Right ventricular apical versus right ventricular outflow tract pacing: impact on left ventricular synchronization / 南方医科大学学报

<p><b>UNLABELLED</b>Objective To compare the impact of right ventricular apical (RVA) versus right ventricular outflow tract (RVOT) pacing on left ventricular systolic synchronization.</p><p><b>METHODS</b>Sixty patients were prospectively recruited and randomized into RVA group (n=30) with the right ventricle leads placed in the RVA and RVOT group (n=30) with right ventricle leads placed in the septum of the RVOT. Speckle tracking imaging was performed with 100% ventricle pacing to measure the differences in the time to maximum left ventricle (LV) radial strain.</p><p><b>RESULTS</b>In RVA group, the difference in the time to 6-segment maximum LV radial strain after pacing was 105.27 ± 19.74 ms, significantly greater than that in RVOT group (41.65 ± 12.17 ms, P<0.001). The standard difference of time to 6-segment maximum LV radial strain was also significantly greater in RVA group than in RVOT group (42.71 ± 17.63 vs 17.63 ± 5.62 ms, P<0.001).</p><p><b>CONCLUSION</b>Left ventricle systolic synchronizaition after RVOT pacing is superior to RVA pacing.</p>

Change of serum associated factors in patients with combined pulmonary fibrosis and emphysema / 中国综合临床

Objective To investigate the levels of transformation growth factor-β1 (TGF-β1),vascular endothelial growth factor (VEGF) and insulin growth factor-Ⅰ (IGF-Ⅰ) role in the pathogenesis of serum of patients with combined pulmonary fibrosis and emphysema (CPFE).Methods Recruited 20 patients with CPFE,40 cases with idiopathic pulmonary interstitial fibrosis (IPF) and 40 cases with emphysema who were admitted to our hospital during July 2011 to February 2012.Serum levels of TGF-β1,VEGF and IGF-Ⅰ were detected by ABC-ELISA.Results Serum levels of TGF-β1 and IGF-Ⅰ were significantly higher in patients with CPFE and IPF than these in patients with emphysema (TGF-β1:(160.73 ± 40.62) ng/L vs.(167.35 ± 42.82) ng/L vs.(128.75 ±35.77) ng/L; IGF-Ⅰ:(179.65 ±60.73) ng/L vs.(192.32 ±58.75) ng/L vs.(148.73 ±49.67) ng/L,P ＜ 0.05 or P ＜ 0.01).The IPF group had significantly higher serum level of VEGF than the emphysema group ((506.12 ±82.37) ng/L vs.(437.31 ±62.58) ng/L,P ＜0.01).Serum levels of TGF-β1 and IGF-Ⅰ in CPFE and emphysema groups were positively correlated (r =0.885,0.918 respectively,P ＜ 0.01).Smokers in the CPFE group had significandy lower level of serum VEGF than those who did no smoke ((406.19 ± 66.94) ng/L vs.(482.88 ± 79.91) ng/L,t =-2.287,P =0.035).Conclusion Serum level of VEGF increased significantly in the IPF group,suggesting the participation of VEGF in pulmonary interstitial fibrosis.IGF-Ⅰ involved in the pathogenesis of pulmonary interstitial fibrosis.TGF-β1 and IGF-Ⅰ have a positive linear regressive relationship,which indicates that they may work synergistically in the process of the fibrosis.