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Objective To investigate the values of echocardiogram for evaluating the changes of left ventricular structure and cardiovascular function of the acute mountain sickness (AMS) patient before and after returning the plain.Methods A total of 33 light AMS patients returning to the plain in time underwent echocardiogram examinations on some cardiovascular indexes before and after returning the plain,including stroke volume (SV),cardiac output (CO),left atrial volume index (LAVI),left ventricular end-diastolic volume (LVEDV),early diastolic mitral flow velocity (E),late diastolic mitral flow velocity (A) and so on.Results The values of heart rate (HR),systolic blood pressure (SBP),diastolic blood pressure (DBP),CO,A and LAVI after going to the plateau were all significantly higher than those before going to the plateau (P＜0.05),while the values of SV,E,E/A and LVEDV were obviously lower (P＜0.05).The values of HR,SBP,DBP,CO,A,E and E/A recovered respectively 1 month after going to the plateau when compared with those before going to the plateau (P＜0.05),while did not restore to the ones before going to the plateau (P＜0.05),and the values of LVEDV,LAVI and SV reached the level before going to the plateau (P＜0.05).The values of LVEDV,SV,SBP,LAVI and E 1 week after returning to the plain came to the level before going to the plateau (P＜0.05),and the values of CO,HR,DBP and A were significantly higher (P＜0.05) while the value of E/A was statistically lower (P＜0.05).Conclusion Echocardiogram can be used to evaluate the left ventricular structure and cardiovascular function of the AMS patient,especially for those light AMS patients in acclimatization period or before and after returning to the plain.
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Objective To evaluate the value and feasibility of tissue mitral annular displacement (TMAD) in the assessment of left ventricular global and segmental longitudinal systolic function and synchronization in patients with hypertrophic cardiomyopathy.Methods The study population consisted of 39 on-obstructive hypertrophic cardiomyopathy (nHCM) patients and 39 healthy volunteers matched by gender and age.Left ventricular global and segmental longitudinal were measured by speckle tracking imaging(STI).The mitral annular displacement (MAD) (anterioseptal,posterioseptal,anterior,lateral,posterior and inferior sites,respectively),peak of time (PT) and left ventricular systolic dyssynchrony index (SDI) were measured by TMAD.The correlation between LSR and MAD was analyzed,and the parameters of MAD and SDI for tow groups were compared.Results The rate of effectively track segments of TMAD was significantly higher than that of STI(98.7％ vs 77.9％,P ＜0.001).There were high correlationship between segmental LSR and MAD(r =-0.784,P ＜0.001),and global and MADglobal (r =-0.897,P ＜0.001).Compared with the control group,MAD of six spots and MADglobal were significantly decreased (P ＜ 0.001,respectively),SDI was significantly increased(P ＜0.001).Conclusions TMAD is a sensitive and reproducible method for the assessment of LV longitudinal functionin patients with nHCM.
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Objective To observe the hemodynamic changes of acute after cardiac resynchronization therapy(CRT) interruption in patients with chronic heart failure (CHF),and explore the benefit of hemodynamic of the reverse remodeling and non-reverse remodeling CHF patients during CRT.Methods 46 CHF patients who had undergone implantation of CRT device for more than 6 months were enrolled in the study.The reverse remodeling and non-reverse remodeling were identified by reduction of LV end-systolic volumes ≥ 15％.The two groups underwent echocardiography,and mitral regurgitation area (MRA),velocity time integral of aortic valve (VTI-AV),velocity time integral of mitral valve(VTI-MV),maximum rising rate of left intra-ventricular pressure(+ dp/dtmax),LVFT/T were measured in on and off mode of CRT.Hemodynamic indicators of two groups were compared in CRT on and off modes.The rate of changes of above mentioned parameters ΔMRA,ΔVTI-AV,ΔVTI-MV,Δdp/dt and ΔLVFT/T were calculated and compared in the two groups.Results MRA had significant increasing in both group after 10 minutes intereuption of CRT (P ＜0.01).Two groups had significant worsening of VTI-AV,VTI-AV,+ dp/dtmax and LVFT/T after 10 minutes interruption of CRT as compared to CRT-on mode (P ＜0.05).ΔMRA,ΔVTI-MV,Δdp/dt of reverse remodeling group significantly higher than non-reverse remodeling group(P ＜0.05).But there was no difference in ΔVTI-AV and ΔLVFT/T(P ＞0.05).Conclusions The hemodynamic index become worsening after 10 minutes interruption of CRT in both group of medium-and long-term CRT patients especially in reverse remodeling group,suggesting that patients of both groups have obtained hemodynamic benefits continuously during CRT.Reverse remodeling group get more benefits than non reverse remodeling group.
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Objective To investigate the effects of echocardiography-guided pacemaker parameters optimization in order to enhance the efficacy of cardiac resynchronization therapy(CRT).Methods Seventeen patients with chronic heart failure received biventricular resynchronous pacing therapy.A-V delay and V-V delay was optimized under the guiding of spectral Doppler echocardiography and tissue Doppler imaging.Results The indices of heart function in all patients were significantly improved after the treatment.The NYHA class of the patients was improved from class Ⅲ～Ⅳ to class Ⅱ～Ⅲ.Since PAV/SAV was optimized to 130-180/100-150 ms,left ventricular filling time(LVFT) was increased from (354±147)ms to (420±112)ms,mitral reflux (MR) was decreased from (8.41±4.55)cm2 to (5.36±4.71)cm2.After VV delay was optimized to 4-40ms,standard deviation of time to regional peak systolic velocity (Ts-SD-12) was decreased from (48.4±17.9)ms to (30.2±18.6)ms,left ventricular outflow tract velocity time integral(VTI LVOT) was increased from (20.6±9.0)cm/s to (26.1±3.1)cm/s.Conclusions Echocardiography-guided optimization of the pacemaker parameters is necessary in order to enhance the efficacy of CRT.