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To observe and analyze the clinical efficacy and ultrasound detection results of treatment of hypertensive patients with heart disease with valsartan combined with hydrochorothiazide. The 160 hypertensive patients with heart disease who were treated in our hospital ere selected as study subjects and randomly divided into study group and reference group, each with 80 patients. Where, the reference group was solely treated with valsartan, while the study group received hydrochlorothiazide treatment on this basis. The therapeutic effects of the two groups were observed and analyzed. Comparison of the overall treatment efficacy and incidence of adverse reactions between the two groups showed that the study group had more significant advantages than the reference group, P<0.05; in comparison of systolic blood pressure and diastolic blood pressure after treatment between the two groups, the study group had higher improvement degree than the reference group, P<0.05; ultrasonic ECG inspection showed that the study group was superior to the reference group with better recovery in indexes including left ventricular mass index, Left ventricular posterior wall thickness, left ventricular ejection fraction, P<0.05. The combination of Valsartan and hydrochlorothiazide for hypertensive patients with heart disease can significantly improve the treatment effect and significanty reduce the incidence of adverse reactions. Therefore, it is worthly of popularization and application
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Objective To investigate the correlation of right ventricular (RV) to left ventricular (LV) volume ratio (RVv/LVv) measured by chest CT with pulmonary arterial pressure estimated by echocardiography before lung transplantation.Methods We reviewed 104 cases of lung transplant.According to the mean pulmonary arterial pressure (mPAP) exceeding 25 mmHg by right heart catheterization,hypertensive group (n =74) and normotensive group (n =30) were set up.Risk factors were assessed individually and adjusted for confounding by a multivariable logistic regression analysis.The area under the curve (AUC) for predicting pulmonary hypertension on chest CT and echocardiography was calculated.Results RVv/LVv and echocardiography-derived ptlmonary arterial systolic pressure (PASP) were significantly different between the two groups (P ＜ 0.05).In the hypertensive group,there was strong correlation between the RVv/LVv and PASP from catheterization (R =0.82,P＜0.001),also between the P ASP from echocardiography and catheterization (R =0.60,P＜ 0.001).The ROC curve displayed that with 0.85 as the cutoff for RVv/LVv,the sensmitivity,specificity and accuracy rate for predicting mPAP over 25 mmHg were 87.5％,91.8％ and 90.9％,respectively.The ROC curve also displayed that based upon an echocardiography-derived PASP of 35 mmHg as the cutoff point,the sensitivity,specificity and accuracy rate for predicting mPAP over 25 mmHg were 91.2％,90.8％ and 88.4％,respectively.Conclusion RV/LV volume ratios on chest CT and echocardiographic evaluation correlate well with PASP assessed by right heart catheterization and can be used to predict pulmonary hypertension with high sensitivity and specificity.
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Objective To determine the changes of heart structure and function in early stage after lung transplant and to study the relationship between decreased pulmonary artery pressure and changes of heart structure and function.Methods 45 cases of lung transplant recipients were included in the study,their preoperative and postoperative echocardiography data were reviewed,and the postoperative early changes of cardiac structure and function were analysed.Then,the Pearson correlation analysis was used to compare the relationships between the decrease of pulmonary artery pressure and the changes of cardiac structure and function.Results After lung transplant,pulmonary artery systolic pressure(PASP) decreased significantly [(62.3 ± 27.2) vs (36.20 ± 7.8)mm Hg,P ＜0.01],and right ventricular dimensions zoomed down,tricuspid valve and pulmonary valve regurgitation reduced,left atrial diameter (LAD) and left ventricular end-diastolic diameter (LVDD) were enlarged,stroke volume (SV) increased [(43.85 ± 14.78) vs (58.68 ± 13.85)],but left ventricular ejection fraction (LVEF) was decreased [(69.31 ± 7.50)％ vs (62.82 ± 8.12) ％],those differences above were statistically significant (P ＜ 0.05) compared with preoperative echocardiography date.Pearson linear correlation analysis show that after lung transplantation the more decreased PASP,the more increased LAD and LVDD,and the more decreased LVEF (P ＜0.05).Conclusions In early stage after lung transplant,the structure of right ventricular was quickly normalized,the function of right ventricular improved,LAD enlarged,SV increased,but left ventricular function reduced,there were a linear correlation between those changes and PASP reduced.Echocardiography has good reference value for early lung transplant patient.
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Objective To evaluate the role of real-time three-dimensional transesophageal echocardiography(RT3D-TEE) in non-valvular atrial fibrillation with left atrial appendage(LAA) stunning after catheter ablation.Methods Clinical and echocardiographic variables were analyzed by univariate regression in order to investigate the relationship between the group of LAA stunning and others in 28 patients after catheter ablation.Results Univariate analysis revealed difference in persisting time of atrial fibrillation[(16.4 ± 11.6)weeks vs (21.3 ± 18.6) weeks,P ＜0.05],left atrial diameter[(43.4 ± 8.3) mm vs (47.6 ± 5.9) mm,P ＜0.05 ],left atrial emptying fraction (0.38 ± 0.04 vs 0.30 ± 0.09,P ＜0.05).LAA emptying fraction based on three-dimensional volume measurements had significant difference (0.20 ± 0.03 vs 0.12 ± 0.02,P ＜ 0.001) between the group of LAA stunning and other cases.Conclusions LAA ejection fraction calculation by RT3D-TEE is feasible and more accurate than by clinical and other echocardiographic in LAA stunning after ablaton of atrial fibrillation.
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Objective To study the very early diagnosis of acute myocardial infarction (AMI) by harmonic imaging integrated backscatter(IBS).Methods Thirty normal persons,12 cases at the very early stage of AMI (in 2 hours),36 cases with AMI (in 2-12 hours) were examined by IBS and the cyclic variation of integrated backscatter (CVIB) with HP Sonos 5500 ultrasonic system in different areas (the areas of myocardial infarction and no myocardial infarction).Results In the areas of AMI of the very early stage (in 2 hours),IBS was much higher than that of the areas of normal (14.7 vs 8.3,P