ABSTRACT
Objective To evaluate the diagnostic accuracy of dual source CT angiography (DSCTA) for coronary artery stenosis.Methods During the period from November 2012 to November 2013, a total of 210 patients with coronary artery disease underwent DSCTA and selective coronary arteriography (CAG). Taking CAG as the gold standard, the diagnostic accuracy of DSCTA for coronary artery stenosis was evaluated. Thirty patients receiving DSCTA and 30 patients receiving CAG were selected, and all of them underwent stent implantation in the anterior descending branch after imaging examination. The angiography positions, the used time of PCI and the used dosage of contrast agent were compared between the two groups. Results DSCTA was performed in 210 patients and a total of 2 630 segments of coronary stenosis or occlusion were detected. Compared with CAG, the diagnostic sensitivity, specificity, positive predictive value and negative predictive value of DSCTA were 95.4%, 96.2%, 91.3%and 100%respectively, which were not significantly different from those obtained by CAG (P=0.066). In performing DSCTA, 2-3 angiography positions were used (2-4 positions less than that of CAG), the used time of PCI was about 15 min (about 10 min less than that of CAG), and the mean used dosage of contrast agent was 48 ml (30-150 ml) (about half less than that of CAG). Conclusion DSCTA has higher accuracy in diagnosing coronary artery stenosis, quite similar to that of CAG. DSCTA is a safe, reliable and noninvasive examination method. Preoperative DSCTA can reduce exposure positions during angiography, can reduce the dosage of contrast agent, and can shorten the time of PCI as well, thus, iatrogenic radioactive radiation dose can be reduced.
ABSTRACT
Objective To investigate the changes of heart function after pacing in right ventricular inlet septum(RVIS) and right ventricular apex(RVA). Methods VVI pacing was performed in 64 patients who were randomly divided into two groups: RVIS group (33 patients) and RVA group (31 patients). The changes of serum brain natriuretic peptide (BNP),pacing parameters and QRS interval were assessed in 24 hours, 3 months and 1 year after the ventricle was paced effectively. Results When the ventricle was paced effectively,the pacing parameters,including voltage threshold and electrode impedance were similar in different stages between the two groups. In 24 hours, 3 months and 1 year after the ventricle was paced effectively,the QRS interval in RVIS group were obviously narrower than those in RVA group [( 128.0±28.6 ) ms vs ( 150.0 ± 37.1 ) ms, ( 131.0±21.5 ) ms vs ( 153.0 ±28.5 ) ms, ( 130.0 ±19.7 ) ms vs ( 155.0±20.2) ms, P < 0.05 ]. After treatment, the level of serum BNP increased significantly in two groups. The BNP level in R VIS group was significantly lower than that in RVA group (P < 0.05). Conclusion The R VIS pacing is not only as safe and effective as RVA pacing, but also is more consistent with the physiological ventricular activation sequence.
ABSTRACT
Objective To study the features of abnormal left ventricular diastolic function in ischemic myocardium by DTI (Doppler Tissue Imaging). Methods Left ventricular diastolic function was studied before and after coronary angiography in 24 patients suspected to have myocardial ischemia, left ventricular pressure parameters were obtained by left cardiac catheterization and diastolic velocity of left ventricular posterior wall (LVPW) was measured by DTI at the same time. Results 1.The lowest left ventricular diastolic pressure increased significantly during ischemia of myocardium(P