass index (EDmassI and ESmassI) calculated with 3D-STI. The study showed that GAS could identify early changes of left ventricular global systolic function in hypertensive patients with normal ventricular geometry.
Adult ; Aged ; Case-Control Studies ; Echocardiography, Three-Dimensional ; methods ; Female ; Humans ; Hypertension ; diagnostic imaging ; physiopathology ; Male ; Middle Aged ; Myocardial Contraction ; physiology ; Ventricular Function, Left ; physiology ; Young Adult

OBJECTIVE: To analyze the characteristics of left ventricular rotation and twist in patients with essential hypertension (EH) of different left ventricular configurations by 3-dimensional speckle tracking echocardiography (3D-STE). METHODS: A total of 106 EH patients were divided into 4 groups: a left ventricular normal configuration (LVN) group (n=30), a concentric remodeling (CCR) group (n=31), a concentric hypertrophy (CCH) group (n=29), an eccentric hypertrophy (ECH) group (n=16), and a control group of 30 healthy subjects. The parameters of LVEF, peak basal rotation (Prot-B), peak apical rotation (Prot-A), left ventricular peak apical rotation (LV-rot), and left ventricular peak apical twist (LV-tw) were compared. RESULTS: The left ventricular mass index in the EH groups, which kept increasing, was higher than that in the normal control group (P<0.05). Compared with the normal control group, LVN and ECH group, the left ventricular posterior wall thickness, interventricular septum at end-diastole, and relative wall thickness significantly increased in the CCH and CCR group (P<0.05). LVEF showed no significant difference among the normal control, LVN, CCR and CCH group (P>0.05), but LVEF was lower in the ECH group than in other groups (P<0.05). Compared with the normal control group, Prot-B, Prot-A, LVrot and LVtw were significantly higher in the LVN, CCR and CCH group (P<0.05), but decreased in the ECH group (P<0.05). CONCLUSION 3D-STE can evaluate the left ventricular rotation and twist in EH patients with different configurations, and reflect changes in the left ventricular systolic function in EH of different configurations.
Adult ; Case-Control Studies ; Echocardiography, Three-Dimensional ; methods ; Female ; Heart Ventricles ; diagnostic imaging ; Humans ; Hypertension ; diagnostic imaging ; physiopathology ; Male ; Middle Aged ; Ventricular Dysfunction, Left ; diagnostic imaging ; physiopathology ; Ventricular Remodeling ; physiology

Atrial Function, Left ; physiology ; Echocardiography, Three-Dimensional ; methods ; Female ; Heart Atria ; diagnostic imaging ; Humans ; Male ; Mitral Valve ; diagnostic imaging ; Stroke Volume ; physiology