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Objective To evaluate the left ventricular systolic circumferential strain by layer specific speckle tracking imaging in healthy volunteers and patients with left bundle branch block (LBBB).Methods Forty patients with LBBB were divided into two groups,LBBB1 group [left ventricular ejection fraction (LVEF≥50％] and LBBB2 group (LVEF＜50％),and 25 healthy subjects were selected as the control group.High frame rate two dimensional images were recorded from the left ventricular short-axis views at the levels of the mitral annulus,papillary muscle and apex respectively.The peak systolic circumferential strain of the endocardium,myocardium and epicardium were measured using layer-specific strain software.Results The circumferential strain of the epicardium and myocardium at the level of the apex showed a statistically significant difference between the LBBB1 group and the control group (P =0.004),while there was no statistically significant difference demonstrated at the levels of the mitral annulus and papillary muscle(P ＞0.01).The circumferential strain of the endocardium at the levels of the papillary muscle and apex showed a statistically significant difference between the LBBB1 group and the control group (P =0.000),while there was no statistically significant difference demonstrated at the level of the mitral annulus (P ＞0.01).The circumferential strain of the endocardium,myocardium and epicardium at the three short axis view levels showed statistically significant differences between the LBBB2 group and the control or LBBB1 groups respectively(P =0.000).Conclusions The circumferential strain of the endocardium at the level of the apex can provide more information about disease prognosis,especially in LBBB patients with a LVEF of ≥50％.
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Objective To analyze the left ventricular (LV) diastolic function parameters of patients with sick sinus syndrome (SSS) and DDD pacemaker implantation during atrioventricular conduction (AVC) and right ventricular apex pacing(RVAP)mode.Methods Forty-six consecutive patients with SSS who had undergone DDD pacemaker implantation were studied.Fifty volunteers were selected as control group.Changing from AVC to RVAP mode,the acute effect on echocardiographic left ventricular diastolic function parameters,including mitral inflow PW parameters,mitral annulus tissue Doppler imaging parameters,left atrial volume index,and LV∕apical∕basal untwist parameters were measured.And all subjects were classified into normal diastolic function or three degrees of LV diastolic dysfunction.Results Compared with control group,both AVC and RVAP mode of patients with DDD pacemaker implantation resulted in the worsening of LV diastolic function as shown by(1) prolonged deceleration time of E wave, decreased descending slope of E wave,as well as decreased early diastolic velocity at the septal mitral annulus,(2) the decrease of LV∕basal∕apical untwist velocity,(3) the increase in the degree of diastolic dysfunction.Conclusions In patients with DDD pacemaker implantation,both AVC and RVAP mode are associated with the deterioration of LV diastolic function,which is particularly obvious in RVAP mode.
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Objective To compare the left ventricular function parameters of patients with sick sinus syndrome ( SSS ) and DDD pacemaker implantation during atrioventricular conduction ( AVC ) and right ventricular apex pacing ( RVAP ) mode . Methods Forty‐six consecutive patients with SSS who had undergone DDD pacemaker implantation were studied . Fifty volunteers were included as control group . Changing from AVC to RVAP mode ,the acute effect on echocardiographic parameters ,including LVEF , parameters of aortic/pulmonary artery pulse wave Doppler ,and parameters of left ventricular twist by speckle tracking imaging were measured respectively . Pacemaker implantation duration and cumulative ventricular pacing proportion ( Cum% VP) were recorded . The relationships of pacemaker parameter and above left ventricular function parameters were analyzed . Results Compared with control group ,values of peak rotation in LV apex and LV twist were significantly lower during AVC and RVAP mode . The value of peak rotation in LV base showed no significant difference between three groups .Apical‐basal rotation delay during RVAP was significantly longer than those during AVC and in control group respectively ( P <0 .05) . LVEF during RVAP decreased statistically ( P< 0 .05 ) ,but showed no difference during AVC , compared with the control group . The peak LV twist related positively with LVEF ,and negatively with Cum% VP . Conclusions RVA pacing decreases left ventricular function , which is independent of asynchrony contraction patterns caused by pacing . LVEF ,apical rotation and LV twist are more sensitive to demonstrate the LV dysfunction in patients with pacemaker implantation . LV twist related negatively with Cum% VP .
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ObjectiveTo investigate left ventricular (LV) radial dyssynchrony and LV rotational change of isolated complete left bundle branch block (CLBBB) and CLBBB with heart failure (HF).Methods Twenty-six isolated CLBBB patients,twenty-four CLBBB patients with HF and twenty healthy controls were studied.Two-dimensional speckle tracking imaging (2D-STI) was applied to short-axis views to calculate LV radial dyssynchrony and LV rotational and twist degree and time to peak rotational and twist degree.ResultsLV radial dyssynchrony and LV rotation and twist degree were intermediately damaged in isolated CLBBB patients and was significantly damaged in CLBBB patients with HF,compared with healthy controls.ConclusionsFor isolated CLBBB patients,even if LV ejection fraction was in the normal range,another parameters of cardiac mechanic had changed and 2DSTI could be used to evaluate these alterations.
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Objective To assess alternations in left ventricular volume and systolic synchrony in patients with frequent premature ventricular complexes(PVCs) from the right ventricular outflow tract(RVOT).Methods Twenty-nine patients with frequent isolated PVCs from RVOT were included and 30 healthy subjects as control.Instantaneous full-volume imaging(IFI) was performed to evaluate left ventricle volumetric parameters,including end-systolic volume (ESV),end-diastolic volume (EDV),stroke volume (SV),ejection fraction (EF),and systolic synchrony parameters,including systolic dyssynchrony index (SDI),dispersion end-systole (DISPES),mean end-systolic time (MES),pre-contraction time volume (PreContr) and post-contraction time volume (PostContr).Contraction front mapping was performed to visualize volumetric contraction sequence.All values of patients with PVCs were recorded during sinus beats (PVC-S) and premature ventricular beats (PVC-V) respectively.Results Significant differences were observed in left ventricular systolic volumetric and synchrony parameters between PVC-V and control subjects (P＜0.01),as well as in MES and PreContr between PVC-S and control subjects (P＜0.01).Conclusions Left ventricular systolic dysynchrony was demonstrated in patients with PVCs from RVOT.IFI was a novel tool to analyze left ventricular global and regional volumetric alternations.
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Objective To construct an oncolytic adenovirus CNHK600-IL24, and to observe the in vivo effects of CNHK600-IL24 in treating breast cancer. Methods The IL-24 gene was cloned into adenovirus shuttle vector SG502-△CR2, and CNHK600-IL24 was obtained by cotransfection of SG502-INSIL24 and pPE3 plasmids and subsequent recombination in 293 cells. Based on the establishment of the athymic mice model of breast cancer in situ and imitated metastatic breast cancer by injection in the vena caudalis and the left artrium, we administered the virus by the tail vein. We used the optical imaging in vivo system to monitor the effects. Results The oncolytic adenovirus CNHK600-IL24 was correctly constructed and confirmed by restriction DNA sequence analysis and PCR. The titer of CNHK600-IL24 reached 1.9 ×1010pfu/ml. Establishing athymic mice model of breast cancer in situ, the volume and photon number of the tumors in the control group was significantly larger than those of the CNHK600-IL24 group( P ＜0. 05). The tumor had conspicuous necrosis after the treatment of CNHK600-IL24. There was noticeable apoptosis of the tumor cells. Immunohistochemistry showed the expression of IL-24 and the Hexon protein in the tumor cells.In athymic mice model of imitated metastatic breast cancer by infusion into the vena caudalis, most of the mice in the control group died before 38 days, the mice of the CNHK600-IL24 group survived significantly longer(P ＜0. 05 ). Using athymic mice model of imitated metastatic breast cancer by infusion in the left artrium, the optical imaging in vivo system showed obvious difference between the control group and the CNHK600-IL24 group. Conclusions The high-titer oncolytic adenovirus CNHK600-IL24 was successfully constructed and purified. The oncolytic adenovirus had obvious antitumor effect on breast cancer.
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Objective To evaluate the patterns of intracardiac flow of left ventricle (LV) in patients with premature ventricular complexes (PVCs) from the right ventricular outflow tract (RVOT) by analyzing the vortex during isovolumetric contraction phase and the distribution rules of flow-time curves in each layer of LV.Methods Twenty-seven patients with frequent isolated PVCs from RVOT were involved and 25 healthy subjects as control.The color Doppler image of LV at apical four-chamber view was acquired.Vector flow mapping (VFM) was performed to assess the parameters of vortex during isovolumic contraction phase, including diameter (transverse and vertical diameter), velocity (maximal positive and negative velocity) and the number of vortex rings.Positive flow during systole and negative flow during diastole of LV in each layer were measured by flow-time curve.All values of patients with PVCs were recorded during sinus beats (PVC-S) and PVC (PVC-V) respectively.Results Significant differences were demonstrated in all parameters of vortex between the PVC-V and control subjects.And the flow-time curves disarrayed in PVC-V.The velocity of vortex in PVC-S was lower than that in control subjects.And the distribution pattern of flow-time curves in LV of PVC-S differed from that of control subjects.Conclusions Alternation of intracardiac fluid pattern in LV was demonstrated in patients with PVCs from RVOT during both sinus beats and PVC.VFM can be used to analyze the intracardiac flow field in normal and pathological electrical activation.
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Objective To evaluate the home-made occluder in the treatment of VSD and its mid-term and long-term results. Methods From Jan. 2004 to May 2007, percutaneous VSD closure therapy under X-ray monitoring was performed in 78 consecutive VSDpatients, including 43 males and 35 females with an average age of (16.5±8.6) years (ranged 3-37 years). TTE, ECG and Holter examinations were performed in 1 week, 3 months, 1 year and 2 years after the procedure. Results Seventy-three home-made occluder devices with a diameter of 5-16 mm (10.3±3.2 mm) were implanted successfully, with a technical successful rate of 93.6% (73/78). The whole course follow-up were carried out in all 73 successful cases (100%). One week after the procedure ITE detected residual shunt in 8 cases, and three months later the residual shunt was observed in 5 cases. Follow-up check at one and two years after the treatment the residual shunt disappeared completely. For the observation of arrhythmia, occasional atrial premature beats or ventricular premature beats occurred in 28 cases (38.4%) within one week after the procedure, and two patients developed grade Ⅲ complete atrioventricular block at the third day after the surgery. The arrhythmia disappeared after medication of prednisone and nutrient drugs for 4-10 days. Bundle branch blocks were observed in 8 cases (10.1%) at one-year and two-year follow-up. Conclusion For the treatment of VSD, the home-made Amplatzer occluder device is reliable and effective, although a close foUow-up is required after the surgery.
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Objective To evaluate the efficacy of transcatheter arterial chemoembolization through left inferior phrenic artery (LIPA) in hepatocellular carcinoma (HCC) feeded by LIPA. Methods Angiographic data of 187 HCC patients were retrospectively analyzed. Five patients with LIPA feeding HCC were diagnosed and successfully treated with TACE through LIPA. Results All 5 patients underwent CT and angiography after 3 months, 3 of them achieved complete remission. LIPA recanalized in the other 2 patients, then these 2 patients underwent TACE through LIPA again. Conclusion LIPA could formed lateral branch to feed HCC. TACE through LIPA is safe and effective.
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OBJECTIVE To compare the effect with the three methods to disinfect the ventilator circuits.(METHODS) To disinfect the ventilator circuits,three methods were used:A,soaking with chlorine compoud(disinfectant);B:soaking with 0.5% peracetic acid;C,sterilizing with ethylene oxide.Samples were taken to(bacteria) culture before and after disifection in every three methods.Biological supervision and the amount of colony were also taken at the same time.RESULTS The results of bacteria culture pre-disinfection were all positive.The amount of bacteria of ventilator circuits was between 70 000-120 000CFU/cm~2.The eligible rate of biological(supervision) in method C was 100% and its positive rate of bacteria culture was 0%.The eligible rate of biological supervision in method A was 86.25% and its positive rate of bacteria culture was 16.25%.The eligible rate of(biological) supervision in method B was 90% and its positive rate of bacteria culture was 13.78%.It was significant when method C was compared with methods A and B and the value P was less than 0.01.CONCLUSIONS It is(serious) about the pollution in ventilator circuits.The soaking methods are apt to be effected by the factors of(environment) and manual operation.Therefore it could be(ineligible) and being polluted after disinfection.The method of sterilization is the best for disinfection.