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Objective: To assess blood levels of renal function related influencing factors with baseline clinical parameters for predicting the risk of 8-year survival in patients with chronic heart failure (CHF). Methods: A total of 293 CHF patients admitted in our hospital from 2006-07 to 2009-11 were enrolled. The patients were followed-up until 2014-6-30, the end point was death. According to followed-up results, they were divided into 2 groups: Survival group,n=107 and Death group,n=186. All patients received routine renal function and electrolytes examination including blood levels of urea nitrogen, creatinine, uric acid, sodium, potassium, chloride, calcium, anion gap and phosphorus; GFR was calculated by MDRD formula. Baseline clinical parameters as left ventricular end diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF) were measured by echocardiography; blood pressure (BP) and heart rate (HR) were recorded. The risk factors for 8-year survival in CHF patients were analyzed. Results: Compared with Survival group, Death group had increased LVEDD, urea nitrogen, creatinine and uric acid, while decreased LVEF, HR, GFR, blood sodium and calcium, allP<0.05. Univariate analysis indicated that LVEDD, LVEF, GFR, urea nitrogen, creatinine, uric acid, blood sodium, calcium and phosphorus had the better predictive value for the risk of 8-year survival in CHF patients, allP<0.05. Multivariate analysis presented that LVEDD, GFR and blood sodium had the highest predictive value for the risk of 8-year survival, allP<0.001; the next one was blood calcium,P<0.01. Conclusion: LVEDD, GFR, blood sodium and calcium were the independent predictors for the risk of 8-year survival in CHF patients.
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Objective: To analyze and to predict the 1 year re-admission risk in patients of chronic heart failure with reduced left ventricular ejection fraction (HFrEF) by echocardiography. Methods: A total of 313 HFrEF patients in our hospital community from 2007-01 to 2008-12 were studied. The patients were followed-up for (6-7) years and the end point was 1 year re-admission. All patients received routine echocardiography and the parameters included left ventricular ejection fraction of (LVEF), left ventricular diameter (LVd), pulmonary artery systolic pressure (PASP), mitral regurgitation (MR), tricuspid regurgitation (TR) and pericardial effusion. Based on the above 6 parameters, the risk factors for 1 year re-admission were analyzed. Results: Univariate analysis indicated that MR (HR=1.437, 95%CI 1.190-1.737, P=0.000), TR (HR=1.288, 95%CI 1.056-1.572, P=0.013) and pericardial effusion (HR=1.560, 95%CI 1.050-2.318, P=0.028) had better predictive value for 1 year re-admission. Multivariate analysis presented that MR (HR=1.404, 95%CI 1.159-1.701, P=0.001) took ifrst place for predicting the 1 year re-admission and pericardial effusion took second place (HR=1.410, 95%CI 1.030-1.928, P=0.032). Conclusion: MR, TR and pericardial effusion were the independent predictors for 1 year readmission in HFrEF patients;while MR and pericardial effusion were the independent risk factors for 1 year re-admission.
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Objective To evaluate the clinical value of quantitative myocardial acoustic densitometry in myocardial fibrosis in relative to the alteration in serum procollagen type Ⅲ amino-terminal propeptide(PⅢNP) concentration in hypertensive patients. Methods Seventy-five consecutive hypertensive patients were recruited with 75 normal persons served as healthy controls. The indexes of acoustic densitometry were evaluated by echocardiography and the concentrations of the serum PⅢNP peptide by radioimmunoassay. Results Calibrated acoustic intensity in septal(CAI1) and posterior wall(CAI2) in hypertension group(0.88?0.06, 0.73?0.06) were greater than that in healthy control group (0.66?0.19, 0.54?0.06) (P
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Objective To investigate relationship between atrial septal thickness and atrial function by transesophageal echocardiography(TEE). Methods TEE and automatic bound detection (ABD) were performed in 83 consecutive sinus rhythm subjects including four groups: control group, nonrheumatic heart disease group, rheumatic mild mitral stenosis group and rheumatic severe mitral stenosis group. Results Atrial septal thickness(AST)and atrial septal thickness fraction (ASTF) were different in various heart diseases. There was high correlation respectively between left atrial diameter(LAD) and AST(r= -0.601 8 ,P
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Objective To evaluate the impact of the off -pump coronary artery bypass (OPCAB) on left ventricular(LV) function with transesophageal echocardiography(TEE). Methods Blood flow velocities of pulmonary vein (PV) and mitral valve (MV) were performed in 21 patients with coronary heart disease and myocardial infarction two weeks pre-OPCAB, and the left ventricular SV, CO and LVEF were measured by biplane Simpson′s method, the data were compared with the results observed one month post-OPCAB. Results The peak flow velocities of PV had significant difference between pre- and post-OPCAB(P
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Objective To evaluate the effect of beat to beat alterations in the cardiac cycle length on systolic flow velocity patterns of the pulmonary vein in patients with atrial fibrillation(AF).Methods Pulmonary vein flow was recorded in 20 control subjects and 74 patients with AF (16 with nonvalvular AF,22 with mild to middle mitral stenosis,and 36 with severe mitral stenosis) by transesophageal echocardiography.The peak velocities of the early systolic reversal wave (PVR) and the systolic forward wave (PVS) were measured.The relationships between the preceding R-R intervals and PVR,PVS were analyzed.Results The early systolic reversal wave was detected in all patients with AF.PVR was significantly lower in patients with severe mitral stenosis than that in patients with nonvalvular AF and mild to middle mitral stenosis.The preceding R-R interval had a significant negative correlation with PVR.PVS was significantly lower in patients with AF than that in controls.The preceding R-R interval had a significant positive correlation with PVS.Conclusions PVR and the systolic forward wave vary with disease conditions and preceding R-R intervals in atrial fibrillation.The evaluation of systolic pulmonary venous flow velocity patterns provides important information about left atrial hemodynamic abnormalities.
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AIM: To establish the experimental acute pulmonary embolism(APE) model and observe the left and right ventricular pressure-volume relationship in different overload situations. METHODS: The present study consisted of seven anesthetized mongrel dogs that were divided into the control group, moderate APE group and severe APE group according to the various phase and different pressure load during the experiment. APE model was induced by suture piece injection through right cardiac catheterization. The hemodynamic indexes were measured by the simultaneous cardiac catheterization and echocardiography.RESULTS: (1) In the group with moderate APE, the pressure-volume relationship of right ventricle tended to right-upward shift, the area of chart increased, the shape of chart transformed form triangle to rectangle. The mild parallel leftward shift, the area of chart decreased mildly and no change of chart shape was observed in the pressure-volume relationship of left ventricle. (2) In the group with severe APE, the chart of right ventricular pressure-volume relationship tended to right-upward shift continuously, the area of chart decreased. The chart of the left ventricle tended to left-downward shift and no change of chart shape was observed in the pressure-volume relationship of left ventricle, the area of chart decreased. The erose shape of charts was also found.CONCLUSION: The chart of ventricular pressure-volume relationships is a practical and reliable method to evaluate left and right ventricular hemodynamic in APE.