采用超声心动图探测冠状静脉窦评价运动员心肌灌注

目的:探讨适用于运动员的无创性心肌灌注评价方法。方法:采用彩色多普勒超声心动图,对206名不同训练等级的现役运动员(运动员组)和218名普通中学生(对照组)进行心脏结构指标、功能指标及灌注指标的测定,并计算冠状静脉窦血流量、左室重量及左室重量指数。分别分析、比较对照组与运动员组以及不同级别运动员的心脏超声测量指标。结果:运动员组冠状静脉窦内径、振幅、速度时间积分和血流量均显著大于对照组(P<0.05),不同级别运动员间冠状静脉窦的速度时间积分和血流量亦不相同,由1级至无级别呈递减趋势。结果表明,超声心动图探测冠状静脉窦可作为评价运动员心肌灌注的一种无创性方法。     

优秀耐力、力量项目运动员心脏形态功能特点

目的:探讨我国优秀耐力、力量项目运动员心脏形态功能特点。方法:运用超声心动图技术对78名优秀耐力、力量项目运动员心脏形态、功能进行分析研究。结果:(1)在心脏形态方面,耐力项目男运动员主肺动脉内径、左室舒张末期前后径、室间隔运动幅度、左室后壁运动幅度、右室内径、左房前后径各指标均显著高于力量项目男运动员(P<0.01);耐力项目女运动员的心脏形态各指标均显著高于力量项目女运动员(P<0.01)。(2)在心脏功能方面,耐力项目男运动员左室舒张末期容积、左室心输出量、左室射血分数、左室缩短分数等均显著高于力量项目男运动员(P<0.01);而耐力项目女运动员二尖瓣前向血流E峰、二尖瓣前向血流A峰、二尖瓣峰值流速E/A、主动脉瓣最大血流速度、左室舒张末期容积、左室收缩末期容积、左室心输出量、左室射血分数、左室缩短分数等均显著高于力量项目女运动员(P<0.01)。结论:(1)在心脏形态方面,相对于力量项目运动员,耐力项目运动员左室、右室和左房明显扩大。(2)在心脏功能方面,耐力项目男运动员左室收缩功能强于力量项目男运动员;而耐力项目女运动员左室舒张和收缩功能以及顺应性均好于力量项目。     

优秀女子足球运动员安静、力竭运动后和恢复期心缩间期的变化

目的:探讨女子足球运动员心脏功能及耐力水平。方法:利用MCA-3C心脏功能信息综合检测仪对女子足球运动员(女足组,n=10)、体育学院体育教育专业(体教组,n=10)和普通院系(对照组,n=10)女大学生进行安静时、力竭运动后和恢复期心缩间期(STI)测试并比较相关指标。结果:女足组无论在安静状态下还是力竭运动后和恢复期,左室射血时间(LVET)、心脏机械收缩时间(MST)均显著高于体教组和对照组(P<0.01);射血前期/左室射血时间(PEP/LVET)、等容收缩期(ICT)、等容收缩期/左室射血时间(ICT/LVET)均低于体教组和对照组;达到力竭的时间和强度也高于体教组和对照组。结果表明,女子足球运动员的心脏功能和耐力素质均优于体育教育专业和普通院系大学生。     

女子速滑运动员左心室形态结构与功能特征

以解放军速滑队和沈阳体育学院附属竞技体校共10名优秀女子速滑运动员为对象,研究她们的左心室形态结构与功能特征.结果表明,女子速滑运动员心脏的左心室腔明显增大,左心室后壁厚度、室间隔厚度明显增厚;与普通女大学生对照组相比,左室心肌重量及重量指数、每搏量均明显提高.女子速滑运动员左心室舒张末期内径的增加是速滑运动员通过训练获得良好心脏适应的特征性表现.女子速滑运动员在安静状态下心脏具有明显的能量节省化现象,其心功能储备能力较强.     

磁共振心肌应变定量评价心肌淀粉样变及与心肌初始T1值和ECV值的相关性分析

目的:探讨磁共振心肌应变定量评价心肌淀粉样变性(CA)价值及与心肌初始T1值和细胞外容积分数(ECV)值的相关性.方法:对30例CA患者(CA组)、10例可疑CA患者(可疑CA组)、20例肥厚型心肌病患者(HCM组)及40名健康志愿者(健康对照组)行3.0 T心脏磁共振检查(CMR),扫描序列包括心脏电影、T1 map...     

健康人直立运动时左室舒末容量的变化

<正> 本文研究了121名健康人运动对左室舒末容量的影响。在自行车测功计上完成直立位多级运动试验,运动负荷从200kpm/min开始,每隔2′增加100 kpm,直至筋疲力竭。左室舒末容量是用放射核素~(99m)锝血管造影术获得的。根据运动耐力状况把受试者分成三组。第一组为运动时间≤7.5′,第二组运动时间为7.6—15′,第三组为>15′。这三组的结果均显示左室舒末容量增加和收末容量的减少。第三组的受试者最为年轻,运动时心率最     

电影磁共振成像对左室心脏功能的研究

目的　研究电影磁共振成像 (cine MRI)对左室心脏功能的测定。资料与方法　通过对 6 0名健康成年人进行cine MRI,并均经询问病史、体格检查、X线胸片、心脏B超等检查确诊为健康者。分别对其测定心脏功能运动指标 ,其中包括舒张末容积、收缩末容积、每搏输出量、射血分数以及室壁的厚度测量等运动指标。结果　图像能够清晰地显示心室壁形态结构 ;左室舒张末容积为 10 1.3± 14.6ml,收缩末容积为 31.9± 9.8ml,射血分数 6 9.8±3.9%;左室后壁、室间隔厚度增厚率分别为 6 0 .6± 13.5 %和 5 7.8± 14.9%。结论　cine MRI对左室心脏功能的评价具有重要的临床价值。     

耐力运动员左室舒张期室壁多普勒频谱初步观察

目的与方法:采用用室壁多普勒频谱图,通过测定和比较普通人和耐力运动员在静息和逐级递增负荷运动时左室E波和A波峰值速度,探讨耐力运动员在静息状态和递增负荷运动时,左室后壁主动松弛和被动充盈功能的变化.结果:(1)静息状态下,耐力运动员组A波速度显著低于普通对照组(P<0.05).50W负荷和100W负荷时,耐力运动员组A波速度显著低于对照组(P<0.05);150W负荷时,两组无显著性差异(P>0.05);200W负荷时,耐力运动员组显著高于普通对照组(P<0.01).(2)静息状态下,普通对照组E波速度显著低于耐力运动员组(P<0.05).在递增负荷过程中,两组E波速度均有升高趋势,耐力组显著高于普通对照组(P<0.05).结果提示,与心力储备相似,心脏舒张功能也有一定的储备能力.心脏舒张功能在四级递增负荷中变化较静息状态更为明显,建议在评定心脏功能,特别是心脏的舒张功能时,引入运动负荷,可能更为准确、客观.     

无氧阈测定在耐力运动员中的预测和评定能力的意义

本文报告77名运动员在Monark自行车上作递增运动试验时达无氧阈和最大吸氧量时各指标的变化。77名受试者分成耐力项运动员60名和非耐力项运动员17名进行统计和比较。结果说明,自行车运动员各项数值较中长跑及非耐力项运动员的数值为大,尤以安静时,AT时的VO_2max,O_2P和HRmax为明显。作者认为,无氧阈的测定(以毫升/分表示(?)的o_2)可作为预测耐力能力的重要指标。     

我国入选第27届奥运会男运动员超声心动图特点

采用超声心动仪对 68名入选 2 0 0 0年奥运会的优秀男运动员进行测试 ,随机选取 2 5名健康学生作为对照 ,以观察与探讨当代优秀运动员左心结构与功能的改变及运动对心脏功能的影响。结果表明 :不同运动项目的运动员随着运动年限的延长 ,左室内径、左室重量及重量指数均有所增加。而室壁厚度仅有轻度的改变。运动员的主要心功能指标明显高于青年学生     

体重指数对中国成年男性左心结构和功能影响的心血管MRI研究

目的 应用心血管磁共振(cardiovascular magnetic resonance,CMR)评价体重指数(body mass index,BMI)对中国成年男性左心结构和功能的影响.方法 选取2010年10月～2018年3月行CMR检查的男性体检者共420例,年龄30 ～50岁,按体重指数(BMI)分为三组,正...     

Assessment of left ventricular volumes and mass with fast 3D cine steady-state free precession k-t space broad-use linear acquisition speed-up technique (k-t BLAST)

PURPOSE: To compare left ventricular (LV) volume and mass assessment using two-dimensional (2D) cine steady-state free precession (SSFP) and k-t space broad-use linear acquisition speed-up technique (k-t BLAST) accelerated 3D magnetic resonance imaging (MRI). MATERIALS AND METHODS: On a commercially available 1.5T MR scanner, 2D cine SSFP, six- and eight-fold accelerated 3D k-t BLAST were performed to evaluate LV volumes and mass in 17 volunteers. After semiautomatic segmentation of the different MR data sets, the resulting volumes and mass were compared according to the mean difference, 95% confidence interval, standard deviation (SD), Pearson's correlation coefficient, Bland-Altman analysis, and the Pitman-Morgan test. RESULTS: Data acquisition was successful in all subjects. The number of required breathholds was reduced from a maximal of five for the 2D cine SSFP sequence to two for 3D k-t BLAST sequences. Comparing LV volumes, there was excellent agreement between 2D and 3D cine 8x k-t BLAST SSFP volumes (mean difference +/- 2SD end-diastolic volume [EDV] = 5 +/- 8 mL, end-systolic volume [ESV] = 1 +/-12 mL, and stroke volume [SV] = 3 +/- 8 mL), and mass (-1.8 +/- 9 g). CONCLUSION: k-t BLAST-accelerated 3D sequences allow accurate assessment of LV volumes and mass compared to 2D cine SSFP. This method may reduce costs and increase patient comfort due to shortened data acquisition time and reduced number of breathholds.     

Normal limits of ejection fraction and volumes determined by gated SPECT in clinically normal patients without cardiac events: a study based on the J-ACCESS database

Purpose Quantitative gated single-photon emission computed tomography (SPECT) is known to have high accuracy and precision for measurement of the principal cardiac functional parameters. We hypothesised that normal values for EF and LV volumes may differ among nationalities, and that optimal threshold values specific to the study population are required. Methods Among 4,670 consecutively registered patients for a J-ACCESS (Japanese investigation regarding prognosis based on gated SPECT) study from 117 hospitals, a total of 268 (149 women, 119 men) were selected who had no baseline cardiac diseases and had experienced no cardiac events during the preceding 3-year period. A gated SPECT study was performed with ^99mTc-tetrofosmin and analysed with Cedars Sinai Medical Center’s quantitative gated SPECT (QGS) software. The results in respect of ejection fraction (EF), end-diastolic volume (EDV), end-systolic volume (ESV) and stroke volume (SV), and EDV, ESV and SV normalised by body surface area (EDVI, ESVI and SVI), were calculated and summarised to obtain normal limits. Results EF for women and men was 74 ± 9% and 63 ± 7%, respectively (p < 0.0001). EDV, ESV and SV were significantly smaller in women than in men. Based on multiple regressions for linear models, the primary and secondary predictors of EF, EDVI, ESVI were gender and age. By stepwise multiple regression analysis, a statistically significant third predictor for EDV, ESV, SV and SVI was body weight. No colinearity was found between age and body weight. Important factors for the studied Japanese population included a high incidence of small hearts in women and the relatively advanced age of the population (the mean age ±SD was 64.1 ± 10.0 years for women and 60.9 ± 11.7 years for men). Conclusion EF and volumes determined by gated SPECT with QGS were significantly affected by gender and age, with body weight as a third predictor for volumes. Moreover, the normal limits were so specific for the population studied that standards appropriate for the study in question should be utilised.     

高住高练低训对男子大学生运动员安静状态下左心室功能的影响

目的:探讨高住高练低训(HiHiLo)对运动员安静状态下左心室功能的影响。方法:大学生运动员在O2浓度相当于海拔2800m~3000m的常压低氧舱房每天居住10小时,在O2浓度相当于海拔2500m~2600m的室内每周训练3次,期间维持常氧训练,实验为期4周;采用超声心动图技术,于HiHiLo前后分别测量48名受试者心脏在安静时的形态结构学指标、收缩功能指标及舒张功能指标。结果:与HiHiLo前相比,4周后受试者左心室形态结构学指标中的LVIDd(左室舒张末期内径)、LVM(左室心肌质量)和LVMI(左室心肌质量指数)分别增加了0.93%(P=0.007)、2.87%(P=0.009)和3.59%(P=0.002);泵功能及舒张功能方面,SV(每搏量)、SI(每搏指数)和EDV(舒张末期容积)分别增加了1.99%(P=0.001)、2.71%(P=0.000)和0.97%(P=0.032),且DSV(每搏量变化量)与DEDV(舒张末期容积变化量)之间存在相关关系;DP(二项乘积)下降了9.35%(P=0.000)。结论:4周HiHiLo后受试者的左心室除产生了生理性肥厚外,其泵功能也显著改善,主要体现在舒张功能明显增强,而且心肌耗能趋向节约化。     

Quantitative analysis of cardiac left ventricular variables obtained by MRI at 3 T: a pre- and post-contrast comparison

Short-axis cine images are acquired during cardiac MRI in order to determine variables of cardiac left ventricular (LV) function such as ejection fraction (EF), end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV) and LV mass. In cardiac perfusion assessments this imaging can be performed in the temporal window between first pass perfusion and the acquisition of delayed enhancement images in order to minimise overall scanning time. The objective of this study was to compare pre- and post-contrast short-axis LV variables of 15 healthy volunteers using a two-dimensional cardiac-gated segmented cine true fast imaging with steady state precession sequence and a 3.0 T MRI unit in order to determine the possible effects of contrast agent on the calculated cardiac function variables. Image analysis was carried out using semi-automated software. The calculated mean LV mass was lower when derived from the post-contrast images, relative to those derived pre-contrast (102 vs 108.1 g, p<0.0001). Small but systematic significant differences were also found between the mean pre- and post-contrast values of EF (69.4% vs 68.7%, p<0.05), EDV (142.4 vs 143.7 ml, p<0.05) and ESV (44.2 vs 45.5 ml, p<0.005), but no significant differences in SV were identified. This study has highlighted that contrast agent delivery can influence the numerical outcome of cardiac variables calculated from MRI and this was particularly noticeable for LV mass. This may have important implications for the correct interpretation of patient data in clinical studies where post-contrast images are used to calculate LV variables, since LV normal ranges have been traditionally derived from pre-contrast data sets.     

Comparison of left ventricular functional parameters measured by gated single photon emission tomography and by two-dimensional echocardiography

The aim of the present study was to evaluate the correlation amongst left ventricular (LV) functional parameters estimated by gated single photon emission tomography (GSPET) and two-dimensional (2D) M-mode, echocardiography (ECHOC). GSPET was performed in a single day stress/rest protocol by using either technetium-99m methoxy-isobutyl-isonitrile ((99m)Tc-MIBI) or technetium-99m tetrofosmin ((99m)Tc-myoview) in 36 consecutive patients, 21 males and 15 females; mean age 57.6+/-11.8 y, range 32-82 y. The various LV parameters studied were: ejection fraction (EF), end systolic volume (ESV), end diastolic volume (EDV), stroke volume (SV) and LV mass (LVM). The GSPET data were reconstructed using an automatic algorithm employing filtered back projection (FBP) and further analyzed by Emory cardiac (EC) toolbox versions EO-00369 and EO-00733 for the quantitative determinations of these parameters. All patients underwent ECHOC within 1-2 h of the post-stress data acquisition of GSPET. Our results showed that the LV volumes and the LVM showed good correlation (r=0.749 to 0.952, P=0.01). These values could thus be used interchangeably. The assessment of these parameters by GSPET therefore does not seem to be affected by the dose of the radioactivity administered as the dose of the (99m)Tc-labeled myocardial agents for acquiring rest study was approximately four times higher than that for the stress study. Our results also showed that the mean +/- SD values of the volumes and the EF of the LV evaluated by the two techniques, differed significantly except significant correlations for ESV, EDV and LVEF were observed between the two methods: r=0.574 to 0.954; 0.347 to 0.952 and 0.516 to 0.876 respectively. On the other hand, a wide disagreement was observed in estimating the LVM by the two techniques. The LVM measurements by 2D ECHOC were approximately double the values estimated by GSPET. Despite the large disagreement, a small correlation (r=0.33, P=0.05) was observed for LVM between the two techniques. In conclusion, although we observed a good correlation for LV volumes and LVM between the GSPET and the ECHOC techniques, yet these two techniques cannot be used interchangeably.     

Reliability of respiratory-triggered two-dimensional cine k-adaptive-t-autocalibrating reconstruction for Cartesian sampling for the assessment of biventricular volume and function in patients with repaired tetralogy of Fallot

Objective:To compare left ventricular (LV) and right ventricular (RV) volume, function, and image quality of a respiratory-triggered two-dimensional (2D)-cine k-adaptive-t-autocalibrating reconstruction for Cartesian sampling (2D kat-ARC) with those of the standard reference, namely, breath-hold 2D balanced steady-state free precession (2D SSFP), in patients with repaired tetralogy of Fallot (TOF).Methods:30 patients (14 males, mean age 32.2 ± 13.9 years) underwent cardiac magnetic resonance, and 2D kat-ARC and 2D SSFP images were acquired on short-axis view. Biventricular end-diastolic volume (EDV) and end-systolic volume (ESV), stroke volume (SV), ejection fraction (EF), and LV mass (LVM) were analysed.Results:The 2D kat-ARC had significantly shorter scan time (35.2 ± 9.1 s vs 80.4 ± 16.7 s; p < 0.0001). Despite an analysis of image quality showed significant impairment using 2D kat-ARC compared to 2D SSFP cine (p < 0.0001), the two sequences demonstrated no significant difference in terms of biventricular EDV, LVESV, LVSV, LVEF, and LVM. However, the RVESV was overestimated for 2D kat-ARC compared with that for 2D SSFP (73.8 ± 43.2 ml vs 70.3 ± 44.5 ml, p = 0.0002) and the RVSV and RVEF were underestimated (RVSV = 46.2±20.5 ml vs 49.4 ± 20.4 ml, p = 0.0024; RVEF = 40.2±12.7% vs. 43.5±14.0%, p = 0.0002).Conclusion:Respiratory-triggered 2D kat-ARC cine is a reliable technique that could be used in the evaluation of LV volumes and function.Advances in knowledge:2D cine kat-ARC is a reliable technique for the assessment LV volume and function in patients with repaired TOF.     

Assessment of left ventricular function by breath-hold cine MR imaging: Comparison of different steady-state free precession sequences

PURPOSE: To compare steady-state free precession (SSFP) sequence protocols with different acquisition times (TA) and temporal resolutions (tRes) due to the implementation of a view sharing technique called shared phases for the assessment of left ventricular (LV) function by breath-hold cine magnetic resonance (MR) imaging. MATERIALS AND METHODS: End-diastolic and end-systolic volumes (EDV, ESV) were measured in contiguous short-axis slices with a thickness of 8 mm acquired in 10 healthy male volunteers. The following true fast imaging with steady-state precession (TrueFISP) sequence protocols were compared: protocol A) internal standard of reference, segmented: tRes 34.5 msec, TA 18 beats per slice; protocol B) segmented, shared phases: tRes 34.1 msec, TA 10 beats per slice; and protocol C) real-time, shared phases, parallel acquisition technique: tRes 47.3 msec, TA 24 beats for 12 slices covering the entire left ventricle. RESULTS: Phase sharing leads to a significant decrease in EDV, stroke volume (SV), and ejection fraction (EF) (median difference -7.0 mL [*], -9.6 mL, and -3.4%, respectively, for protocol B; -15.3 mL, -13.3 mL, and -2.4% for protocol C; P = 0.002, *P = 0.021). The observed median difference of real-time EDV and SV estimates is of clinical relevance. Real-time cine MR imaging shows a greater variability of EDV and SV. No relevant differences in ESV were observed. CONCLUSION: The true cine frame duration of both shared phases sequence protocols exceeds the period of isovolumetric contraction (IVCT) of the left ventricle resulting in a systematic and significant underestimation of EDV and consequently SV and EF. SSFP sequence protocol parameters, particularly tRes and use of view sharing techniques, should therefore be known at follow-up examinations in order to be able to assess LV remodeling in patients with heart failure.     

Validation of left ventricular volume measurements by gated SPECT Tc-labeled sestamibi imaging

Background. Previous studies have shown that gated single photon emission computed tomography (SPECT) technetium 99-labeled sestamibi imaging provides accurate and reproducible measurement of left ventricular (LV) ejection fraction (EF), wall motion, and thickening. This study examined the reliability of gated SPECT sestamibi imaging in measuring LV end-diastolic volume (EDV), end-systolic volume (ESV), and stroke volume (SV).Methods and Results. Gated SPECT measurements were compared with an independent nongeometrie method based on thermodilution SV and first-pass radionuclide angiographic EF (using a multicrystal gamma camera). Twenty-four patients aged 58 ± 11 years underwent cardiac catheterization and coronary angiography for evaluation of chest pain syndromes. None had primary valvular disease, intracardiac shunts, or atrial fibrillation.Results. The correlation between the two methods were as follows: EDV: R = 0.89, P < .001; ESV: R = .938, P < .001; SV: R = 0.577, P < .001. Bland-Altman plots showed mean differences (± standard deviation [SD]) for EDV of −14.3 ± 33.3 mL, for ESV of −0.4 ± 23.7 mL, and for SV of −13.9 ± 15.2 mL. The reproducibility of measuring EDV and ESV by gated SPECT was very high (r = 0.99 each).Conclusion. Gated ^99mTc-labeled sestamibi SPECT provides reproducible LV volume measurements. With validation of volume measurement, gated SPECT provides comprehensive assessment of regional and global LV function. This information is important in many patient groups such as those with ischemic cardiomyopathy, concomitant coronary and valve disease, and those who have had myocardial infarction. It will also be useful to assess the incremental value of LV volumes in risk assessment.     

Gender and strain variations in left ventricular cardiac function and mass determined with magnetic resonance imaging at 7 tesla in adult mice

OBJECTIVES: We sought to assess with magnetic resonance imaging (MRI) the influence of strain type and gender on left ventricular (LV) global function and mass in 3 inbred mouse strains with a normal cardiac phenotype. MATERIALS AND METHODS: A total of 30 mice from 3 inbred strains (C57BL/6, 29S2/SvPasCrl, and C3HFeJ) were studied on a 7.05-T MR scanner using ECG-triggered cine sequences. LV mass and volumes were calculated with inclusion and exclusion of papillary muscles (PMs) in the LV wall. RESULTS: Significant differences were found with strain and gender (P < 0.001), with strain-effect but no gender-effect for ejection fraction (EF), end-diastolic volume (EDV), and end-systolic volume (ESV). There were no differences in LV mass between strains but lower values in female mice except in the C3H strain. The exclusion of PMs led to the relative underestimation of EF (-6.1%) and of LV mass (-6.4 mg) and the relative overestimation of EDV (6.3 microL) and ESV (5.3 microL). Inter- and intraobserver reproducibility was better when PMs were included. CONCLUSION: The use of MRI demonstrates cardiac interstrain and gender-related phenotypic diversities that are essential factors to consider when building genomic databases and designing studies.