Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Electrocardiography wikipedia , lookup
Coronary artery disease wikipedia , lookup
Aortic stenosis wikipedia , lookup
Quantium Medical Cardiac Output wikipedia , lookup
Myocardial infarction wikipedia , lookup
Jatene procedure wikipedia , lookup
Hypertrophic cardiomyopathy wikipedia , lookup
Atrial septal defect wikipedia , lookup
Lutembacher's syndrome wikipedia , lookup
Mitral insufficiency wikipedia , lookup
Arrhythmogenic right ventricular dysplasia wikipedia , lookup
The method for evaluating cardiac function by echocardiography 10. 16. 2008. Research Meeting Yasuhiro Maejima MD, PhD The features of echocardiography 1. Echocardiography is used to diagnose cardiovascular diseases. In fact, it is one of the most widely used diagnostic tests for heart disease. It can provide a wealth of helpful information, including the size and shape of the heart, its pumping capacity and the location and extent of any damage to its tissues. 2. It is especially useful for assessing diseases of the heart as follows: (1) Coronary artery disease: wall motion, systolic function (2) Cardiomyopathy (hypertrophic, dilated, etc): wall thickness, systolic function (3) Valvular heart disease: valvular dysfunction (stenosis, regurgitation) (4) Others: Pericardial diseases, Aortic diseases, Pulmonary vascular diseases 3. The biggest advantage to echocardiography is that it is noninvasive (doesn't involve breaking the skin or entering body cavities) and can do repeatedly. M-mode & 2-D echocardiography • Ultrasound is an acoustic wave with a frequency higher than 20 kHz. Echocardiography: 2.5〜3.5MHz (Human), 10〜12.5MHz (Mouse) • An echocardiogram is a recording of the reflected ultrasonic beam.There are two major types of echocardiography: M-mode and two-dimensional (2-D). • In the M-mode, a single beam of ultrasound is used. The reflections of the signal are recorded and displayed as monochronic dots. The location is proportional to the distance from the reflective region, and the intensity contains the information about acoustic impedance of the region. The M-mode has excellent axial resolution, but it carries essentially one-dimensional information. •The 2-D echocardiograph typically uses a multielement transducer, which generates a single ultrasonic beam with changing direction. This technique allows one to create a two-dimensional image, which has good lateral resolution but lacks accuracy in the axial dimension. 2-D Echocardiography Long axis view of the heart (Human) Interventricular septum Left ventricle Right ventricle Aortic valve Mitral valve Left atrium Aorta QuickTimeý Dz ÉVÉlÉpÉbÉN êLí£ÉvÉçÉOÉâÉÄ Ç™Ç±ÇÃÉsÉNÉ`ÉÉǾå©ÇÈǞǽDžÇÕïKóvÇÇ• ÅB Right ventricle Left ventricle Aortic valve Mitral valve Left atrium Long axis view of the heart in 2-D echocardiography (Mouse) Right ventricle Left ventricle Aorta Mitral valve Left atrium Short axis view of the heart Middle portion Right ventricle Interventricular septum Left ventricle Left ventricle Papillary muscle Apical portion Right ventricle QuickTimeý Dz ÉVÉlÉpÉbÉN êLí£ÉvÉçÉOÉâÉÄ Ç™Ç±ÇÃÉsÉNÉ`ÉÉǾå©ÇÈǞǽDžÇÕïKóvÇÇ• ÅB Papillary muscle Left ventricle 2-D short axis image M-mode image 2-D image → M-mode image Human Mouse Measurement parameters of left ventricle Right ventricle diameter End-diastolic septal wall thickness (DSEP WT) End-systolic septal wall thickness (SSEP WT) End-diastolic left ventricular diameter (LVEDD) End-systolic left ventricular diameter (LVEDD) End-diastolic posterior wall thickness (DPW WT) End-systolic posterior wall thickness (SPW WT) Left ventricular ejection fraction (LVEF) When we evaluate LVEF by M-mode echocardiography, we regard the heart as a oval solid of revolution. So we measure LVEDD and LVESD and then calculate an approximate value of LVEF by the formula as described below: LVEF = End Systolic Volume - End Diastolic Volume End Diastolic Volume = 7× LVEDD3 - 7× LVESD3 2.4 + LVEDD 2.4 + LVESD 7× LVEDD3 2.4 + LVEDD × 100 × 100 (Teicholz LE et al. Am J Cardiol. 1976) Abnormality of LV wall motion in acute myocardial infarction (short axis view) Normal QuickTimeý Dz Sorenson Video 3 êLí£ÉvÉçÉOÉâÉÄ Ç™Ç±ÇÃÉsÉNÉ`ÉÉǾå©ÇÈǞǽDžÇÕïKóvÇÇ• ÅB QuickTimeý Dz Sorenson Video 3 êLí£ÉvÉçÉOÉâÉÄ Ç™Ç±ÇÃÉsÉNÉ`ÉÉǾå©ÇÈǞǽDžÇÕïKóvÇÇ• ÅB Anterior MI QuickTimeý Dz Sorenson Video 3 êLí£ÉvÉçÉOÉâÉÄ Ç™Ç±ÇÃÉsÉNÉ`ÉÉǾå©ÇÈǞǽDžÇÕïKóvÇÇ• ÅB Abnormality of LV wall motion in acute myocardial infarction (apical view) Normal QuickTimeý Dz Sorenson Video 3 êLí£ÉvÉçÉOÉâÉÄ Ç™Ç±ÇÃÉsÉNÉ`ÉÉǾå©ÇÈǞǽDžÇÕïKóvÇÇ• ÅB QuickTimeý Dz Sorenson Video 3 êLí£ÉvÉçÉOÉâÉÄ Ç™Ç±ÇÃÉsÉNÉ`ÉÉǾå©ÇÈǞǽDžÇÕïKóvÇÇ• ÅB Anterior MI QuickTimeý Dz Sorenson Video 3 êLí£ÉvÉçÉOÉâÉÄ Ç™Ç±ÇÃÉsÉNÉ`ÉÉǾå©ÇÈǞǽDžÇÕïKóvÇÇ• ÅB Images of mouse heart in acute myocardial infarction Long axis M-mode Alternative ways of evaluating LV systolic function LVEDD - LVESD Left ventricular fractional shortening (%FS) = LVEDD × 100 (Quinones MA et al. Chest. 1978) L LVEF (Simpson’s method) = π 4 L × Σ rn 2 × 20 r1,2,3,・・・ End-diastolic phase End-systolic phase The method of evaluating echocardiographic data 1. Download image analyzing software. Image J: http://rsbweb.nih.gov/ij/ (Windows, Mac OS X) Scion image: http://www.scioncorp.com/ (Windows Xp) 2. Open the data file that was made by Excel file. 3. Input the information about your mice in the data file (red letters). 4. Open the raw data sent from Shumin by image analyzing software (“.bmp” file). 5. Click “Point selections” button (Image J). 6. To begin analyzing the echo data, click on the picture of raw data, push “Ctrl +M” button, and then you can see the ① table of “Results”.③ ② ③ ①&② 7. Click the specific point that indicates DSEP WT, LVEDD, DPW WT, SSEP WT, LVESD and SPW WT on the raw data and repeat this process for three times. Re:Measurement parameters of left ventricle DSEP WT LVEDD DPW WT SSEP WT LVEDD SPW WT 8. Click the specific point that indicates R-R interval, time and length on the raw data as described below: ② Time (0.2 sec): 2 points ① R-R interval: 4 points ③ Length (10 mm)R-R: 2 points 10. Copy the data of “X and Y” values from “Results” table. Then, paste that data on the specific area of data file. → We can get ECHO DATA ! Notice for evaluating echo data in M-mode When you evaluate echocardiographic data, be careful for confusing structures that is easy to mistake for LV wall: valves, papillary muscles. False (part of mitral valve) True posterior wall