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Objective:To evaluate the effect of cinacalcet on right ventricular function in rats with MCT-induced arterial pulmonary hypertension by echocardiography.Methods:Thirty male SD rats were randomly divided into control group, PAH group, and cinacalcet group, with 10 rats in each group. Rats in the cinacalcet group were given intraperitoneal injection of cinacalcet hydrochloride with 30 mg/kg, and the control group and the PAH group were given equal-volume of solvent. Echocardiographic parameters: right ventricular wall thickness (RVWT), right ventricular basal dimension (RVD), left ventricular eccentricity index (EI), tricuspid annular plane systolic excursion (TAPSE), right ventricular fractional area change (RVFAC), tricuspid lateral annular systolic velocity (s′), right ventricular global longitudinal strain (RV4CSL), and right ventricular free wall longitudinal strain (RVFWSL), etc. Histopathological parameters: pulmonary arteriole wall thickness (WT), right ventricular cardiomyocyte mean diameter (RV cell-D), collagen volume fraction (CVF) and right ventricular hypertrophy index (RVI). Echocardiographic and pathological parameters were compared among three groups, and the correlation between right ventricular pathological changes and strain parameters was analyzed.Results:①Compared with the control group, WT, RV cell-D, CVF and RVI in PAH group were increased (all P<0.01), the size of right ventricle and thickness of RV wall were increased (all P<0.05), and the right ventricular longitudinal strain was reduced ( P<0.01). ②Compared with the PAH group, rats in the cinacalcet group showed reduced WT, RV cell-D, CVF and RVI (all P<0.01), as well as improved structure and function of the right ventricle (all P<0.05). There was no statistical difference of the above parameters between cinacalcet and control group (all P>0.05). ③Correlation analysis: the right chamber remodeling parameters CVF and RV cell-D were positively correlated with WT ( rs=0.706 3, 0.629 4; both P<0.05); and RVFWSL correlated well with CVF, RV cell-D ( rs=-0.685 3, r=-0.767 2; both P<0.05). Conclusions:The right ventricular inverse remodeling of PAH rats with the intervention of cinacalcet was retained, suggesting that cinacalcet had a protective effect on the structure and function of the right ventricle in rats with PAH.
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Objective:To assess global myocardial work in non-ST-segment-elevation acute coronary syndrome (NSTE-ACS) patients with no obvious regional wall motion abnormalities and preserved left ventricular ejection fraction (LVEF) by noninvasive left ventricular (LV) pressure-strain loops, and to explore its diagnostic value in patients with NSTE-ACS.Methods:A total of 169 NSTE-ACS patients with normal wall motion abnormalities and LVEF (>55%) were recruited in Beijing Chao Yang Hospital, Capital Medical University from June to December 2019. The patients were divided into two groups according to the degree of coronary stenosis, including severe coronary artery stenosis group ( n=121), and no severe stenosis group ( n=48). The patients of severe coronary artery stenosis group were further subdivided into single-vessel severe stenosis group ( n=52) and multi-vessel severe stenosis group ( n=69). Global longitudinal strain (GLS) analysis was performed by speckle tracking echocardiography before coronary angiography. Brachial cuff systolic pressure was used as left ventricular pressure to construct a non-invasive left ventricular pressure-strain loop. Global myocardial work index (GWI), global constructive work (GCW), global waste work (GWW) and global myocardial work efficiency (GWE) was computed by LV pressure-strain loops with a proprietary algorithm between groups. ROC curve analysis was used to determine the optimal cutoff value of the parameters to detect severe coronary artery stenosis. Independent factors affecting left ventricular myocardial function were assessed by Logistic regression analysis. Results:GLS, GWI, GCW and GWE were significantly reduced, and GWW was increased in severe coronary artery stenosis group than in no severe stenosis group(all P<0.05). GLS was significantly reduced in multi-vessel severe stenosis group ( P<0.05) but not in single-vessel severe stenosis group ( P=0.32). GWE was an independent factor affecting myocardial function in severe coronary artery stenosis group, GWE<96% had a area under the curve (AUC)=0.83 (74% for sensitivity, 81% for specificity) to identify severe coronary artery stenosis, and was superior to GLS (AUC=0.66, P<0.05) and GWI (AUC=0.70, P<0.05). Conclusions:In NSTE-ACS patients with severe coronary artery stenosis, no obvious regional wall motion abnormalities and preserved LVEF, LV global myocardial function is impaired based on noninvasive pressure-strain loops, GWI, GCW, and GWE are reduced, and GWW is increased, and GWE is a more sensitive index than GLS and GWI to predict severe coronary artery stenosis in NSTE-ACS patients.
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Objective To evaluate the cardiac hemodynamics and function before and after balloon pulmonary angioplasty ( BPA ) treatment in patients with chronic thromboembolic pulmonary hypertension ( CTEPH) using echocardiography ,and to discuss the clinical value of the treatment . Methods A total of 36 CT EPH patients with medium‐high risk stratification underwent BPA during the period of September 2016 to January 2019 in Beijing Chao‐Yang Hospital ,Capital M edical University were recruited . T he following conventional echocardiographic parameters including right ventricular basal diameter ( RVD ) ,left ventricular basal diameter ( LVD) ,right atrial diameter ( RAD) ,left atrial diameter ( LAD) ,main pulmonary artery diameter ( DM PA ) , left ventricular eccentricity index ( LVEI ) , left ventricular ejection fraction ( LVEF) and pulmonary artery systolic pressure ( PASP ) were recorded .Echocardiographic parameters of right ventricular ( RV ) function including tricuspid annular plane systolic excursion ( T APSE ) , right ventricular fractional area change ( RVFAC ) ,tissue Doppler – derived tricuspid lateral annular systolic velocity ( S′) ,RV index of myocardial performance ( RIM P ) and right ventricular free wall longitudinal strain ( GLS) were measured . T he patients were divided into 2 groups according to the threshold value of postoperative SPAP of 50 mmHg (group Ⅰ :SPAP ≤ 50 mmHg ,group Ⅱ :SPAP＞50 mmHg) . Changes between each parameter before and after BPA were analyzed . Results ① T he frequency of BPA treatment for CT EPH patients ranged from 1 to 6 times . After BPA treatment ,SPAP decreased significantly ,and the measurements of RV function including T APSE ,RVFAC ,RIM P and GLS improved significantly ( all P ＜0 .05) . ②Patients in group Ⅰ showed significantly better RV function including T APSE ,RVFAC and GLS compared with group Ⅱ before BPA ( P ＜0 .05) . ③Univariate logistic regression showed that parameters of preoperative RV function T APSE , RVFAC and GLS had certain effects on the curative effect of interventional surgery . Conclusions Echocardiography can evaluate the hemodynamics and RV function in CT EPH patients with BPA .After BPA ,pulmonary artery pressure decreases and RV function improves to some extent ,suggesting that the treatment of BPA has certain clinical application and popularization value .
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Objective@#To evaluate the cardiac hemodynamics and function before and after balloon pulmonary angioplasty (BPA) treatment in patients with chronic thromboembolic pulmonary hypertension (CTEPH) using echocardiography, and to discuss the clinical value of the treatment.@*Methods@#A total of 36 CTEPH patients with medium-high risk stratification underwent BPA during the period of September 2016 to January 2019 in Beijing Chao-Yang Hospital, Capital Medical University were recruited. The following conventional echocardiographic parameters including right ventricular basal diameter (RVD), left ventricular basal diameter (LVD), right atrial diameter (RAD), left atrial diameter (LAD), main pulmonary artery diameter (DMPA), left ventricular eccentricity index (LVEI), left ventricular ejection fraction (LVEF) and pulmonary artery systolic pressure (PASP) were recorded.Echocardiographic parameters of right ventricular (RV) function including tricuspid annular plane systolic excursion (TAPSE), right ventricular fractional area change (RVFAC), tissue Doppler–derived tricuspid lateral annular systolic velocity (S′), RV index of myocardial performance (RIMP) and right ventricular free wall longitudinal strain (GLS) were measured. The patients were divided into 2 groups according to the threshold value of postoperative SPAP of 50 mmHg (group Ⅰ: SPAP ≤ 50 mmHg, group Ⅱ: SPAP>50 mmHg). Changes between each parameter before and after BPA were analyzed.@*Results@#①The frequency of BPA treatment for CTEPH patients ranged from 1 to 6 times. After BPA treatment, SPAP decreased significantly, and the measurements of RV function including TAPSE, RVFAC, RIMP and GLS improved significantly (all P<0.05). ②Patients in group Ⅰ showed significantly better RV function including TAPSE, RVFAC and GLS compared with group Ⅱ before BPA (P<0.05). ③Univariate logistic regression showed that parameters of preoperative RV function TAPSE, RVFAC and GLS had certain effects on the curative effect of interventional surgery.@*Conclusions@#Echocardiography can evaluate the hemodynamics and RV function in CTEPH patients with BPA.After BPA, pulmonary artery pressure decreases and RV function improves to some extent, suggesting that the treatment of BPA has certain clinical application and popularization value.
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Objective To evaluate right ventricular ( RV ) function in male rats with pulmonary arterial hypertension (PAH) induced by Monocrotaline (MCT) and discuss the effect of 17β-estradiol (E2) on RV function in PAH rats . Methods Thirty-two male SD rats were randomly divided into 4 groups( n =8) :MCT group ,MCT+E2 group ,MCT+Veh group and control group . MCT group ,MCT +E2 group and MCT+Veh group were given monocrotaline through intraperitoneal injection . MCT + E2 group and MCT+Veh group were also treated with E2 and placebo at the same time respectively . Echocardiography was performed four weeks later after MCT injection . Right heart catheterization was performed after echocardiography . Echocardiography right ventricular function parameters included:tricuspid annular plane systolic excursion (TAPSE) ,RV index of myocardial performance (RIMP) ,right ventricular fractional area change ( RVFAC) ,tissue Doppler-derived tricuspid lateral annular systolic velocity ( s′) and right ventricular free wall longitudinal strain ( RVLSFW ) . Results Compared with control group ,TAPSE ,RVFAC and RVLSFW decreased ,and RIMP increased in MCT group ,( P <0 .001 , P <0 .001 , P <0 .001 , P =0 .001 , P <0 .001 ,respectively) . TAPSE ,RVFAC and RVLSFW in MCT+ E2 group were higher and RIMP was lower than those in MCT group ( P < 0 .001 , P = 0 .001 , P = 0 .001 , P = 0 .002 , P = 0 .002 , respectively) . The parameters regarding RV function were slightly lower in MCT + E2 group ,compared with control group . However , these differences had no obvious statistical significance ( P > 0 .05 ) . Moreover ,Pearson correlation analysis showed that the serum E2 level was positively correlated with TAPSE ,RVFAC ,s′and RVLSFW ( r =0 .845 , P <0 .001 ;r =0 .859 , P <0 .001 ;r =0 .802 , P =0 .006 , respectively) ,and negatively correlated with RIPM ( r = -0 .803 , P <0 .001) . Conclusions RV function in male PAH rats induced by MCT decreased significantly ,while E2 could improve RV function in PAH rats and has a protective effect on RV function . Echocardiography could contribute to the quantitative evaluation of RV function in PAH rats induced by MCT .