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Objective To investigate the characteristics of clinical and cardiovascular magnetic resonance imaging(CMR) of arrhythmogenic cardiomyopathy with left ventricular(ALVC) involvement. Methods Ten cases of arrhythmogenic cardiomyopathy with left ventricular involvement and sixteen randomly chosen cases of arrhythmogenic cardiomyopathy with right ventricular (ARVC) involvement were enrolled in this study. Clinical symptoms, cardiac electrophysiological changes as well as the cardiac morpharage, ventricular functions and delayed enhancement of myocardium assessed by CMR were compared between the two groups. The size of heart chambers, global ventricular functions and the fat/fibrosis infiltration were evaluated by turbo fast spin echo, ture FISP cine and delayed enhancement. These were statistically analyzed by independent samples t test, respectively.Results There was no significant difference in age and gender between two groups. All the patients in two groups presented non-specific clinical manifestations with no significant differences (P>0.05) except for short of breath(P=0.034). The end-diastolic diameter of left ventricular, left ventricular end-diastolic volume index, left and right ejection fraction in ALVC and ARVC group were (64.2±7.7), (49.2±5.9) mm(t=5.551,P<0.001), (113.9±24.0), (69.2± 30.0) ml/m2(t=3.962, P<0.001), (38.5±3.1)%, (56.0±8.4)%(t=-6.733,P<0.001), (42.0±5.5)%, (18.0±7.3)%(t=8.817, P<0.001) respectively. An medium of 11 and 14 segments of fat or fat/fibrosis were found in intramural wall of the LV myocardiumin patients with ALVC,while only 0 segment(all P<0.001)was found in patients with ARVC.Conclusions The clinical manifestations of arrhythmogenic cardiomyopathy with left ventricular involvement was similar to ARVC, however, with regarding to cardiac morphological, functional and myocardial lesions, these two diseases have different characteristics in CMR features.“one-stop-shop”MRI examination has high value in the diagnosis of arrhythmogenic cardiomyopathy with Left ventricular involvement.
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<p><b>OBJECTIVE</b>To investigate the predictive value of cardiac magnetic resonance (CMR) on outcome of patients with hypertrophic obstructive cardiomyopathy (HOCM) undergoing percutaneous transluminal septal myocardial ablation (PTSMA).</p><p><b>METHODS</b>A total of 38 consecutive HOCM patients underwent CMR imaging before PTSMA in Fuwai hospital From March 2010 to September 2012 were included in this retrospective study. The efficacy was defined as >30 mmHg (1 mmHg = 0.133 kPa) reduction of echocardiography derived left ventricular outflow tract gradient (LVOTG) at 6 months post operation. The relationship between CMR imaging derived parameters and effect of PTSMA was analyzed. Receiver operating curve (ROC) was applied to assess the predicting effectiveness of related CMR parameters.</p><p><b>RESULTS</b>The effective rate of PTSMA was 65.8% (25/38). The thickness of basal anterior wall (r = 0.505, P = 0.001), basal anteroseptal wall (0.500, P = 0.001) and the sum of the two segments (r = 0.656, P < 0.001) was positively correlated to the post-procedure reduction of LVOTG. The area under the ROC curve of the thickness of basal anterior wall, basal anteroseptal wall and the sum of the two segments was 0.806, 0.675 and 0.834, respectively. The sensitivity was 84.6% and specificity was 84.0% to predict the efficacy of PTSMA using the sum of left ventricular basal anterior wall and basal anteroseptal wall thickness 49.6 mm as cut-off value.</p><p><b>CONCLUSIONS</b>LVOTG reduction post PTSMA positively correlates to pre-procedure left ventricular basal anterior wall, basal anteroseptal wall and the total thickness of these two segments in patients with HOCM. The total thickness of these two segments is a superior parameter for predicting efficacy of PTSMA in HOCM patients.</p>
Subject(s)
Humans , Cardiac Surgical Procedures , Cardiomyopathy, Hypertrophic , Diagnosis , Therapeutics , Echocardiography , Heart Septum , Heart Ventricles , Magnetic Resonance Spectroscopy , Predictive Value of Tests , Prognosis , Retrospective Studies , Sensitivity and SpecificityABSTRACT
Objective: To observe the effect of amlodipine on bone marrow endothelial progenitor cell (EPC) mobilization, neo-vascularization and cardiac function in diabetic rats after myocardial infarction (MI) with the possible mechanisms. Methods: A total of 60 male SD rats were divided into 2 groups. Normal group, n=20. Diabetic group, n=40, the rats were fed with high fat diet (HFD) for 4 weeks and then received streptozotocin followed by left anterior descending coronary artery ligation to establish MI model, those rats were further divided into 2 sub-groups:Control group, the rats received sodium carboxymethylcellulose 1 ml/day with HFD and Treatment group, the rats received amlodipine 2 mg/kg/day with HFD, n=20 in each sub-group, all animals were treated for 4 weeks. The EPC level in peripheral blood CD45-/low+/CD133+/KDR+ at before and 1, 3, 5, 7, 14, 28 days after operation were examined by lfow cytometry, plasma vascular endothelial growth factor (VEGF) level was measured by ELISA, capillary density in MI area was determined by CD31 staining, EPC related protein expressions were detected by western blot analysis and the cardiac function was evaluated by echocardiography. Results: EPC in CD45-/low+/CD133+/KDR+in Treatment group at 7 days after operation was increased than Control group at 5 days after operation (112 ± 30/106) vs (55 ± 10/106), plasma VEGF in Treatment group was higher than Control group (5.63 ± 1.33) ng/L vs (3.68 ± 0.98) ng/L; Treatment group presented increased expressions of protein kinase B, endothelial nitric oxide synthase (eNOS) and matrix metallopeptidase-9, increased capillary density in MI area, higher LVEF and left ventricular fractional shorting, all P Conclusion: Amlodipine improves EPC mobilization, neo-vascularization and cardiac function in diabetic-MI rats, it may be related to VEGF/eNOS cascade activation.
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Objective To investigate the feasibility of a small amount of water intake at the early stage after general anesthesia in children.Methods Five hundred and seventy children underwent operations under general anesthesia were randomly divided into 2 groups:control group ( n =288) and early postoperative drinking group ( n =282).The children received routine water deprivation after operation in control group.After recovery from anesthesia and recovery of coughing and swallowing reflexes,the children were allowed to drink a small amount of water in early postoperative drinking group.The incidences of crying,bucking,aspiration and hyoxemia were recorded before water intake and at 5 min after water intake.Results Compared with control group,the incidence of crying was significantly decreased and no significant change was found in the incidence of bucking in early postoperative drinking group.No patients exhibited aspiration and hyoxemia in the two groups.Conclusion It is feasible that children drink a small amount of water at the early stage after general anesthesia.
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BACKGROUND:Children with learning difficulty often present with cognitive impairments and imbalanced development of intelligence accompanied by emotional and behavioral problems.OBJECTIVE:To evaluate the therapeutic effects of integrated interventions in multiple aspects for children with learning difficulties.DESIGN:A case-control study of children with learning difficulties.SETTING:Department of Pediatric Internal Medicine, Union Hospital Affiliated to Fujian Medical University.PARTICIPANTS:This study involved school-age children of 6 to 12years old with learning difficulties who came to the department specialized in pediatric psychology for consultation from July 1998 to July 2001. The diagnosis of learning difficulties conformed to the diagnostic criteria for special learning disability in ICD-10 with IQ ＞ 70 as an essential condition. Children with emotional disorders, mental deficiency, hyperactivity,visual and auditory dysfunctions and organic cerebral diseases were excluded. The diagnosis was further verified by a professor specialized in neuropsychology. The children voluntarily participated in the cognitive training, behavioral intervention and comprehensive trainings of senses and those who fulfilled the one-year treatment were included in this study. The ratio of therapists to the children was 1:2, and each session of treatment lasted for 90-120 minutes given 2-3 times a week, and a treatment course consisted of 24 sessions. The children were supposed to complete 4 consecutive treatment courses. Totally 31 children completed the treatment courses, including 24 boys and 7 girls with the mean age of(7.7±1.2)years who had an average IQ of 87.5±8.6.grated interventions for one year consisting of cognitive training, behavioral intervention and comprehensive training of the senses. Raven's Deductive Reasoning test and Beery Visual-Motor Integration Test were use to examine the deductive reasoning ability and visual-motor integration of the children, and visual attention test and auditory attention test, as well as sequential and reverse-sequence memory tests were employed to test their attentions. Achenbach children behavioral scale was applied to evaluate the children's behavioral problems, and Conners' questionnaire for children's behavioral problem was used to measure their attention-deficit/hyperactivity disorder (ADHD) index.MAIN OUTCOME MEASURES:Changes in the deductive reasoning ability, capability of visual-motor integration, attention and psychological behaviors after one year of intervention.RESULTS:All the 31 patients children entered the result analysis with no loss. After one year of integrated intervention, the children had significantly improved scores for Raven's Deductive Reasoning Test (87.51 ±8.64 vs 90.03±8.70, t=-9.610, P ＜ 0.001) and Beery Visual-Motor Integration Test (6.75±1.74 vs 8.27±1.94, t=-9.002, P ＜ 0.001). Obvious improvement was also seen in the visual attention test (15.90±20.11 vs 2.74±3.67), scope of auditory attention and memory (7.70±1.60 vs 11.23±1.23for sequential memory and 3.52±0.93 vs 6.97±0.16 for reversed-sequence memory, P ＜ 0.01). The total scores for ADHD assessment declined to different extents at 3 and 6 months during the treatment and upon the completion of the treatment (22.65±3.53 vs 18.87±4.14 at month 3, 5.65±3.92at month 6 and 12.65±3.36 at one year, t=7.35-15.36, P ＜ 0.01). The scores for 9 psychobehavioral items in Achenbach children behavioral scale obviously declined were also reduced significantly during the therapy,and 87% (26/31) of the children had obviously improved academic performance.CONCLUSION:Interventions integrating cognitive training, behavioral intervention and comprehensive training of the senses may produce good and persistent effect on the cognitive and emotional symptoms of children with learning difficulties, resulting in obviously improved visual, auditory and brain functions.