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Objective To evaluate intra- and interatrial asynchrony and its determinants in aged patients with paroxysmal atrial fibrillation (PAF) by using tissue Doppler imaging. Methods Ninty-one patients without PAF (control group, including 40 elder patients and 51 non-elder patients) and 52 aged patients with PAF were included. As to assessment of intra- and interatrial synchronicity, the atrioventricular plane were selected on the right atrial (RA) free wall, interatrial septum (IAS), and left atrial (LA) free wall. The time differences from the onset of the P wave to the onset of the A wave at the left atrium (P-LA), the IAS (P-IAS), and the right atrium (P-RA) were measured. Intra-atrial asynchrony was defined as the differences between P-IAS and P-RA (RA asynchrony) and between P-LA and P-IAS (LA asynchrony). Interatrial asynchrony was defined as the difference between P-LA and P-RA. Stepwise regression was made to determine the influencing factors for atrial asynchrony in aged patients with PAF. Results Compared with the control group, aged patients with PAF had significant LA and interatrial asynchrony (P＜0.01). Multivariate stepwise regression demonstrated that systolic blood pressure (x2), age (x1) and left ventricular mass index (LVMI x5) entered the regression equation in aged patients with PAF (Y=-57.241+0.481 x1+0.223 x2+0.294 x5). Conclusions Aged patients with PAF have LA and interatrial asynchrony. LVH, aged and SBP are important factors leading to these asynchronies in the aged patients with PAF.
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Objective To investigate the relationship between the abnormalities in the area behind the heart in the four-chamber view and fetal defects, the clinical significance of assessment of area behind the heart in fetal screening.Methods 7062 fetuses were scanned.Area behind the heart in the four-chamber view and anatomical survey were detected.Results Fifty-three cases (0.8％, 53/7062) with abnormal sonographic findings in the area behind the heart in the four-chamber view were detected prenatally.Thirtyseven cases were confirmed by autopsy postnatally.Among these cases, 73.0％ (27/37) had heterotaxy syndrome,8.1％(3/37) had situs inversus totalis,18.9％ (7/37) had heart defects.Conclusions There is close relationship between the abnormalities in the area behind the heart and the fetal defects.This can be used as an effective and simple indicator in screening situs inversus and cardiovascular abnomalities.
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Objective To investigate the relation between anormalities of fetal abdominal great vessels and heterotaxy, the clinical significance of screening fetal heterotaxy by the abnormalities of fetal abdominal great vessels. Methods 6532 fetuses from our hospital were scanned and the fetuses with abdominal great vessels abnormalities were included. Parameters of fetal growth, abdominal great vessels and anatomical survey were detected. Results Forty-five cases (0.7%) of fetal abdominal great vessels abnormalities were detected prenatally. Forty-two cases were confirmed postnatally, including 35 cases of heterotaxy syndrome and 7 cases of situs inversus totalis and 3 cases missed. The incidences of the abnormal fetus,heterotaxy syndrome and situs inversus totalis of the fetuses with abnormal abdominal great vessels were higher than that of the fetuses with normal abdominal great vessels, the differences were statistically significant( P＜ 0.001). The incidence of both type Ⅰ and type Ⅱ of the heterotaxy syndrome were significantly higher than that of type Ⅳ (P＜0.001). There was a high incidence of left isomerism in abnormal type Ⅰ and of right isomerism in abnormal type Ⅱ , the differences were statistically significant (P＜ 0.001). Conclusions Abnormal great vessels abnormalities have strong relations to heterotaxy and situs inversus which can be used as effective and simple indicator in screening heterotaxy syndrome.
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Objective To compare different delayed scanning methods in multi-slice spiral CT angiography (MSCTA)in diagnosis of pulmonary embolism (PE). Methods Sixty patients with suspected PE were divided into three groups (A, B and C). MSCT with same Iodine concentration, injection rate, contrast medium but different delayed scanning methods was performed after injection of contrast medium. Patients in group A were examined with fixed time method (15 s), in group B with small dose-density curve method, while in group C with contrast medium track and triggering technoligy. The number, position and the shapes of emboli were evaluated with MIP, MPR and VR. Results The successful examination rate of group A was 55.00% (11/20), while of group B and C was both 100%. The coincidence rate of MSCTA compared with DSA in each group was 96.04% (291/303). Conclusion The best delayed scanning method in MSCTA for diagnosis of pulmonary embolism is contrast medium tracking and triggering technology.
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Objective:To evaluate the preventive effect of Danshen Shuizi Capsule on vascular restenosis after stent implantation.Methods:48 patients with endovascular stent implantation were randomly assigned to control group(n=25) (treated with western medicines)and treatment group(n=23)(treated with Danshen Shuizi Capsule)after endovascular stenting implantation.The intraluminal diameter of stenting segment was measured by QCA at 6 months after stent implantation.Results: The diameter of reference vessel in two groups was not significantly different.The intraluminal diameter of stent segment in the treatment group was not larger than that in the control group(2.22?0.21)mm vs(2.18?0.25)mm.The index number of vessel diameter reduction in treatment group was not less than that in the control group(0.50?0.16)mm vs(0.51?0.11)mm.The rate of restenosis(18.4%)and reintervention(13.1%)in treatment group were not lower than those in the control(20%,12%).However,the complication in treatment group was significantly lower than that in control group.Conclusion:These findings indicated that endovascular was useful for the prevention of endovascular restenosis after stent implantation with fewer complications