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Objective To analyze and compare the changes of cardiac structure and function in patients with borderline pulmonary hypertension.Methods Echocardiographic data of 617 outpatients from February to October 2018 in Peking University People's Hospital were retrospectively analyzed.According to the estimated mean pulmonary artery pressure (mPAP),the patients were divided into normal group (mPAP<19 mmHg),borderline group(19 mmHg≤mPAP<25 mmHg)and elevated group(mPAP≥25 mmHg).Results ①Compared with normal group,the patients were older in borderline group and elevated group[(39.2±10.1)years old vs(46.5±13.5)years old vs(51.8±14.2)years old,all P <0.001]and the proportions of male were relatively lower(69.9％ vs 58.9％ vs 54.4％,all P <0.01).The incidences of smoking,drinking and cardiovascular complications increased significantly.②Compared with normal group, the left atrium[(30.2±8.2)ml/m2 vs(34.5±9.7)ml/m2,P <0.001],left ventricle[(57.4±11.6)ml/m2 vs(60.6±12.5)ml/m2,P <0.01]and right atrium[(19.5±5.9)ml/m2 vs(22.6±7.0)ml/m2,P<0.001] were enlarged in borderline group.Left ventricular global long-axis strain (GLSLV) increased [(-20.1±2.5)％ vs (-21.1 ±3.1)％,P <0.001],but the long-axis strain in the middle segment of right ventricular free wall(GLSRVFWmid)decreased[(-31.4±6.6)％ 对(-27.2±8.8)％,P <0.001]in borderline group.Meanwhile,left ventricular diastolic function was impaired.③Age,sex,right atrial volume,right ventricular area,RV-S',GLSLV ,GLSRVFW mid and mitral valve E/e' were independent risk factors for mPAP elevation.Conclusions Early changes of cardiac structure and function exist in the patients with borderline pulmonary hypertension.Echocardiography is critical for the early diagnosis andfollow-up monitoring of pulmonary hypertension.
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Objective@#To analyze and compare the changes of cardiac structure and function in patients with borderline pulmonary hypertension.@*Methods@#Echocardiographic data of 617 outpatients from February to October 2018 in Peking University People′s Hospital were retrospectively analyzed. According to the estimated mean pulmonary artery pressure (mPAP), the patients were divided into normal group (mPAP<19 mmHg), borderline group (19 mmHg≤mPAP<25 mmHg) and elevated group (mPAP≥25 mmHg).@*Results@#①Compared with normal group，the patients were older in borderline group and elevated group[(39.2±10.1)years old vs (46.5±13.5)years old vs (51.8±14.2)years old，all P<0.001] and the proportions of male were relatively lower (69.9% vs 58.9% vs 54.4%，all P<0.01). The incidences of smoking，drinking and cardiovascular complications increased significantly. ②Compared with normal group，the left atrium[(30.2±8.2)ml/m2 vs (34.5±9.7)ml/m2，P<0.001]，left ventricle[(57.4±11.6)ml/m2 vs (60.6±12.5)ml/m2，P<0.01]and right atrium[(19.5±5.9)ml/m2 vs (22.6±7.0)ml/m2，P<0.001] were enlarged in borderline group.Left ventricular global long-axis strain (GLSLV) increased[(-20.1±2.5)% vs (-21.1±3.1)%，P<0.001]，but the long-axis strain in the middle segment of right ventricular free wall (GLSRVFWmid) decreased[(-31.4±6.6)%对(-27.2±8.8)%，P<0.001] in borderline group.Meanwhile，left ventricular diastolic function was impaired. ③Age，sex，right atrial volume，right ventricular area，RV-S′，GLSLV，GLSRVFWmid and mitral valve E/e′ were independent risk factors for mPAP elevation.@*Conclusions@#Early changes of cardiac structure and function exist in the patients with borderline pulmonary hypertension. Echocardiography is critical for the early diagnosis and follow-up monitoring of pulmonary hypertension.
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Objective To analyze and compare the classification of left atrial size by different echocardiographic measurements based on the latest large sample of normal Chinese adults'echocardiographic data . Methods The echocardiography data of 1067 unselected adult outpatients were retrospectively analyzed . The outpatients were divided into normal or enlarged groups according to the left atrialantero-posteriordiameter(LAD)andleftatrialvolume(LAV),respectively.Results ①LADand LAV enlargement were found in 299 (28 .0％ ) patients and 449 (42 .1％ ) patients of the total population , respectively . ②There was a good positive linear correlation between LAD and LAV ( r = 0 .642 , P =0 .000) ,but the agreement for the classification of left atrial size by LAD and LAV was not ideal ( Kappa =0 .392 , P = 0 .000) . The majority of the patients ( 74 .6％ ) with abnormal LAD had abnormal LAV . Conversely ,among the patients with abnormal LAV ( 50 .3％ ) had normal LAD . ③ The sensitivity and specificity of judging left atrial enlargement were 76 .8％ and 66 .8％ for LAD>3 .7 cm in male ,and 74 .9％and 70 .6％ for LAD>3 .4 cm in female ,respectively . The sensitivity and specificity of judging severely left atrial enlargement were 75 .5％ and 78 .7％ for LAD>4 .0 cm in male ,and 84 .2％ and 75 .8％ for LAD>3 .7 cm in female ,respectively . Conclusions The agreement of the classification of left atrial size by LAD and LAV is limited . LAD-based assessment may result in an underestimation of left atrial size . When LAD is larger than 4 .0 cm for male or 3 .7 cm for female ,the accuracy of LAD in the diagnosis of left atrial enlargement is better .
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Assessment of left ventricular systolic function is the basis of clinical decision making for heart diseases, and is the most common application of echocardiography. Understanding and mastering the methods of left ventricular systolic function assessment is the basic requirement for learning echocardiographic techniques. This article describes the assessment of global systolic function and local systolic function of left ventricle with echocardiography.
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Objective To study the clinical characteristics of hospitalized patients with pericardial effusion.Methods Four hundred and sixty-three pericardial effusion patients (211 males and 252 females) aged 5-92 (57.1±19.4) years admitted to Peking University People's Hospital were divided into 5-39 years old group (n=92),40-59 years old group (n=138),and 60-92 years old group (n=233).Their clinical data were analyzed.Results The top 3 etilogical factors of pericardial perfusion were tumor (22.7％),immune disease (15.8％) and unknown reasons (14.7％).The incidence of pericardial effusion due to immune disease and hypothyroidism was significantly higher while that of pericardial effusion due to chronic renal disease and tuberculosis was significantly lower in female patients than in male patients (P＜0.05,P＜0.01).The incidence of pericardial effusion due to immune disease,unknown reasons and hematopathy was significantly different in 3 groups (33.7％ vs 18.8％ vs 6.9％,9.8％ vs 8.0％ vs 20.6％,18.5％ vs 13.8％ vs 3.0％,P＜0.01).The most common risk factors for pericardial effusion were heart failure,infection,hypoproteinemia and renal insufficiency,with infection accounting for 61.6％.Conclusion ≥1risk factors can aggravate pericardial effusion in most pericardial effusion patients
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<p><b>OBJECTIVE</b>To investigate the interaction between myocardial norepinephrine (NET) and protein interacting with kinase Cα (PICK1), and examine the myocardial expression pattern of NET and PICK1 in mice with adriamycin-induced congestive heart failure.</p><p><b>METHODS</b>(1) Cellular experiments: 293T cells were transfected with NET, GFP-PICK1, NET+GFP-PICK1 or NET+GFP-PICK1(KD-AA), respectively. Immunofluorescence staining was performed 48 h after the transfection. (2) Animal experiments: 40 male C57BL/6J mice were divided into control group and adriamycin group (intraperitoneal injection of 2 mg/kg adriamycin with a cumulative amount of 22 mg/kg). The myocardial mRNA and protein expression level of NET, PICK1 and adrenergic receptor (β1-AR) were detected by real-time PCR and Western blot after 10 weeks.</p><p><b>RESULTS</b>(1) PICK1 mediates the intracellular trafficking of NET. (2) Compared to controls, cardiac mRNA expression of NET remained unchanged, but PICK1 and β1-AR mRNA level were significantly reduced in the heart failure mice. (3) Myocardial NET protein expression level was significantly reduced, whereas tyrosine hydroxylase (TH) protein expression was significantly upregulated in heart failure mice. (4) The myocardial density of sympathetic nerve fibers remained unchanged in heart failure mice.</p><p><b>CONCLUSIONS</b>Cardiac expression of NET and PICK1 are down-regulated in heart failure mice. Reduced PICK1-mediated intracellular trafficking of NET may be involved in the impairment of NET function in this congestive heart failure mice model.</p>
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Animals , Male , Mice , Carrier Proteins , Genetics , Metabolism , Disease Models, Animal , Doxorubicin , Heart Failure , Metabolism , Mice, Inbred C57BL , Myocardium , Metabolism , Norepinephrine Plasma Membrane Transport Proteins , Genetics , Metabolism , Nuclear Proteins , Genetics , Metabolism , RNA, Messenger , GeneticsABSTRACT
Objective To explore the effect of valasartan, an angiotensin Ⅱ type 1 (AT 1) receptor antagonist, on the plasma levels of calcitonin gene-related peptide (CGRP) in patients with essential hypertension. Methods 29 outpatients with essential hypertension were treated with valasartan 80mg/day for 6 weeks. 28 age-matched normal blood pressure people were taken as controls. The plasma levels of CGRP were measured in all patients before and after treatment and in controls. Results The plasma levels of CGRP in hypertensive patients were significantly lower than those in controls (minimal value: 0.00 vs 39.95pg/ml; maximal value: 24.07 vs 155.59pg/ml; P