CN101862206A - Method for evaluating diastolic function of long axis of left ventricle of primary hypertension patient - Google Patents

Method for evaluating diastolic function of long axis of left ventricle of primary hypertension patient Download PDF

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CN101862206A
CN101862206A CN201010000780A CN201010000780A CN101862206A CN 101862206 A CN101862206 A CN 101862206A CN 201010000780 A CN201010000780 A CN 201010000780A CN 201010000780 A CN201010000780 A CN 201010000780A CN 101862206 A CN101862206 A CN 101862206A
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left ventricle
long axis
lvidd
analysis
diastole
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何香芹
王志斌
聂晶
李艳
付秀秀
王勇
裴秋艳
王丽
韩心灯
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何香芹
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Abstract

The invention discloses a method for evaluating a diastolic function of a long axis of the left ventricle of a primary hypertension patient, which aims to overcome defects of the prior art. The method comprises the following steps of: 1, using a GE Vivid 7 Dimension type multifunctional color Doppler ultrasonic diagnosis apparatus; 2, when a subject is on a left lateral position and breathes smoothly, acquiring an ultrasonic image in a breath holding state at the end of breathing, measuring at least three continuous cardiac cycles for each ultrasonic index, averaging the three continuous cardiac cycles, and synchronously recording a cardiogram; 3, putting an M3S probe aside a breast bone to measure the inside diameter of the left atrium, the end diastolic inside diameter of the left ventricle, the end diastolic thickness of an inter-ventricular septum and the end diastolic thickness of the posterior wall of the left ventricle, and calculating the ejection fraction and the cardiac muscle quality of the left ventricle; 4, using a real-time three-plane imaging function of a V3 probe to synchronously obtain three tangential planes of apex cordis four chambers, apex cordis two chambers and an apex cordis left ventricle long axis, and continuously acquiring images of the three cardiac cycles for off-line analyses; and 5, performing a statistical analysis, namely using SPSS13.0 statistics software to perform an analysis.

Description

A kind of evaluating diastolic function of long axis of left ventricle of primary hypertension patient method
Technical field: the invention belongs to medical ultrasound and check technical field, particularly a kind of evaluating diastolic function of long axis of left ventricle of primary hypertension patient method.
Background technology: essential hypertension is the modal independently paathogenic factor that cardiovascular disease takes place, in primary hypertension patient, because pressure load increases, left ventricular hypertrophy interstitial collagen fiber increases progressively, gathers, cause left ventricle to be shunk and the diastole malfunction, so left ventricular hypertrophy has been considered to cause the independently risk factor of cardiovascular accident.The stringer cardiac muscle mainly is positioned under the endocardium of left ventricle, visceral pericardium following and papillary muscles, and than the easier influence that is subjected to pathological factors such as myocardial ischemia of belt cardiac muscle fiber in middle level, it is impaired early to show as diastolic function of long axis of left ventricle.Strain Rate Imaging (strain rate imaging, SRI) technology is a kind of new technique that grows up on the tissue doppler imaging basis, what reflect is the speed of myocardium instantaneous generation deformation, but and then the local myocardial diastolic function of long axis in the quantitative assessment left ventricle of primary hypertension patient reconstruct progress, more valuable than tissue Doppler tachometric survey, more can represent the inherent mechanical characteristic of cardiac activity, the more truly functional status of reflecting myocardium than parameters such as speed.
Variability imaging technique assess cardiac function receives clinical concern further in recent years, and real-time three plane variability imaging techniques are new techniques that newly-developed gets up, and progressively are applied to clinical research.But up to the present, the report of real-time three plane strain rate imaging evaluating diastolic function of long axis of left ventricle of primary hypertension patient methods had not been arranged, therefore invented this method.
Summary of the invention: the objective of the invention is for overcoming the existing in prior technology deficiency, and invent a kind of evaluating diastolic function of long axis of left ventricle of primary hypertension patient method.
The present invention is realized by following technical scheme:
Invent a kind of evaluating diastolic function of long axis of left ventricle of primary hypertension patient method, it is characterized in that: its method may further comprise the steps:
1, uses GE Vivid 7 Dimension type duplex color Doppler diasonographs, be furnished with two-dimensional probe M3S, frequency 1.7~3.4MHz, three-dimensional probe V3, frequency 1.5~4.0MHz.
2, person under inspection's left lateral position is steadily breathed, and gathers ultrasonoscopy under end-tidal is held one's breath state, and each ultrasonic index is measured 3 continuous cardiac cycles at least, averages; The synchronous recording electrocardiogram.
3, place parasternal to show the long axis of left ventricle tangent plane with the M3S probe, measure left atrium internal diameter (LAD); And in chordae tendineae of mitral valve level collection left ventricle M type ultrasoundcardiogram, measure left ventricular end diastolic internal diameter (LVIDd), interventricular septum diastole end thickness (IVSd), left ventricular posterior wall diastole end thickness (LVPWd) calculates left ventricle relative wall thickness (RWT)=(IVSd+LVPWd)/LVIDd; Use the Teichholtz formula and calculate left ventricular ejection fraction (EF); Use the Devereux updating formula and calculate myocardium of left ventricle quality (LVM), LVM=0.8 * 1.04 * [(LVIDd+IVSd+LVPWd) 3-LVIDd 3]+0.6, left chamber myocardial mass index (LVMI)=myocardium of left ventricle quality/body surface area.
4, use the V3 real-time three planar imaging functions of popping one's head in, obtain apical four-chamber (showing interval, back and sidewall), the apex of the heart two chambeies (showing antetheca and lower wall) and 3 tangent planes of apex of the heart long axis of left ventricle (showing rear wall and space before) simultaneously, start the Strain Rate Imaging pattern, the image of 3 cardiac cycles of continuous acquisition is for off-line analysis.Getting strain length is 1.2cm, places respectively in each wall basal segment and the interlude subendocardiac muscle tissue, starts the strain rate curve that above-mentioned 12 sections are obtained in quantitative analysis, carries out each sections Strain Rate Imaging analysis on the basis of real-time three planar imagings; Measure and record diastole early stage peak strain rate SRe and diastole peak strain in late period rate SRa.
5, statistical analysis is used SPSS13.0 statistics software, the measurement data data with
Figure DEST_PATH_GSB00000237414700021
Expression, variable relatively adopts one factor analysis of variance and S-N-K check between group, and there is statistical significance P<0.05 for difference.
Advantage of the present invention and beneficial effect:
1, real-time three plane strain rate imagings can be more objective, different geometric configurations change the extent of damage to the local myocardial diastolic function of long axis in the responsive noninvasive evaluation constitutional left ventricle of primary hypertension patient myocardial remodelling, SRe is at normal configuration, centration reconstruct type, be in each group of eccentric hypertrophy type and concentric hypertrophy type and reduce trend gradually, for quantitatively, accurately estimate left chamber local myocardial diastolic function new method is provided, early diagnosis and prognosis to the primary hypertension patient abnormality of diastolic function judge to have using value, for instructing the evaluation clinical treatment important clinical meaning are arranged.
2, the stringer cardiac muscle mainly is positioned under the endocardium of left ventricle, visceral pericardium is following and papillary muscles, the easier influence that is subjected to pathological factors such as myocardial ischemia of belt cardiac muscle fiber than the middle level, it is impaired early to show as diastolic function of long axis of left ventricle, analysis to major axis myocardial relaxation function helps the early diagnosis myocardial function unusual, but the local myocardial diastolic function of long axis in the Strain Rate Imaging quantitative assessment left ventricle of primary hypertension patient reconstruct progress.Using real-time three plane strain rate imagings can go up mutually in same a period of time of same cardiac cycle, show three tangent planes synchronously, saved the scanning time, and removed the influence of different cardiac cycles variation to the quantitative analysis of left ventricle local myocardial sections, make each sections cardiac motion have more comparability, thus make quantitative real-time three plane strain rate imaging I to the evaluation of the local major axis function of left ventricle more accurately and reliably.
3, help further to inquire into relation between local myocardial diastolic function of long axis and ventricle geometric configuration change in the left ventricle of primary hypertension patient reconstruct, more can further enrich clinical diagnosis information, for clinical diagnosis and treatment effectiveness evaluation etc. provides a kind of brand-new means, have broad application prospects.
The specific embodiment:
Further the present invention is described further below by the specific embodiment, following examples be descriptive be not determinate, can not limit protection scope of the present invention with this.
Embodiment 1
Yang, the woman, 48 years old, the healthy volunteer used GE Vivid 7 Dimension type duplex color Doppler diasonographs, is furnished with two-dimensional probe M3S, frequency 1.7~3.4MHz, three-dimensional probe V3, frequency 1.5~4.0MHz.Person under inspection's left lateral position is steadily breathed, and gathers ultrasonoscopy under end-tidal is held one's breath state, and each ultrasonic index is measured 3 continuous cardiac cycles at least, averages; The synchronous recording electrocardiogram.Using the M3S probe places parasternal to show the long axis of left ventricle tangent plane, gather left ventricle M type ultrasoundcardiogram in the chordae tendineae of mitral valve level, measure left ventricular end diastolic internal diameter (LVIDd), interventricular septum diastole end thickness (IVSd), left ventricular posterior wall diastole end thickness (LVPWd), calculate left ventricle relative wall thickness (RWT)=(IVSd+LVPWd)/LVIDd, record RWT:0.37; Use the Devereux updating formula and calculate myocardium of left ventricle quality (LVM), LVM=0.8 * 1.04 * [(LVIDd+IVSd+LVPWd) 3-LVIDd 3]+0.6, left chamber myocardial mass index (LVMI)=myocardium of left ventricle quality/body surface area records LVMI:90.5; This patient belongs to the normal control group.Use the V3 real-time three planar imaging functions of popping one's head in, obtain apical four-chamber (showing interval, back and sidewall), the apex of the heart two chambeies (showing antetheca and lower wall) and 3 tangent planes of apex of the heart long axis of left ventricle (showing rear wall and space before) simultaneously, start the Strain Rate Imaging pattern, the image of 3 cardiac cycles of continuous acquisition is for off-line analysis.Getting strain length is 1.2cm, places respectively in each wall basal segment and the interlude subendocardiac muscle tissue, starts the strain rate curve that above-mentioned 12 sections are obtained in quantitative analysis, carries out each sections Strain Rate Imaging analysis on the basis of real-time three planar imagings; Measure and record diastole early stage peak strain rate SRe and diastole peak strain in late period rate SRa.
Embodiment 2
Patient Lee, the woman, 47 years old, suffered from hypertension 2 years, blood pressure 145/105mmHg uses GE Vivid 7 Dimension type duplex color Doppler diasonographs, is furnished with two-dimensional probe M3S, frequency 1.7~3.4MHz, three-dimensional probe V3, frequency 1.5~4.0MHz.Person under inspection's left lateral position is steadily breathed, and gathers ultrasonoscopy under end-tidal is held one's breath state, and each ultrasonic index is measured 3 continuous cardiac cycles at least, averages; The synchronous recording electrocardiogram.Using the M3S probe places parasternal to show the long axis of left ventricle tangent plane, gather left ventricle M type ultrasoundcardiogram in the chordae tendineae of mitral valve level, measure left ventricular end diastolic internal diameter (LVIDd), interventricular septum diastole end thickness (IVSd), left ventricular posterior wall diastole art thickness (LVPWd), calculate left ventricle relative wall thickness (RWT)=(IVSd+LVPWd)/LVIDd, record RWT:0.39; Use the Devereux updating formula and calculate myocardium of left ventricle quality (LVM), LVM=0.8 * 1.04 * [(LVIDd+IVSd+LVPWd) 3-LVIDd 3]+0.6, left chamber myocardial mass index (LVMI)=myocardium of left ventricle quality/body surface area records LVMI:98.5; This patient belongs to essential hypertension normal configuration group.Use the V3 real-time three planar imaging functions of popping one's head in, obtain apical four-chamber (showing interval, back and sidewall), the apex of the heart two chambeies (showing antetheca and lower wall) and 3 tangent planes of apex of the heart long axis of left ventricle (showing rear wall and space before) simultaneously, start the Strain Rate Imaging pattern, the image of 3 cardiac cycles of continuous acquisition is for off-line analysis.Getting strain length is 1.2cm, places respectively in each wall basal segment and the interlude subendocardiac muscle tissue, starts the strain rate curve that above-mentioned 12 sections are obtained in quantitative analysis, carries out each sections Strain Rate Imaging analysis on the basis of real-time three planar imagings; Measure and record diastole early stage peak strain rate SRe and diastole peak strain in late period rate SRa.
Embodiment 3
Patient Korea Spro so-and-so, the man, 57 years old, suffered from hypertension 10 years, blood pressure 160/90mmHg uses GEVivid 7 Dimension type duplex color Doppler diasonographs, is furnished with two-dimensional probe M3S, frequency 1.7~3.4MHz, three-dimensional probe V3, frequency 1.5~4.0MHz.Person under inspection's left lateral position is steadily breathed, and gathers ultrasonoscopy under end-tidal is held one's breath state, and each ultrasonic index is measured 3 continuous cardiac cycles at least, averages; The synchronous recording electrocardiogram.Using the M3S probe places parasternal to show the long axis of left ventricle tangent plane, gather left ventricle M type ultrasoundcardiogram in the chordae tendineae of mitral valve level, measure left ventricular end diastolic internal diameter (LVIDd), interventricular septum diastole end thickness (IVSd), left ventricular posterior wall diastole end thickness (LVPWd), calculate left ventricle relative wall thickness (RWT)=(IVSd+LVPWd)/LVIDd, record RWT:0.47; Use the Devereux updating formula and calculate the myocardium of left ventricle quality [4](LVM), LVM=0.8 * 1.04 * [(LVIDd+IVSd+LVPWd) 3-LVIDd 3]+0.6, left chamber myocardial mass index (LVMI)=myocardium of left ventricle quality/body surface area records LVMI:116.5; This patient belongs to essential hypertension centration reconstruct group.Use the V3 real-time three planar imaging functions of popping one's head in, obtain apical four-chamber (showing interval, back and sidewall), the apex of the heart two chambeies (showing antetheca and lower wall) and 3 tangent planes of apex of the heart long axis of left ventricle (showing rear wall and space before) simultaneously, start the Strain Rate Imaging pattern, the image of 3 cardiac cycles of continuous acquisition is for off-line analysis.Getting strain length is 1.2cm, places respectively in each wall basal segment and the interlude subendocardiac muscle tissue, starts the strain rate curve that above-mentioned 12 sections are obtained in quantitative analysis, carries out each sections Strain Rate Imaging analysis on the basis of real-time three planar imagings; Measure and record diastole early stage peak strain rate SRe and diastole peak strain in late period rate SRa.
Embodiment 4
Patient Cai so-and-so, the man, 37 years old, suffered from hypertension 3 years, blood pressure 180/100mmHg uses GEVivid 7 Dimension type duplex color Doppler diasonographs, is furnished with two-dimensional probe M3S, frequency 1.7~3.4MHz, three-dimensional probe V3, frequency 1.5~4.0MHz.Person under inspection's left lateral position is steadily breathed, and gathers ultrasonoscopy under end-tidal is held one's breath state, and each ultrasonic index is measured 3 continuous cardiac cycles at least, averages; The synchronous recording electrocardiogram.Using the M3S probe places parasternal to show the long axis of left ventricle tangent plane, gather left ventricle M type ultrasoundcardiogram in the chordae tendineae of mitral valve level, measure left ventricular end diastolic internal diameter (LVIDd), interventricular septum diastole end thickness (IVSd), left ventricular posterior wall diastole end thickness (LVPWd), calculate left ventricle relative wall thickness (RWT)=(IVSd+LVPWd)/LVIDd, record RWT:0.42; Use the Devereux updating formula and calculate myocardium of left ventricle quality (LVM), LVM=0.8 * 1.04 * [(LVIDd+IVSd+LVPWd) 3-LVIDd 3]+0.6, left chamber myocardial mass index (LVMI)=myocardium of left ventricle quality/body surface area records LVMI:138.5; This patient belongs to essential hypertension eccentric hypertrophy group.Use the V3 real-time three planar imaging functions of popping one's head in, obtain apical four-chamber (showing interval, back and sidewall), the apex of the heart two chambeies (showing antetheca and lower wall) and 3 tangent planes of apex of the heart long axis of left ventricle (showing rear wall and space before) simultaneously, start the Strain Rate Imaging pattern, the image of 3 cardiac cycles of continuous acquisition is for off-line analysis.Getting strain length is 1.2cm, places respectively in each wall basal segment and the interlude subendocardiac muscle tissue, starts the strain rate curve that above-mentioned 12 sections are obtained in quantitative analysis, carries out each sections Strain Rate Imaging analysis on the basis of real-time three planar imagings; Measure and record diastole early stage peak strain rate SRe and diastole peak strain in late period rate SRa.
Embodiment 5
Patient gold certain, the man, 54 years old, suffered from hypertension 2 years, blood pressure 160/120mmHg uses GE Vivid 7 Dimension type duplex color Doppler diasonographs, is furnished with two-dimensional probe M3S, frequency 1.7~3.4MHz, three-dimensional probe V3, frequency 1.5~4.0MHz.Person under inspection's left lateral position is steadily breathed, and gathers ultrasonoscopy under end-tidal is held one's breath state, and each ultrasonic index is measured 3 continuous cardiac cycles at least, averages; The synchronous recording electrocardiogram.Using the M3S probe places parasternal to show the long axis of left ventricle tangent plane, gather left ventricle M type ultrasoundcardiogram in the chordae tendineae of mitral valve level, measure left ventricular end diastolic internal diameter (LVIDd), interventricular septum diastole end thickness (IVSd), left ventricular posterior wall diastole end thickness (LVPWd), calculate left ventricle relative wall thickness (RWT)=(IVSd+LVPWd)/LVIDd, record RWT:0.59; Use the Devereux updating formula and calculate myocardium of left ventricle quality (LVM), LVM=0.8 * 1.04 * [(LVIDd+IVSd+LVPWd) 3-LVIDd 3]+0.6, left chamber myocardial mass index (LVMI)=myocardium of left ventricle quality/body surface area records LVMI:142.7; This patient belongs to essential hypertension concentric hypertrophy group.Use the V3 real-time three planar imaging functions of popping one's head in, obtain apical four-chamber (showing interval, back and sidewall), the apex of the heart two chambeies (showing antetheca and lower wall) and 3 tangent planes of apex of the heart long axis of left ventricle (showing rear wall and space before) simultaneously, start the Strain Rate Imaging pattern, the image of 3 cardiac cycles of continuous acquisition is for off-line analysis.Getting strain length is 1.2cm, places respectively in each wall basal segment and the interlude subendocardiac muscle tissue, starts the strain rate curve that above-mentioned 12 sections are obtained in quantitative analysis, carries out each sections Strain Rate Imaging analysis on the basis of real-time three planar imagings; Measure and record diastole early stage peak strain rate SRe and diastole peak strain in late period rate SRa.

Claims (1)

1. evaluating diastolic function of long axis of left ventricle of primary hypertension patient method, it is characterized in that: its method may further comprise the steps:
(1), use GE Vivid7 Dimension type duplex color Doppler diasonograph, be furnished with two-dimensional probe M3S, frequency 1.7~3.4MHz, three-dimensional probe V3, frequency 1.5~4.0MHz.
(2), person under inspection's left lateral position, steadily breathe, under end-tidal is held one's breath state, gather ultrasonoscopy, each ultrasonic index is measured 3 continuous cardiac cycles at least, averages; The synchronous recording electrocardiogram.
(3), place parasternal demonstration long axis of left ventricle tangent plane, measurement left atrium internal diameter (LAD) with the M3S probe;
And in chordae tendineae of mitral valve level collection left ventricle M type ultrasoundcardiogram, measure left ventricular end diastolic internal diameter (LVIDd), interventricular septum diastole end thickness (IVSd), left ventricular posterior wall diastole end thickness (LVPWd) calculates left ventricle relative wall thickness (RWT)=(IVSd+LVPWd)/LVIDd; Use the Teichholtz formula and calculate left ventricular ejection fraction (EF); Use the Devereux updating formula and calculate myocardium of left ventricle quality (LVM), LVM=0.8 * 1.04 * [(LVIDd+IVSd+LVPWd) 3-LVIDd 3]+0.6, left chamber myocardial mass index (LVMI)=myocardium of left ventricle quality/body surface area.
(4), use the V3 real-time three planar imaging functions of popping one's head in, obtain apical four-chamber (showing interval, back and sidewall), the apex of the heart two chambeies (showing antetheca and lower wall) and 3 tangent planes of apex of the heart long axis of left ventricle (showing rear wall and space before) simultaneously, start the Strain Rate Imaging pattern, the image of 3 cardiac cycles of continuous acquisition is for off-line analysis.Getting strain length is 1.2cm, places respectively in each wall basal segment and the interlude subendocardiac muscle tissue, starts the strain rate curve that above-mentioned 12 sections are obtained in quantitative analysis, carries out each sections Strain Rate Imaging analysis on the basis of real-time three planar imagings; Measure and record diastole early stage peak strain rate SRe and diastole peak strain in late period rate SRa.
(5), statistical analysis uses SPSS13.0 statistics software, the measurement data data represent that with x ± s variable relatively adopts one factor analysis of variance and S-N-K check between group, there is statistical significance P<0.05 for difference.
CN201010000780A 2010-01-19 2010-01-19 Method for evaluating diastolic function of long axis of left ventricle of primary hypertension patient Pending CN101862206A (en)

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Cited By (3)

* Cited by examiner, † Cited by third party
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CN109069114A (en) * 2017-02-16 2018-12-21 深圳迈瑞生物医疗电子股份有限公司 Ultrasound medicine detection device and imaging method, imaging system, display terminal
CN110335236A (en) * 2019-04-29 2019-10-15 上海依智医疗技术有限公司 Processing method, processing unit, processing system and the medium of cardiologic medical image
CN119055278A (en) * 2024-11-04 2024-12-03 中国医学科学院阜外医院 Left ventricular ejection fraction prediction method and system based on echocardiography

Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN109069114A (en) * 2017-02-16 2018-12-21 深圳迈瑞生物医疗电子股份有限公司 Ultrasound medicine detection device and imaging method, imaging system, display terminal
CN109069114B (en) * 2017-02-16 2021-10-22 深圳迈瑞生物医疗电子股份有限公司 Ultrasonic medical detection equipment, imaging method, imaging system and display terminal
US11259780B2 (en) 2017-02-16 2022-03-01 Shenzhen Mindray Bio-Medical Electronics Co., Ltd. Ultrasound medical detection devices and imaging method, imaging system and display terminal
CN110335236A (en) * 2019-04-29 2019-10-15 上海依智医疗技术有限公司 Processing method, processing unit, processing system and the medium of cardiologic medical image
CN110335236B (en) * 2019-04-29 2021-06-11 上海依智医疗技术有限公司 Method, apparatus, system and medium for processing cardiac medical image
CN119055278A (en) * 2024-11-04 2024-12-03 中国医学科学院阜外医院 Left ventricular ejection fraction prediction method and system based on echocardiography

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