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1181: Ultrasound-Guided Subxiphoid Indwelling Catheter Insertion into Pericardial Cavity
S148
Ultrasound in Medicine and Biology
1180 Research of Longitudinal Motion of Infarcted Myocardium and Ischemic Myocardium with Velocity Vector Imaging Hong Tang, West China Hospital of Sichuan University, Chengdu, China Zhaohuan Li, West China Hospital of Sichuan University, Chengdu, China Yuan Feng, West China Hospital of Sichuan University, Chengdu, China Objective: To analysis longitudinal motion of infarcted myocardium and ischemic myocardium with a new echocardiographic technology, velocity vector imaging(VVI), and assess its accuracy. Methods: 6 patients suffered acute anterior myocardial infartion (MI group), 9 patients had myocardial ischemia (over 70% stenosis of LAD,MS group) and 16 healthy subjects (control group) were included. The long axis view and 2-chambers view of left ventricle at the apex of heart were acquired. The longitudinal velocity, displacement, strain and strain rate were analyzed with off-line. Results: In control group, longitudinal peak systolic velocity(Vs)and peak displacement(D)decreased progressively from base level to apex level in anterior wall and anterior septal wall (P⬍0.05), while peak strain (S) and peak systolic strain rate (SRs) kept the same in three levels. S and SRs significantly decreased in all segments of infarcted myocardium (P⬍0.05), compared with normal and ischemic myocardium. In ischemic myocardium, only base and middle segments strain of anterior wall decreased (P⬍0.05). A myocardial S lower than -6.94% in at least one segment showed best sensitivity (100%) and specificity (100%) for detecting an infarcted left ventricle. A myocardial SR lower than -0.81% in at least one segment showed 100% sensitivity and 80% specificity, and lower than -0.46% showed 83% specificity and 100% sensitivity. Conclusion: VVI is a useful tool for assessing myocardial regional function. Especially, S and SR were useful predictors of the presence of regional dysfunction in infarcted myocardium. Key Words: velocity vector imaging (VVI); infarted myocardium; ischemic myocardium; echocardiography
Volume 35, Number 8S, 2009 drainage continuous to drain the pericardial effusions. It is also convenient to irrigation and administering drugs. Keywords: Ultrasonography; Pericardial effusion; Drainage; Catheter, Indwelling 1182 Enhanced Early Diastolic Left Ventricular Mismatch between Wall Motion and Inflow by Preload Augmentation: Assessment by Dual-Doppler Echocardiography Hirotsugu Yamada, The University of Tokushima, Japan Kenya Kusunose, The University of Tokushima, Japan Noriko Tomita, The University of Tokushima, Japan Yoko Tadatsu, The University of Tokushima, Japan Susumu Nishio, Tokushima University Hospital, Japan Mitsuyo Sato, Tokushima University Hospital, Japan Hazuki Hiraoka, Tokushima University Hospital, Japan Masataka Sata, The University of Tokushima, Japan Background: Early diastolic mitral annular motion occurs concomitant with or prior to transmitral flow in healthy subjects, whereas the flow precedes the annular motion in evaluation of end-diastolic pressure (LVEDP). We evaluated the degree of this mismatch using dual Doppler echocardiography and compared with catheter derived invasive indices. Methods: Twenty patients who underwent cardiac catheterization were recruited for this study. Transmitral flow and mitral annular velocities were simultaneously recorded by Dual Doppler echocardiographic system (Hitachi EUB-8500). Time interval between the onset of flow and motion (Te’-E) was measured before and after lower body positive pressure (LBPP). Results: LVEDP was increased during LBPP while tau did not change. The peak early diastolic inflow velocity and Te’-E increased during LBPP, although the peak mitral annular velocity did not change. The Te’-E correlated well with LVEDP (r⫽0.78, p⬍0.01). Conclusions: Elevation of LVEDP prolonged the Te’-E, suggesting that it enhanced early diastolic mismatch between mitral inflow and annular motion. The Te’-E is a sensitive index for noninvasive estimation of LVEDP and dual Doppler echocardiography is practical method for measuring this index accurately.
1181 Ultrasound-Guided Subxiphoid Indwelling Catheter Insertion into Pericardial Cavity Li Xiaolin, Ultrasound Department, The No. 2 Hospital of General Hospital of the People’s Liberation Army, China Subject: To study the clinical effect of subxiphoid indwelling catheter into pericardial cavity for the treatment of refractory tuberculous pericardial effusion by ultrasound guided for the whole process and real time. Methods: 51 patients with refractory tuberculous pericardial effusion were given 1⬃2 kinds of antituberculotic never used before in each case to ALP [amikacin sulphate(A), Levofloxacin(L), Sodium Aminosalicylate(P)], and subxiphoid inserted catheter into pericardial cavity with drainage and administered drugs (isoniazid, rifampicin, dexamethasone) regularly. The treating courses spend a mean 3 months. Results: Pericardiocentesis in 51 patients were successfully without complication. The catheters were remained for 21-60 days, with an average of 32⫾3 days. The fluid volume was 1700-3800ml, with an average of 2400⫾55ml. The patients’ uncomfortable symptom all disappeared, and pericardial effusion was absorbed completely. Nobody get constrictive pericarditis. Conclusion: It is a safe treatment of subxiphoid indwelling catheter into pericardial cavity by ultrasound-guided to therapy refractory tuberculous pericardial effusion, which can avoid myocardial trauma and
1183 Diastolic Heart Function and Tei-Index in Chronic Stable Coronary Artery Disease Ilias Zarkos, 3rd IKA Hospital, Greece Irini Vrana, 3rd IKA Hospital, Greece Gerasimos Livieratos, 3rd IKA Hospital, Greece Athanasios Triadafyllou, 3rd IKA Hospital, Greece Objectives: To find the correlation between the global myocardial performance index (Tei-index) and the classic Echo-parameters associated with the diastolic function of the heart, with ischemic parameters, as detected in stress-test, in chronic stable coronary artery disease. Methods: 79 patients (65 male, 14 female, mean age 54,3⫾4,1yrs), all with established (by coronary angiography) coronary artery disease, underwent an Echo-test and a stress treadmill test. We studied by Echo the following parameters: Tei-index, systolic parameters (EF, LVESV, LVEDV, SV), and diastolic parameters (Evel, Avel, E/A, IVRT, dtE, dtA) of the heart function. We studied also by stress-treadmill test, using the Bruce protocol, the following parameters: ST depression, exercise time, Duke treadmill score, Athens QRS score, QRS duration, Heart rate Recovery. Statistical analysis was performed using paired t-test (SPSS, version 14.0 for Windows). Results: In the patients (62) with signs of active myocardial ischemia in stress-test, Tei-index was 0,36⫾0,13. In the absence of active myocardial
Ultrasound in Medicine and Biology
1180 Research of Longitudinal Motion of Infarcted Myocardium and Ischemic Myocardium with Velocity Vector Imaging Hong Tang, West China Hospital of Sichuan University, Chengdu, China Zhaohuan Li, West China Hospital of Sichuan University, Chengdu, China Yuan Feng, West China Hospital of Sichuan University, Chengdu, China Objective: To analysis longitudinal motion of infarcted myocardium and ischemic myocardium with a new echocardiographic technology, velocity vector imaging(VVI), and assess its accuracy. Methods: 6 patients suffered acute anterior myocardial infartion (MI group), 9 patients had myocardial ischemia (over 70% stenosis of LAD,MS group) and 16 healthy subjects (control group) were included. The long axis view and 2-chambers view of left ventricle at the apex of heart were acquired. The longitudinal velocity, displacement, strain and strain rate were analyzed with off-line. Results: In control group, longitudinal peak systolic velocity(Vs)and peak displacement(D)decreased progressively from base level to apex level in anterior wall and anterior septal wall (P⬍0.05), while peak strain (S) and peak systolic strain rate (SRs) kept the same in three levels. S and SRs significantly decreased in all segments of infarcted myocardium (P⬍0.05), compared with normal and ischemic myocardium. In ischemic myocardium, only base and middle segments strain of anterior wall decreased (P⬍0.05). A myocardial S lower than -6.94% in at least one segment showed best sensitivity (100%) and specificity (100%) for detecting an infarcted left ventricle. A myocardial SR lower than -0.81% in at least one segment showed 100% sensitivity and 80% specificity, and lower than -0.46% showed 83% specificity and 100% sensitivity. Conclusion: VVI is a useful tool for assessing myocardial regional function. Especially, S and SR were useful predictors of the presence of regional dysfunction in infarcted myocardium. Key Words: velocity vector imaging (VVI); infarted myocardium; ischemic myocardium; echocardiography
Volume 35, Number 8S, 2009 drainage continuous to drain the pericardial effusions. It is also convenient to irrigation and administering drugs. Keywords: Ultrasonography; Pericardial effusion; Drainage; Catheter, Indwelling 1182 Enhanced Early Diastolic Left Ventricular Mismatch between Wall Motion and Inflow by Preload Augmentation: Assessment by Dual-Doppler Echocardiography Hirotsugu Yamada, The University of Tokushima, Japan Kenya Kusunose, The University of Tokushima, Japan Noriko Tomita, The University of Tokushima, Japan Yoko Tadatsu, The University of Tokushima, Japan Susumu Nishio, Tokushima University Hospital, Japan Mitsuyo Sato, Tokushima University Hospital, Japan Hazuki Hiraoka, Tokushima University Hospital, Japan Masataka Sata, The University of Tokushima, Japan Background: Early diastolic mitral annular motion occurs concomitant with or prior to transmitral flow in healthy subjects, whereas the flow precedes the annular motion in evaluation of end-diastolic pressure (LVEDP). We evaluated the degree of this mismatch using dual Doppler echocardiography and compared with catheter derived invasive indices. Methods: Twenty patients who underwent cardiac catheterization were recruited for this study. Transmitral flow and mitral annular velocities were simultaneously recorded by Dual Doppler echocardiographic system (Hitachi EUB-8500). Time interval between the onset of flow and motion (Te’-E) was measured before and after lower body positive pressure (LBPP). Results: LVEDP was increased during LBPP while tau did not change. The peak early diastolic inflow velocity and Te’-E increased during LBPP, although the peak mitral annular velocity did not change. The Te’-E correlated well with LVEDP (r⫽0.78, p⬍0.01). Conclusions: Elevation of LVEDP prolonged the Te’-E, suggesting that it enhanced early diastolic mismatch between mitral inflow and annular motion. The Te’-E is a sensitive index for noninvasive estimation of LVEDP and dual Doppler echocardiography is practical method for measuring this index accurately.
1181 Ultrasound-Guided Subxiphoid Indwelling Catheter Insertion into Pericardial Cavity Li Xiaolin, Ultrasound Department, The No. 2 Hospital of General Hospital of the People’s Liberation Army, China Subject: To study the clinical effect of subxiphoid indwelling catheter into pericardial cavity for the treatment of refractory tuberculous pericardial effusion by ultrasound guided for the whole process and real time. Methods: 51 patients with refractory tuberculous pericardial effusion were given 1⬃2 kinds of antituberculotic never used before in each case to ALP [amikacin sulphate(A), Levofloxacin(L), Sodium Aminosalicylate(P)], and subxiphoid inserted catheter into pericardial cavity with drainage and administered drugs (isoniazid, rifampicin, dexamethasone) regularly. The treating courses spend a mean 3 months. Results: Pericardiocentesis in 51 patients were successfully without complication. The catheters were remained for 21-60 days, with an average of 32⫾3 days. The fluid volume was 1700-3800ml, with an average of 2400⫾55ml. The patients’ uncomfortable symptom all disappeared, and pericardial effusion was absorbed completely. Nobody get constrictive pericarditis. Conclusion: It is a safe treatment of subxiphoid indwelling catheter into pericardial cavity by ultrasound-guided to therapy refractory tuberculous pericardial effusion, which can avoid myocardial trauma and
1183 Diastolic Heart Function and Tei-Index in Chronic Stable Coronary Artery Disease Ilias Zarkos, 3rd IKA Hospital, Greece Irini Vrana, 3rd IKA Hospital, Greece Gerasimos Livieratos, 3rd IKA Hospital, Greece Athanasios Triadafyllou, 3rd IKA Hospital, Greece Objectives: To find the correlation between the global myocardial performance index (Tei-index) and the classic Echo-parameters associated with the diastolic function of the heart, with ischemic parameters, as detected in stress-test, in chronic stable coronary artery disease. Methods: 79 patients (65 male, 14 female, mean age 54,3⫾4,1yrs), all with established (by coronary angiography) coronary artery disease, underwent an Echo-test and a stress treadmill test. We studied by Echo the following parameters: Tei-index, systolic parameters (EF, LVESV, LVEDV, SV), and diastolic parameters (Evel, Avel, E/A, IVRT, dtE, dtA) of the heart function. We studied also by stress-treadmill test, using the Bruce protocol, the following parameters: ST depression, exercise time, Duke treadmill score, Athens QRS score, QRS duration, Heart rate Recovery. Statistical analysis was performed using paired t-test (SPSS, version 14.0 for Windows). Results: In the patients (62) with signs of active myocardial ischemia in stress-test, Tei-index was 0,36⫾0,13. In the absence of active myocardial