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|a urn:nbn:de:hbz:6-72329482082
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|a ger
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|a 610 Medizin und Gesundheit
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|a Landgraf, Christian
|0 http://d-nb.info/gnd/1055933875
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|a Universitäts- und Landesbibliothek Münster
|0 http://d-nb.info/gnd/5091030-9
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|a Deformationsanalyse der Fabry-Kardiomyopathie durch 3D-Speckle-Tracking-Echokardiographie
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|a Deformationsanalyse der Fabry-Kardiomyopathie durch 3D Speckle Tracking Echokardiographie
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|a [Electronic ed.]
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|c 2014
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|b Universitäts- und Landesbibliothek Münster
|c 2014-08-25
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|a Inhaltsverzeichnis -- Abbildungsverzeichnis ...................................................................................................... 3 -- Tabellenverzeichnis .......................................................................................................... 4 -- Abkürzungsverzeichnis ..................................................................................................... 5 -- 1 Einleitung ............................................................................................................ 6 -- 2 Morbus Fabry ......................................................................................................... 7 -- 2.1 Übersicht ....................................................................................................................... 7 -- 2.2 Genetik und Epidemiologie ........................................................................................... 7 -- 2.3 Symptome ..................................................................................................................... 8 -- 2.4 Kardiale Beteiligung ................................................................................................... 10 -- 2.5 Diagnose ...................................................................................................................... 12 -- 2.6 Therapie ....................................................................................................................... 14 -- 3 Physikalische und technische Grundlagen der Echokardiographie ................ 17 -- 3.1 Schall ........................................................................................................................... 17 -- 3.2 Ultraschallbildgebung ................................................................................................. 22 -- 3.3 Konventionelle Echokardiographie ............................................................................. 24 -- 3.3.1 M-Mode ............................................................................................................... 24 -- 3.3.2 B-Mode ............................................................................................................... 25 -- 3.4 3D-Echokardiographie ................................................................................................ 25 -- 3.4.1 3D-Rekonstruktion .............................................................................................. 25 -- 3.4.2 Echtzeit-3D-Echokardiographie .......................................................................... 25 -- 3.5 Doppler-Verfahren ...................................................................................................... 26 -- 3.5.1 Kontinuierlicher Doppler .................................................................................... 27 -- 3.5.2 Gepulster Doppler ............................................................................................... 27 -- 3.5.3 Farbdoppler ......................................................................................................... 28 -- 3.5.4 Gewebedoppler .................................................................................................... 28 -- 3.6 Speckle Tracking ......................................................................................................... 29 -- 4 Bewegung und Verformung ................................................................................. 32 -- 4.1 Theoretische Grundlagen ............................................................................................ 32 -- 4.1.1 Bewegung ............................................................................................................ 32 -- 4.1.2 Strain ................................................................................................................... 32 -- 4.2 Anwendung in der Echokardiographie ........................................................................ 34 -- 4.3 Koordinatensysteme .................................................................................................... 36 -- 4.3.1 Das Kartesische Koordinatensystem ................................................................... 37 -- 4.3.2 Das Ultraschallkoordinatensystem ...................................................................... 37 -- 4.3.3 Das lokale Herzkoordinatensystem ..................................................................... 37 -- 4.3.4 Bewegung des Herzmuskels ................................................................................ 38 -- 4.4 Parameter ..................................................................................................................... 41 -- 4.5 Vergleich der Verfahren .............................................................................................. 42 -- 5 Methoden ............................................................................................................... 44 -- 5.1 Echokardiographie ...................................................................................................... 44 -- 5.1.1 Standarduntersuchung ......................................................................................... 44 -- 5.1.2 Verformungsbildgebung ...................................................................................... 46 -- 5.2 Speckle Tracking Analyse ........................................................................................... 46 -- 5.2.1 2D Speckle Tracking ........................................................................................... 48 -- 5.2.2 3D Speckle Tracking ........................................................................................... 49 -- 5.2.3 Werte und Bezeichnungen................................................................................... 51 -- 5.3 Statistik ........................................................................................................................ 51 -- 6 Studienpopulation ................................................................................................. 52 -- 6.1 Patientenkollektiv ........................................................................................................ 52 -- 6.1.1 Untersuchungen im Fabry-Zentrum .................................................................... 52 -- 6.1.2 Kardiale Befunde ................................................................................................. 54 -- 6.2 Kontrollkollektiv ......................................................................................................... 55 -- 6.2.1 Kardiale Befunde ................................................................................................. 56 -- 7 Ergebnisse ............................................................................................................. 57 -- 7.1 3D Speckle Tracking ................................................................................................... 58 -- 7.1.1 Strain ................................................................................................................... 58 -- 7.1.2 Area Tracking und 3D-Strain .............................................................................. 58 -- 7.1.3 Displacement ....................................................................................................... 59 -- 7.1.4 Rotation ............................................................................................................... 60 -- 7.1.5 Twist und Torsion ............................................................................................... 60 -- 7.1.6 Segmentale Analyse ............................................................................................ 60 -- 7.2 2D Speckle Tracking ................................................................................................... 61 -- 7.2.1 Strain ................................................................................................................... 61 -- 7.2.2 Displacement ....................................................................................................... 62 -- 7.2.3 Rotation ............................................................................................................... 62 -- 7.3 Korrelationen zwischen 3D und 2D Speckle Tracking ............................................... 63 -- 8 Diskussion .............................................................................................................. 68 -- 8.1 Speckle Tracking ......................................................................................................... 68 -- 8.1.1 Longitudinale Funktion ....................................................................................... 68 -- 8.1.2 Radiale Funktion ................................................................................................. 69 -- 8.1.3 Zirkumferenzielle Funktion ................................................................................. 70 -- 8.1.4 Rotation, Twist und Torsion ................................................................................ 70 -- 8.1.5 Area Tracking, 3D-Strain und 3D-Displacement ................................................ 70 -- 8.1.6 Segmentale Analyse ............................................................................................ 71 -- 8.1.7 Korrelationen zwischen 3D und 2D Speckle Tracking ....................................... 72 -- 8.1.8 Bewegung oder Verformung ............................................................................... 73 -- 8.2 Limitationen der Studie ............................................................................................... 74 -- 8.3 Ausblick ...................................................................................................................... 74 -- 9 Zusammenfassung ................................................................................................ 76 -- 10
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|a Der Morbus Fabry ist eine angeborene Stoffwechselstörung, die u. a. zu einer progredienten Hypertrophie des Herzmuskels führt. Diese "Fabry-Kardiomyopathie" wurde mittels 2D und 3D Speckle Tracking Echokardiographie untersucht: Hierfür wurden 15 Patienten (40 ± 15 Jahre, 9 m., 6 w.) mit 15 in Alter und Geschlecht abgestimmten herzgesunden Kontrollen verglichen. Ausmaß (Peak) und Zeitpunkt (Time to Peak) des systolischen Kontraktionsmaximums wurden in Parametern der Bewegung und Verformung analysiert. Signifikante Unterschiede zeigten sich v. a. in Parametern der longitudinalen Funktion (L. Strain, L. Displacement, Area Tracking, 3D-Displacement) als verzögerte Time to Peak bei M. Fabry. Globale 3D Parameter erwiesen sich als besonders stabil. Hinsichtlich Peak konnten ebenso wenig aussagekräftige Unterschiede festgestellt werden wie in Parametern der radialen und zirkumferenziellen Funktion. Die Korrelation zwischen 2D und 3D Verfahren war in Longitudinal Strain und Displacement gut.
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|a The present study analyzes the suitability of two‐ and three‐dimensional (2D/3D) speckle tracking echocardiography (STE) for early detecting abnormalities of left ventricular (LV) deformation of Fabry disease (FD) patients.15 FD patients (9 males, 40 ± 15 years) and 15 age‐ and gender‐matched healthy controls underwent 2D and 3D STE.LV deformation was analyzed on global and segmental level. ANOVA was performed for systolic peak and time to peak values.Inter‐technique comparisons included correlation and Bland‐Altman analysis.The main finding was a prolonged time to peak in FD patients in parameters associated with longitudinal function, most significantly in global 3D longitudinal displacement, strain, 3D‐displacement and area tracking.There were no significant differences in corresponding peak values or regarding radial and circumferential function.Global 3D parameters emerged to be particularly stable. Inter‐technique agreement was best in longitudinal strain and displacement.
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|a specialized
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|a InC 1.0
|u https://rightsstatements.org/vocab/InC/1.0/
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|a Morbus Fabry
|a 3D Speckle Tracking Echokardiographie
|a Longitudinale Funktion
|a Strain
|a Displacement
|a Area Tracking
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|a Fabry disease
|a Three‐dimensional speckle tracking echocardiography
|a Longitudinal function
|a Strain
|a Displacement
|a Area tracking
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|2 DRIVER Types
|a Dissertation/Habilitation
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|a Text
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|a Stypmann, Jörg
|0 http://d-nb.info/gnd/172952247
|0 http://viaf.org/viaf/240986703
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|u https://nbn-resolving.de/urn:nbn:de:hbz:6-72329482082
|u urn:nbn:de:hbz:6-72329482082
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|u https://repositorium.uni-muenster.de/document/miami/56ca8ba7-5501-4774-af10-79c6be7f7b82/diss_landgraf.pdf
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