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@#Objective To explore the mechanism of volume-related mitral regurgitation (MR) from the anatomy of mitral valve. Methods A total of 32 patients with ventricular septal defect (VSD) combined MR meeting inclusion criteria in West China Hospital from September 2018 to November 2019 were enrolled in this study. The direction relative to the cardiac axis: the deviation of the MR bundle along the left atrial wall was eccentric, otherwises it was central. There were 23 patients of VSD and eccentric MR (EMR, a VSD-EMR group), including 10 males and 13 females aged 21 (10, 56) months, and 9 patients of VSD and central MR (CMR, a VSD-CMR group), including 4 males and 5 females aged 26 (12, 87) months. Besides, 9 healthy children were enrolled in a control group, including 4 males and 5 females aged 49 (15, 72) months. All patients underwent transthoracic echocardiography (TTE) examination at 2 weeks before surgery and 6 months after surgery, respectively, The MR degree, end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), ejection fraction (EF), antero-posterior diameter (AP), annulus circumference (AC), commissural diameter (CD) were assessed. Results Before operation, EDV, ESV, SV, AP, AC and CD in the VSD-EMR and VSD-CMR groups were significantly larger or longer than those in the control group (P<0.05); after operation, EDV, ESV, SV, AP and CD decreased compared with those before operation (P<0.05), but there was no significant difference compared with the control group (P>0.05). Compared with the control group, AC was slightly decreased (P<0.05). There was no significant difference in EF between and within groups before and after operation (P>0.05). The improvement rate of MR was 78.9%(15/19) in the VSD-EMR group and 100.0% (9/9) in the VSD-CMR group. Conclusion After unloading of volume, the valve structure is back to normal except AC. The improvement rate of MR in the VSD-EMR group is lower than that in the VSD-CMR group, which may indicate that the mechanism of VSD-EMR is more complicated.
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Objective To investigate the pollution status of phthalate esters in household indoor air particles in Wuhan. Methods The indoor air particulate matter PM10 and PM2.5 from residential houses in Wuhan were collected. The concentrations of 15 phthalate esters were determined by gas chromatography-mass spectrometry (GC-MS). Results A total of 5 phthalates were detected, including DMP, DEP, DiBP, DBP, and DEHP. The detection rate of DiBP, DBP and DEHP was 100%, while DMP and DEP were detected in only some of the samples. Conclusion Phthalate esters pollution was widespread in indoor air particles of residential houses in Wuhan. DiBP, DBP and DEHP were the main pollutants. Decoration materials and plastic household articles were important sources of the phthalate esters pollution, and their impact as a health hazard needs attention.
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Objective To assess the strain and synchronism of left ventricular papillary muscles (PM) in functional mitral regurgitation (FMR) patients using two-dimensional speckle tracking echocardiography,and to explore the relation of PM function and the development of FMR.Methods Sixty ischemic cardiomyopathy patients with FMR and 60 idiopathic dilated cardiomyopathy patients with FMR were prospectively recruited.They were divided into three groups as the degree of FMR,patients with mild FMR was group F1,with moderate FMR was group F2,with severe FMR was group F3.Control group involved 42 healthy volunteers.The longitudinal peak strain of anterior and posterior PM (ALS,PLS),the peak time of longitudinal peak strain (APT,PPT),and the delay time of peak value between ALS and PLS (DT) were quantified.Results The ALS and PLS decreased company with increased of FMR degree (P ＜ 0.05,respectively),whereas the DT increased (P ＜ 0.05,respectively),and there was no significant variation trend of the APT and PPT.There was no intergroup difference of ALS and PLS,APT and PPT (P ＞ 0.05,respectively).ALS,PLS had negative correlation with LVM (P ＜ 0.05,respectively),and positive correlation with LVEF (P ＜0.05,respectively).DT had positive correlation with LVM(P ＜ 0.05),and negative correlation with LVEF (P ＜ 0.05).Conclusions The dysfunction and desynchronization of PM are closely related to the severity of FMR.The results may helpful to screen proper patients for cardiac resynchronization treatment.
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Objective To explore the accuracy of three dimensional speckle tracking imaging (3D-STI) in quantitative coronary evaluation of (CHD) patients' left ventricular global systolic function.Methods Sixty-eight CHD patients were divided into three groups according to the coronary artery angiography (CAG) results:32 cases in severe stenosis group,23 cases in moderate stenosis group,and 13 cases in mild stenosis group.Thirty gender-age-matched healthy subjects(control group) were enrolled in this study.All patients underwent 2D-echocardiography and real-time three-dimensional echocardiography (3DE).The global longitudinal strain(GLS),global radial strain(GRS),global circumferential strain(GCS),global area strain (GAS),global area strain rate (GASrate) and 3D global LV strain (3D-Strain) were analyzed using 3D-STI.Correlation between strain measurements and left ventricular ejection fraction (LVEF) by simpson method,3D-LVEF by 3DE were assessed using linear regression analysis.Results All 3D-STI parameters in the severe stenosis group were significant decreased compared with the other groups.GLS,GRS,GCS,GAS,3D-Strain of moderate stenosis group shown more significant decrease than both mild stenosis group and control group (P ＜ 0.05).Strong correlations were demonstrated in all 3D-STI parameters between 3D-LVEF and LVEF.The strongest correlation was observed between GAS with 3D-LVEF in severe stenosis group(r =-0.910,P ＜0.05).Intraobserver and interobserver reliability of GAS was better than other parameters.Conclusions Global strain of 3D-STI can quantitatively evaluate the global LV function in CHD patients,and GAS is more sensitive and reproducible than other parameters.
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Objective To analyze the relation between ischemic mitral regurgitation (IMR)and the changes of left ventricular systolic synchrony and volume parameters before and after percutaneous coronary intervention (PCI)in patients with subacute myocardial infarction and to evaluate the impact of PCI on IMR by measuring such changes with three-dimensional echocardiography volume quantitation technology. Methods Eighty-seven patients were enrolled and echo data were acquired before and 6 months after PCI. Patients were classified into alleviation group (group Ⅰ)and non-alleviation group (group Ⅱ)according to the change of mitral regurgitation volume (MRvol).The systolic synchrony indexes (Tmsv 1 6-SD%,Tmsv 1 6-Dif%)and left ventricle volume parameters (LVEDVI and LVESVI)before and after PCI for patients of two groups were measured and contrasted.Results Systolic synchrony indexes of all patients of two groups were improved after PCI.Left ventricular volume parameters were decreased after PCI in group Ⅰ,and the remodeling was reduced.Correlation analysis of the parameters variations showed that,there was significant positive correlation between variations of left ventricular volume and MRvol in all patients and no significant correlation between variation of systolic synchrony index and MRvol.Conclusions PCI can improve left ventricular systolic dyssynchrony for submyocardial infarct patients.Left ventricular volume index that reflects the remodeling process is closely related to IMR.
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The present study aimed to investigate the impact of hypothyroidism on left ventricular systolic function using real-time three-dimensional speckle tracking imaging (RT3D-STI). Thirty hypothyroidism patients and forty healthy volunteers were recruited and received RT3DSTI measurement of global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS), and global area strain (GAS). A comparison of differences between the hypothyroidism patients and those in the healthy group was carried out and we obtained the results as followings. The values of GLS were (-18.93 +/- 3.89) vs. (-21.44 +/- 1.99), with P < 0.01, GRS were (51.13 +/- 11.95) vs. (56.10 +/- 5.76), with P < 0.0; and GAS were (-31.63 +/- 5.38) vs. (-34.40 +/- 2.32), with P < 0.01, i.e. they were lower in hypothyroidism group than those in the health group. While GCS were (-17.75 +/- 1.92) vs. 17.03 +/- 3.45), with P > 0.05, which were not significantly different between the two groups. In linear regres sion, GLS showed significant correlation with both TSH (b = -0.69, P < 0.01) and FT3 (b = 0.71, P < 0.01). Meanwhile, the GRS (b = 2.98, P < 0.05) and GAS (b = 3.11, P < 0.05) linearly correlated with FT3 level. In conclusion, the present study shows that the global longitudinal and radial moves of left ventricular are weaker in patients with hypothyroidism than healthy controls. And the impairment of left ventricular function would aggravate as FSH rises or FT3 declines.
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Humans , Case-Control Studies , Echocardiography, Three-Dimensional , Heart Ventricles , Hypothyroidism , Imaging, Three-Dimensional , Reproducibility of Results , Systole , Ventricular Dysfunction, Left , Diagnosis , Ventricular Function, LeftABSTRACT
Objective To clone and express of Rv0091 encoding protein in Mycobacterium tuberculosis,identify and characterize of the enzyme activities.Methods Construct the Rv0091 prokaryotic expression plasmid,the vector was transformed into E.coli strain BL21trxB.After induced by IPTG,recombinant protein was purified by Ni2+-NTA chromatography and analyzed for purity by SDS-PAGE gels stained with Coomassie Blue.Immunological activity was identified by Western blot.The recombinant protein molecular weight was identified by Mass spectrometry.The enzyme-coupled assay detectes enzyme activity.Results The expression plasmid pET32a-Rv0091 was constructed and expressed in E.coli.BL21trxB,and the optimum expression system was conformed.The purity of the recombinant protein was more than 95％.Western blot analysis confirmed that recombinant protein was one of Mycobacterium tuberculosis proteins.Mass spectrometry identified the relative molecular weight and theoretical molecular weight was basically the same.Enzyme assay showed the recombinant protein able to catalyze the substrate MTA.Enzymatic properties showed that the optimal buffer for the phosphate and Hepes buffer,the poor thermal stability of the enzyme,the optimal temperature of 37℃,optimal pH10-12,when the pH ≤7,the protein denaturation and loss of some vitality.Conclusion The recombinant protein methylthioadenosine nucleosidase(MTAN) was obtained and enzyme activity was detected and plays a key role in the metabolism of Mycobacterium tuberculosis.
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Objective To evaluate the usefulness of real-time three-dimensional transesophageal echocardiography(RT-3D-TEE)in cardiac valvular diseases.Methods Preoperative and postoperative RT-3D-TEE studies were performed in 32 patients who had undertaken cardiac valve repair or valvular replacement using Philips iE33 with X7-2 probe,and quantitative analysed the mitral structure in cases of mitral valve prolapse by using online QLAB7.0 quantitative analysis software.Results RT-3D-TEE can demonstrate the anatomicsl structure clearly,evaluate the function of cardiac valves precisely,and reveal details of type,position and extent of lesions vividly in surgical view.RT-3D-TEE helped correct misdiagnose in 2 cases,revised surgical plans in 3 cases,and guided implementation of remedial surgery in 1 case.Conclusions RT-3D-TEE can present images lively,and it can provide adequate information for preoperative diagnosis,aid the formulation of surgical plan and evaluate surgical effect.
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Objective To evaluate the mechanical characteristics of systolic left ventricular(LV) transmural torsion in different LV electro-mechanical patterns using speckle tracking imaging. Methods Five open-chest canine models were employed for the acquirement of the basal, apical short-axis and four-chamber views of LV during baseline(BASE) and right atrial appendage(RAA), right ventricular apical (RVA), left ventricular lateral wall (LVL) and left ventrieular apical (LVA) pacing. Subendocardial (subend),subepicardial(subepi) and bulk rotation angle(RA) and segmental angle excursion(AE) at basal and apical level were analyzed using a dedicated workstation. LV torsion at different layers and bulk and global LV ejection fraction (EF) were calculated. Results ① There were no significant difference of transmural torsion and RA at basal and apical level between BASE and RAA pacing (P>0.05);② LV torsion of subend, subepi and bulk during RVA pacing were lower than those during RAA pacing(P0.05);LV torsion of subend and bulk during LVA pacing were lower than those during RAA pacing(P0.05);LV RA of subend,subepi and bulk at basal level during RVA and LVA pacing were lower than those during RAA pacing (P<0.05); ③ For normal electro-mechanical pattern, LV torsion of subend were significant higher than that of subepi(P<0.05), there only were a higher tendency for all pacing models (P>0.05); ④AE of segments near the pacing site decreased during different ventricle paeings (P<0.05); ⑤At BASE and during RAA pacing, LV bulk and subepi torsion were positively correlated to EF; RA of subend,subepi and bulk at basal level were positively correlated to EF. Conclusions LV transmual torsion are significantly depressed during RVA and LVA pacing. There is a spatial co-relationship between LV EF and torsion and rotation of bulk and subepi at basal level in normal LV electro-mechanical patterns.
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Objective To evaluate the clinical value of transesophageal echocardiography (TEE) on minimally invasive surgical closure of heart septal defects. Methods Thirty-four patients with atrial septal defect (ASD) and 38 patients with ventricular septal defect(VSD) were selected by transthoracic echocardiography (TTE) prepared for minimally invasive surgical closure. TEE was performed to choose appropriate occluder and guide occluder release during the procedure. The immediate closure effect also evaluated by using TEE. A week follow-up was done by using TTE. Results Successful occlusion was in 32 patients with ASD and 29 patients with VSD. On 1 week follow-up,neither displacement for the occluders nor residual shunt except minimal residual shunt in 3 patients. The ventrieular remodeling was improved, the valvular regurgitation and pulmonary arterial pressure decreased. Conclusions TEE is important in minimally invasive surgical closure of atrial, ventricular septal defects, especially in choosing the candidate for the procedure and occluder, guiding occluder released and evaluating the procedure.