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Objective To assess the difference in left atrial properties between elderly and younger control subjects and the role of left atrium remodeling in patients of different ages with atrial fibrillation.Methods A total of 194 patients with non-valvular atrial fibrillation were enrolled from September 2014 to June 2016.Based on age,patients were divided into an elderly group (≥60 years,n=129) and a younger group (＜60 years,n=65).We evaluated remodeling parameters for the left atrium using an Ultrasound Cardiography (UCG) system in 125 elder subjects,together with 64 control subjects.All remodeling parameters were recorded,including left atrial diameter (LAD),left atrial square (LAS),left atrial pressure (LAP) and left ventricular end-diastolic dimension (LVEDD).Results The elderly group had more female patients and more patients with persistent atrial fibrillation.Meanwhile,scores of CHA2DS2Vsc and levels of N-terminal pro-brain natriuretic peptide (NT-ProBNP) were significantly increased in elderly patients (both P＜0.05).Moreover,the elderly group was associated with increased values of LAD and LAS[(39.1±4.4)mm vs.(37.1±5.3)mm,P＜0.01;and(23.3±4.5)cm2 vs.(21.4±4.8)cm2,P＜0.01;respectively],compared with those in the control group.Spearman's correlation analysis showed that LAD,LAS and LAP were all markedly related to age (r=0.213,P＜0.05;r=-0.175,P＜0.05;r=0.170,P＜0.05;respectively),persistent onset of atrial fibrillation (r=0.401,P＜0.05;r=0.446,P＜0.05;r=0.160,P＜0.05;respectively),and impaired heart function,measured by left ventricular ejection fraction (r=-0.4371,P＜0.05;r=-0.403,P＜0.05;r=-0.364,P＜0.05;respectively) and NT-ProBNP (r=0.485,P＜0.01;r=0.483,P＜ 0.01;r =0.293,P＜ 0.01;respectively).Conclusions Left atrial remodeling properties measured by the UCG system in the elderly with non-valvular atrial fibrillation are more serious than those in mid-aged and young subjects.As a convenient and accurate assessment of remodeling parameters,the UCG system is an excellent option for measuring left atrial remodeling in the elderly population.
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<p><b>OBJECTIVE</b>To observe the association between ambulatory blood pressure levels and blood pressure variability (BPV) with myocardial performance index (MPI) in untreated hypertensive patients.</p><p><b>METHODS</b>From January to September 2013, a total of 81 untreated hypertensive patients were included in this study. All patients received ambulatory blood pressure monitoring and echocardiography measurements. MPI was determined in all patients by the following formula: MPI = (isovolumic contraction time + isovolumic relaxation time)/ejection time. The patients were divided into two groups according to left ventricular MPI: patients with MPI < 0.47 (n = 39) and patients with MPI ≤ 0.47 (n = 42). The mean levels and standard deviation (SD) of 24 h, daytime and nighttime blood pressures were compared between the two groups. SD was used to express BPV. Determinants of MPI were identified by multivariate regression analysis.</p><p><b>RESULTS</b>24 h and daytime systolic blood pressure, 24 h, daytime and nighttime diastolic blood pressure, as well as SD of 24 h and daytime systolic blood pressure ((130.1±8.7), (134.0±8.2), (89.1±6.3), (90.9±6.4), (83.1±9.9), (13.7±3.3) and (14.2±3.5) mmHg (1 mmHg = 0.133 kPa), respectively) were significantly higher in patients with MPI > 0.47 than those ((124.8±8.7), (126.7±8.8), (84.5±7.1), (86.2±7.4), (76.4±7.5), (11.8±2.1) and (10.4±1.9) mmHg, respectively) in patients with MPI ≤ 0.47 (all P < 0.05). Multivariate regression analysis showed that 24 h diastolic blood pressure (β = 0.239, P = 0.007) and SD of 24 h systolic blood pressure (β = 0.333, P < 0.001), left ventricular mass index and early diastolic mitral annular velocity were independently associated with MPI.</p><p><b>CONCLUSION</b>The increase of diastolic blood pressure and systolic BPV are associated with the deterioration of left ventricular function.</p>
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Humans , Blood Pressure , Blood Pressure Monitoring, Ambulatory , Diastole , Echocardiography , Heart Ventricles , Hypertension , Mitral Valve , Ventricular Function, LeftABSTRACT
Objective: To assess the predictive value of coronary lfow reserve (CFR) for diagnosing coronary stenosis by transthoracic Doppler echocardiography (TTDE) in patients with hypertension. Methods: A total of 132 patients scheduled for elective coronary angiography (CAG) due to chest pain were enrolled. The patients were divided into 2 groups: Hypertension group,n=95 and Non-hypertension group,n=37. The CRF of left anterior descending coronary artery (LAD) was measured by ATP stress TTDE at 2 days before CAG in all patients and the results were compared between 2 groups. ROC curve was conducted to assess CFR value in diagnosing LAD stenosis which was deifned by LAD luminal diameter stenosis ≥ 70% in relevant patients. Results: The condition of LAD stenosis was similar between 2 groups (42.1% vs. 35.1%),P>0.05. The CFR value in Hypertension group was lower than that in Non-hypertension group (2.39 ± 0.86) vs. (2.87 ± 1.12),P Conclusion: The patients of hypertension combining chest pain had decreased CFR which implied the dysfunction of their microcirculation. CFR had the better diagnostic value for predicting the signiifcant LAD stenosis in such patients.
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Objective To assess the differences in carotid artery stiffness properties and endothelium-independent dilation (EID)between elderly and young patients,and evaluate the echotracking (ET)system for vascular stiffness at different ages.Methods A total of 79 outpatients with multiple cardiovascular risks were recruited.Clinical data including medical history,height,weight,blood pressure,fasting blood glucose and blood lipid were collected.We evaluated the arterial stiffness parameters of carotid artery and EID using an ultrasonic ET system in 46 elderly subjects,compared with 33 sex-matched non-elderly subjects.The impaired EID function was defined as brachial artery nitroglycerin mediated dilation (NMD)below 4％.Results All stiffness parameters including pressure-strain elasticity modulus stiffness index β (Ep),pulse wave velocity β (PWVβ)and augmentation index (AI)were significantly increased in elderly group compared with the non-elderly group [(138.9±64.7)kPa vs.(100.6±30.8)kPa,(10.9±4.7)vs.(8.2±2.3),and (6.9±1.4)m/s vs.(6.1±0.9)m/s,P＜0.05 respectively],while the exception of arterial compliance (AC)was reduced (0.9±0.3)mm2/kPa vs.(1.0±0.5)mm2/kPa(P＜0.05).The incidence of impaired EID in elderly group was higher than in non-elderly group [56.5％ (26 cases) vs.33.3％ (11 cases),P＜0.05].ET parameters including Ep,stiffness index β,PWVβ,AC and AI were related to age (r=-0.44,-0.45,-0.40,-0.40,0.34,all P＜0.01)； Ep,stiffness index β,PWVβ and AC were also related to impaired EDI (r=-0.38,-0.40,-0.34,-0.29,all P＜0.01).Conclusions Arterial stiffness properties and EID measured by ET system was more serious in elderly with multiple cardiovascular risks than in non-elderly subjects.As a convenient and accurate assessment of stiffness parameters,ET system is optimal option for measuring arterial stiffness and EID in elderly people.
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Objective To evaluate the structure and function of left ventricle in diabetes mellitus (DM) patients without complications by myocardial velocity gradient (MVG) measured by myocardial velocity profile (MVP). Methods Thirty type 2 DM patients without complications and 30 healthy volunteers as controls were enrolled. The heart structure, systolic function and diastolic function of left ventricle were measured by echocardiography and the left ventricular mass index (LVMI) was calculated. Mitral annular systolic movement (Sm) , early rapid filling phase movement ( Em) and atrial contraction movement(Am) were measured by tissue Doppler image and the left ventricular MVG at diastole and systole in subendocardium and subepicardium (MVGs,MVGd) were measured by MVP. Results The diameter of left atria and left ventricle, thickness of interventricular septum and LVMI were higher in DM group than those of control group ( P <0. 05 or P <0. 01) , MVGs, MVGd, and Em were lower in DM group than those of control group( P <0. 05 or P <0. 01). There were no significant differences on E/A, Em/Am and E/Em between two groups. In addition, there were also no significant differences on Sm,left ventricular ejection fraction and left ventricular fraction shortening between two groups. Conclusions Structure and function of left ventricle have changed in patients of DM without complications. MVG measured by MVP is an accurate and sensitive index to assess left ventricular systolic and diastolic function.
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Objective:To explore the related factors of ventricular arrhythmia (VA) complicating acute phase of myocardial infarction and their effects on short term prognosis. Methods:A total of 161 subjects with acute myocardial infarction (AMI) were divided into 5 groups according to VA types: frequent single ventricular premature beat group(n=10),bigeminy or paired ventricular premature beat group (n=21),non-sus- tained ventricular tachycardia group (n=31),ventricular tachycardia and fibrillation group (n=11) and control group (n=88). The characteristics of coronary artery and left ventricular ejection fraction were determined. Results:The incidence of left main coronary occlusion was more frequent in ventricular tachycardia and fibrillation group than in control group (P
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0.05). Conclusion: ?-adrenergic activation inhibits TNF-? (but not IL-6) production induced by LPS in monocytes. The inhibitory effects were not different between early staged hypertensive patients and healthy subjects.
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Objective:To analyze the clinical and echocardiographic features of constrictive pericarditis. Methods: Thirty-six patients diagnosed as having constrictive pericarditis from Oct. 1989 to Jun. 2007 were enrolled in this retrospective study. Clinical manifestations and echocardiographic features were analyzed. Results: The main clinical manifestations were fatigue, effort dyspnea(100%), and sign of pressure elevation of vena cava(97%). Echocardiographic features included thickening of pericardium(67%), abnormal motion of septal and posterior wall of left ventricle in diastole(83%,75% respectively), left and right atrial enlargement(92%,39% respectively), early filling changes of mitral flow with respiration(93%), inferior vena cava dilation and without respiration variation(100%), mitral annulus paradoxical enhanced motion in early diastole. Conclusion: Clinical manifestations of pressure elevation of vena cava were indicators for diagnosis of constrictive pericarditis. Echocardiography could be a valuable method for confirming the diagnosis.
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Objective:To clarify the role of Heat shock proteins (HSPs) on the cardiac function during acute myocardial infarction (AMI) after bone marrow cell implantation (BMT), we examined the expression of HSP32 and HSP70 in a rat model of myocardial infarction. Methods: Myocardial infarction model was induced in the inbred Lewis rats by left anterior descending artery ligation,and 5?10 6 of bone marrow mononuclear cells (BM MNCs) were injected into an ischemic zone. On days 1, 3, 7 and 14 post infarct, the differentiations of transplanted cells and the expressions of HSP32 and HSP70 were determined by immunofluorescence or RT-PCR. The cardiac function was evaluated by echocardiography. Results: Immunofluorescence microscopy of hearts from BMT group revealed that expressions of HSP32 and HSP70 were promoted within cardiomyocytes in the infarction zone and the peri infarct zone,and expressed within some transplanted bone marrow cells as well. RT-PCR also showed the mRNA expression levels of HSP32 and HSP70 in BMT group were significantly higher than those of the control group, peaked on day 3 post infarct (5.0 fold and 2.9 fold, respectively, P
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Objective To analyze the evolutionary trend of clinical features in infective endocarditis.Methods The study enrolled 68 patients who were diagnosed as having infective endocarditis from July 1987 to July 2007.The patients were divided into two groups:group Ⅰ included patients from 1987 to 1997,group Ⅱ included patients from 1997 to 2007.All clinic data were compared.Results In both groups,61 patients(89.7%) had basic heart diseases,67 patients(98.5%) had fever and 62 patients(91.2%)had cardiac murmur;41 patients(60.3%) had positive results in the blood culture.Vegetations were found in 57 cases(83.8%) by echocardiography.The rate of surgical treatment was 19.1%,the total cure rate was 66.7%.Comparing the data between the two groups,age of onset changed from (36.7?12.7)years to (44.4?18.6)years(P
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AIM: To compare the evaluations for the structure and function of the hypertrophic hearts induced by volume overload or pressure overload in rats. METHODS: Volume overload-induced cardiac hypertrophy was established by abdominal aortacaval fistula (ACF) and pressure overload-induced cardiac hypertrophy was developed by constriction of aorta (CA). The cardiac structure and function were analyzed by echocardiography, hemodynamic determination, heart weight measurement and histological examination. RESULTS: Heart weight of rats in all the operated groups was increased compared to the sham-operated groups. In 1-week ACF group, the internal diameter (0.67?0.03)cm vs (0.60?0.02)cm, P
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In the isolated adult rat's ventricular myocytes and artificial bio-membrane-liposomes, the lipid peroxidation caused by generating system of free radicals (FeCl2 & ascorbic acid ) was significantly inhibited by Co Q10, and the inhibition effect of Co Q10 was both dose-and time-dependent. The results showed that Co Q10 had an antioxi-dation effect and served as a scavenger of free radicals at the level of membrane .