ABSTRACT
Objective:To analyze the value of shear wave elastography (SWE) in evaluating carotid artery elasticity in type 2 diabetes mellitus (T2DM) patients with nonalcoholic fatty liver disease (NAFLD).Methods:A total of 98 T2DM patients diagnosed in the Second Affiliated Hospital of Dalian Medical University were selected and divided into three groups according to the results of liver ultrasound examination. 35 patients without NAFLD were in group A, 33 patients with mild NAFLD were in group B, and 30 patients with moderate to severe NAFLD were in group C. All selected individuals showed no plaque formation on carotid ultrasound examination. Left carotid artery intima-media thickness (IMT), carotid artery systolic diameter (Ds), carotid artery diastolic diameter (Dd), and peak systolic velocity (PSV) were measured using conventional two-dimensional and M-mode ultrasound. The stiffness coefficient (β) was obtained through calculation. SWE was used to measure the mean longitudinal modulus of elasticity (MEmean), mean minimum modulus of elasticity (MEmin), and mean maximum modulus of elasticity (MEmax) of the left carotid artery at the end of diastole.Results:There was no statistically significant difference in Ds, Dd, and PSV among the three groups (all P>0.05). Compared with group A and group B, group C had significantly higher IMT, β, MEmean, MEmax, and MEmin (all P<0.05). Compared with the group A, the group B had higher levels of MEmean, MEmax, and MEmin (all P<0.05), there was no statistically significant difference in IMT and β between the groups (all P>0.05). Correlation analysis showed that MEmax, MEmean, and MEmin in each group were positively correlated with β ( r=0.537, 0.543, 0.525, P<0.01), and also positively correlated with HbA 1c ( r=0.456, 0.483, 0.438, P<0.01), but not with IMT (all P>0.05). The intra observer Intraclass correlation coefficient (ICC) of MEmax, MEmean and MEmin measured by SWE was 0.847-0.887, and the inter observer ICC was 0.791-0.934, indicating a good repeatability. Conclusions:SWE can quantitatively evaluate the elasticity of the carotid artery in patients with T2DM and NAFLD.
ABSTRACT
Objective:Three-dimensional speckle tracking echocardiography (3D-STE) was used to evaluate the left ventricular function in patients with triple vessel coronary artery disease without myocardial infarction.Methods:60 patients with three vessel disease of coronary heart disease without myocardial infarction treated in the Second Affiliated Hospital of Dalian Medical University from June 2018 to December 2020 were selected. They were divided into two groups according to the results of coronary angiography. There were 31 cases in group B, and the stenosis rate of all triple vessel coronary artery was 50%-<75%; 29 cases in group C, the stenosis rate of all triple vessel coronary artery was ≥75%; Thirty healthy subjects were recruited as the group A. We measured left ventricular (LV) end-diastolic and end-systolic volume (LVEDV, LVESV) and LV ejection fraction (LVEF) using real-time dynamic three-dimensional echocardiography. The LV strain parameters were acquired by 3D-STE, including global longitudinal strain (GLS), global area strain, global radial strain (GRS) and global circumferential strain (GCS). The correlation between 3D-STE parameters and N-terminal proBNP (NT-proBNP), left ventricular end-diastolic pressure (LVEDP) were analyzed by Pearson linear correlation analysis.Results:The LVEDV and LVESV in group A and B were significantly lower than those in group C (all P<0.05), and the absolute values of LVEF, GLS, GRS, GCS and GAS were higher than those in group C (all P<0.05). There were no significant difference in LVEDV, LVESV and LVEF between group B and group A (all P>0.05), while the absolute values of GLS, GCS and GAS in group B were significantly lower than those in group A (all P<0.05). The absolute values of GLS, GRS, GCS and GAS in group C were negatively correlated with NT-proBNP and LVEDP (all P<0.05). The absolute value of GLS in group B was negatively correlated with NT-proBNP ( P<0.05), and the absolute value of GLS, GRS, GCS and GAS was negatively correlated with LVEDP (all P<0.05). Conclusions:Our study shows that 3D-STE can evaluate the LV function in patients with triple vessel coronary artery disease without myocardial infarction through multiple strain parameters.
ABSTRACT
Background:Inflammatory bowel disease (IBD)is a group of chronic gastrointestinal inflammatory disease and its diagnosis depends on analysis of clinical,endoscopic and pathological characteristics. Aims:To analyze the clinical, endoscopic and pathological characteristics of IBD. Methods:Clinical,endoscopic and pathological characteristics of 99 patients with IBD [including 61 ulcerative colitis (UC)and 38 Crohn's disease (CD)]from January 2010 to April 2017 at Yijishan Hospital were retrospectively analyzed. Results:Compared with CD patients,age in UC patients was significantly increased,incidences of diarrhea,bloody stool were significantly increased while incidence of abdominal mass was significantly decreased (P < 0. 05). Extensive type UC and ileocolonic type CD were common. Proportion of patients received 5-aminosalicylic acid (5-ASA)was significantly higher in UC than in CD (90. 2% vs. 71. 1%,P = 0. 014). Two UC patients achieved remission shown by endoscopy,and endoscopic remission achieved in 3 CD patients. The main pathological features of UC were cryptic branching (57. 1%),cryptic twisting (76. 2%),cryptic atrophy (54. 8%)and cryptic irregularity (28. 6%). Ulcer was seen in 78. 9% of CD patients with active chronic inflammation (mainly lymphocyte and plasmocyte infiltration),and the detection rate of non-caseating granuloma was 15. 8% . Conclusions:UC patients are characterized with older age,diarrhea,bloody stool and higher administration rate of 5-ASA,and the endoscopic features were mucosal bleeding and ulcers. Pathological characteristics of UC were mainly cryptic architectural change and inflammatory infiltration,while those of CD were mainly segmental lesions and chronic inflammation with lymphocyte and plasmocyte infiltration and some with non-caseating granuloma.