the method for evaluating cardiac function by echocardiography yasuhiro maejima md, phd 10. 16....
TRANSCRIPT
The method for evaluating cardiac f
unction by echocardiography
Yasuhiro Maejima MD, PhD
10. 16. 2008. Research Meeting
The features of echocardiography
1. Echocardiography is used to diagnose cardiovascular diseases. In fact, it is one of th
e most widely used diagnostic tests for heart disease. It can provide a wealth of hel
pful 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 si
gnal are recorded and displayed as monochronic dots. The location is proporti
onal to the distance from the reflective region, and the intensity contains the in
formation 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 ge
nerates a single ultrasonic beam with changing direction. This technique allow
s one to create a two-dimensional image, which has good lateral resolution bu
t lacks accuracy in the axial dimension.
2-D Echocardiography
Long axis view of the heart (Human)
Left ventricleAortaInterventricular septum
Right ventricle
Aortic valve
Mitral valve
Left atrium
Left ventricle
Left atrium
Aortic valve
Mitral valve
Right ventricle
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Left ventricle
Mitral valveLeft atrium
Aorta
Right ventricle
Long axis view of the heart in 2-D echocardiography (Mouse)
Left ventricle Papillary muscle
Interventricular septum
Right ventricle
Middle portion
Apical portion
Short axis view of the heart
Left ventricle
Right ventricle
Papillary muscle Left ventricle
M-mode image2-D short axis image
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2-D image → M-mode image
Human Mouse
Measurement parameters of left ventricle
End-systolic left ventricular diameter (L VEDD )
End-diastolic septal wall thickness (DSEP WT)
End-diastolic left ventricular diameter (L VEDD )
Right ventricle diameter
End-systolic posterior wall thickness (SPW WT)
End-diastolic posterior wall thickness (DPW WT)
End-systolic septal wall thickness (SSEP WT)
(Teicholz LE et al. Am J Cardiol. 1976)
2.4 + LVEDD
LVEF =
× 100
7× LVEDD3
2.4 + LVESD7× LVESD3
-
2.4 + LVEDD7× LVEDD3
Left ventricular ejection fraction (LVEF)
End Systolic Volume - End Diastolic Volume
End Diastolic Volume × 100
=
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:
Normal
Anterior MI
Abnormality of LV wall motion in acute myocardial infarction (short axis view)
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Abnormality of LV wall motion in acute myocardial infarction (apical view)
Normal
Anterior MI
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Images of mouse heart in acute myocardial infarction
Long axis
M-mode
LVEDD - LVESDLeft ventricular fractional shortening (%FS) =
LVEDD× 100
(Quinones MA et al. Chest. 1978)
LVEF (Simpson’s method) = π4 × Σ rn2 ×
L20
End-diastolic phase
L
r1,2,
3, ・・・
Alternative ways of evaluating LV systolic function
End-systolic phase
Image J: http://rsbweb.nih.gov/ij/ (Windows, Mac OS X)
Scion image: http://www.scioncorp.com/ (Windows Xp)
1. Download image analyzing software.
The method of evaluating echocardiographic data
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
table of “Results”.① ②
③
①&②
③
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
L VEDD
DSEP WT
L VEDD
SPW WTDPW WT
SSEP WT
8. Click the specific point that indicates R-R interval, time and
length on the raw data as described below:
① R-R interval: 4 points
② Time (0.2 sec): 2 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
False (part of mitral valve)
True posterior wall
When you evaluate echocardiographic data, be careful for confusing structures that is easy to mistake for LV wall: valves, papillary muscles.