Objectives To assess left ventricular systolic function and synchrony, and the correlation between left ventricular systolic function, systolic synchrony, and end systolic spherical index in patients with acute anterior myocardial infarction and in patients with ischaemic heart failure by real time three-dimensional echocardiography (RT-3DE).

Methods

1. Study population: 22 patients with ischaemic heart failure. 20 patients with acute anterior wall myocardial infarction.

2. Protocol: A SIEMENS sc 2000 diasonograph with a real-time three-dimensional 4zV-1 matrix probe was applied at the department of ultrasound of Second Hospital of Hebei Medical University. Imaging was performed for by the same doctor.

3. High quality images of two-dimensional ultrasonography were first collected using the 4v1c matrix probe. Then 4zV-1 matrix probe was placed at the apex of the heart, imaging of three-dimensional echocardiography was done after the apical four chamber view image was acquired. The software can automatically delineate dynamic 3D endocardial shape, display time-volume curve of 16 segments of left ventricle, and calculate left ventricular function parameters: LVEDV, LVESV, LVEF and LVSDI16. All images were kept for further analysis. The SDI of 5.12% as a cut-off value, judging whether left ventricular systolic synchronisation.

4. Statistical analysis: All data were represented as mean ± SD. All the statistical examinations were performed using either Student’s t-test or one-way ANOVA by SPSS 19.0 software. Data failing normality or equal variance were analysed by Kruskal-Wallis test. The correlation between two variables was analysed using linear correlation analysis.

Results

1. General condition

   The average age and heart rate were 55.85 ± 7.24 years old and 60.0 ± 7.5 bpm in the normal control group, repectively. The average age and heart rate were 60.14 ± 6.88 years old and 80 ± 9.09 bpm in patients with ischaemic heart failure, repectively. The average age and heart rate were 57.80 ± 11.27 years old and 77.50 ± 8.26 bpm in patients with acute anterior myocardial infarction. There is no significant difference in age and heart rate between normal control group and the other two groups.

2. The left ventricular function and synchronism in different groups

   2.1 1 group: The average SDI16, LVEF and ESSI were 2.15 ± 0.88, 60.22 ± 4.22 and 35.72 ± 5.72, respectively. 2.2 2 group: The average SDI, LVEF and ESSI were 11.41 ± 5.53, 31.89 ± 8.35 and 66.29 ± 19.76, respectively.

   2.3 3 group: The average SDI, LVEF and ESSI were 6.01 ± 3.01, 42.13 ± 9.87 and 54.50 ± 12.30, respectively.

3. The LVEF was negatively correlated with SDI16 in 2 and 3 group

   The LVEF was negatively correlated with the ESSI in 2 and 3 group.

   The ESSI was positively correlated with SDI16 in 2 and 3 group.

4. Data obtained by two dimensional ultrasound and RT-3DE

   The LVEF was significatly larger by two dimensional ultrasound than by RT-3DE in 2 and 3 group

Conclusions Patients with heart failure have significantly lower left ventricular function and synchronicity than that of patients with myocardial infarction; The ESSI, SDI was positively correlated with LVEF in both myocardial infarction and ischaemic heart failure group, it may be a promising biomarker for evaluating left ventricular function.