ABSTRACT
Abstract Objectives: The aim of the study was to investigate atrial contractile function in patients with paroxysmal atrial fibrillation (AF) in sinus rhythm using transthoracic echocardiography (EchoCG). Methods and results: Thirty-five patients with paroxysmal AF and arterial hypertension (mean age 62 ± 10 years, 43% male) in sinus rhythm were enrolled in the study. The control group was composed of comparable patients with arterial hypertension without heart rhythm disturbances. EchoCG was performed during sinus rhythm according to an extended protocol, which included the ejection fraction (EF) of the left atrium (LA) and tissue Doppler measurements. Myocardial fibrosis was assessed quantitatively by videodensitometry in intraventricular and intraatrial (IAS) septa using an original image post-processing algorithm. We found a significant decrease in the left atrial contraction function during sinus rhythm in patients with AF when compared to controls. LA EF (34 ± 14 vs. 54 ± 17, p = 0.03) and A' velocity (0.17 ± 0.04 vs. 0.22 ± 0.04, p = 0.008) decreased while A/A' ratio (2.7 ± 0.2 vs. 1.9 ± 0.1, p = 0.006) increased. Peak A velocity was not affected. Videodensitometric analysis revealed a 2.3-fold increase in IAS fibrosis fraction in AF patients compared with controls (p = 0.01). Conclusion: Patients with AF in sinus rhythm have markedly depressed atrial contractile function. Videodensitometry of IAS has the potential to be used as inexpensive method of atrial fibrosis assessment in patients with AF.
Resumen Objetivo: El objetivo del estudio fue investigar la función contráctil auricular en pacientes con fibrilación auricular paroxística (FA) en ritmo sinusal mediante una ecocardiografía transtorácica (EchoCG). Material y métodos: Treinta y cinco pacientes con FA paroxística e hipertensión arterial (edad media de 62 ± 10 años, el 43% varones) se inscribieron en el estudio en ritmo sinusal. El grupo de control estaba compuesto por pacientes comparables con hipertensión arterial sin alteraciones del ritmo cardíaco. Se realizó una ecocardiografía durante el ritmo sinusal, según el protocolo extendido, incluidas la fracción de eyección (FE) de la aurícula izquierda (AI) y las mediciones Doppler tisulares. La fibrosis miocárdica se evaluó cuantitativamente mediante una videodensitometría de los septos interventricular e interauricular (IAS) utilizando un algoritmo de posprocesamiento de imágenes originales. Resultados: Encontramos una disminución significativa en la función de contracción de la aurícula izquierda durante el ritmo sinusal en pacientes con FA en comparación con el grupo de control. Cabe destacar que la FE de la AI (34 ± 14 vs. 54 ± 17, p = 0.03) y la velocidad A' disminuyeron (0.17 ± 0.04 vs. 0.22 ± 0.04, p = 0,008) mientras que la relación A/A' aumentó (2,7 ± 0,2 vs. 1.9 ± 0.1, p = 0,006). La velocidad pico A no se vio afectada. El análisis videodensitométrico reveló que la fracción de fibrosis IAS en pacientes con FA fue 2.3 veces mayor que en el grupo de control (p = 0.01). Conclusiones: Incluso en ritmo sinusal, los pacientes con FA tienen una función contráctil auricular marcadamente deprimida. La videodensitometría de IAS tiene el potencial de utilizarse como método económico de diagnóstico de la fibrosis auricular en pacientes con FA.
ABSTRACT
@#Objective To observe the clinical effect of Mirabegron combined with Silodosin on detrusor hyperactivity with impaired contractile (DHIC).Methods From September, 2019 to December, 2021, 40 patients with DHIC in the Department of Urology of Beijing Bo'ai Hospital were selected and randomly divided into control group and experimental group, with 20 cases in each group. The control group took Silodosin only, and the experimental group took Mirabegron in addition, for four weeks. The urinary diary, residual urine volume, Overactive Bladder Symptom Score (OABSS) and quality of life (QOL) score were compared before and after treatment.Results A total of 18 patients in the control group and 19 in the experimental group finished the trial. After treatment, the number of night urination per day, the residual urine volume and QOL score improved in the control group (P<0.01); the number of urination per 24 hours, the number of night urination per day, the volume per urination, the residual urine volume, the daily urgency score, the OABSS score and QOL score improved in the experimental group (P<0.01). The number decrease of urination per 24 hours, the volume decrease of per urination, the daily urgency score decrease, the OABSS score decrease and QOL score decrease were more in the experimental group than in the control group (P<0.01). The adverse reactions included palpitations, increased heart rate, dyspareunia, increased blood pressure, gastric discomfort, postural hypotension, and retrograde ejaculation, and there was no significant difference between two groups (P > 0.05).Conclusion The efficacy of Mirabellone combined with Silodosin on DHIC is better than Silodosin only, and there was no significant increase in drug-related adverse effects.
ABSTRACT
In humans, left atrial enlargement and reduced contractile functions are associated with adverse cardiovascular events and a poor prognosis in many dilatation of the left atrium occurs with the gradual evolution of chronic mitral valve disease and is well diseases. The left atrium is the most compromised cardiac chamber in dogs with chronic mitral valve disease (CMVD). Therefore, this study aimed to compare the main parameters of left atrial enlargement (left atrium/aorta ratio, left atrial diameter and volume indices) and contractile function (transmitral flow peak velocity A wave and time velocity integral, atrial fraction, and atrial ejection force) at different stages of valve disease, and correlate the left atrial diameter, volume, and contractile function indices with echocardiographic variables predictive of heart failure in dogs (transmitral flow peak velocity E wave, E wave/IVRT ratio, E wave/E´wave ratio, and E wave/A wave ratio). The results showed that progressive characterized by the left atrium/aorta ratio and left atrium volume index. The left atrial diameter and volume indices and left atrium/aorta ratio correlated positively with the transmitral flow peak velocity E wave and E wave/IVRT ratio, which are important indices of diastolic function. The left atrial contractile function indices increased as CMVD evolved. Except for the atrial fraction, the left atrial contractile function indices correlated with the left ventricular filling pressure indices.(AU)
O tamanho e a função atrial esquerda estão relacionados em humanos com eventos cardiovasculares adversos e prognóstico nas principais cardiopatias. Na doença valvar crônica de mitral (DVCM) em cães, o átrio esquerdo é a câmara cardíaca mais comprometida. Portanto, os objetivos deste estudo foram comparar os principais parâmetros de aumento atrial esquerdo (relação átrio esquerdo/aorta, índice do diâmetro atrial esquerdo e índice do volume atrial esquerdo) e função contrátil de átrio esquerdo (velocidade máxima e integral de velocidade da onda A do fluxo transvalvar mitral, fração atrial e força de ejeção atrial) nos diferentes estágios da doença valvar; correlacionar diâmetro e volume atrial esquerdo e os índices de função contrátil atrial esquerda com as variáveis ecocardiográficas preditivas de insuficiência cardíaca em cães (velocidade máxima da onda E do fluxo transvalvar mitral, relação E/TRIV, relação E/E'par e relação E/A). Os resultados mostraram que com a evolução progressiva da doença valvar crônica de mitral, ocorre dilatação progressiva do átrio esquerdo, bem caracterizada pela relação átrio esquerdo/aorta e pelo índice de volume atrial esquerdo. O índice do diâmetro atrial esquerdo, o índice de volume atrial esquerdo e a relação átrio esquerdo/aorta correlacionam-se, positivamente, com a velocidade da onda E e com a relação E/TRIV, que são importantes índices de função diastólica. Os índices de função contrátil do átrio esquerdo aumentam à medida que a DVCM evolui. Os índices de função contrátil do átrio esquerdo apresentam correlação positiva com os índices de pressão de enchimento ventricular esquerdo, exceção feita à fração atrial.(AU)
Subject(s)
Animals , Dogs , Blood Pressure , Dogs/anatomy & histology , Dogs/blood , Heart/anatomy & histologyABSTRACT
Objective To study the effect of an essential α,β-unsaturated aldehyde from cigarette smoke crotonal-dehyde on myocardial contractile function and intracellular Ca2+function in mice. Methods Hearts of from male C57BL/6 mice were digested by Langendorff to islate the cardiomyocytes. The cardiomyocytes of mice were then in-cubated with crotonaldehyde(1,10,25 and 50 μmol/L) for 6 h,and the control group was treated without croton-aldehyde,then they were evaluated including peak shortening(PS),maximal velocity of shortening/relengthening (±dL/dt),time-to-PS(TPS),time-to-90% relengthening(TR90),fura-2 fluorescence intensity(FFI),intracel-lular Ca2+decay and SERCA 45Ca2+uptake and the expression of Na+-Ca2+exchange were evaluated by Western blot analysis. Results Compared with the control group, the higher concentrations of the crotonaldehyde(25 and 50 μmol/L) groups significantly diminished the PS, ±dL/dt,ΔFFI,SERCA activity and Ca2+decay (P<0.05), as well as prolonged the TR90(P<0.05);however the crotonaldehyde with different concentrations had no effect on the expression of Na+-Ca2+exchange in cardiomyocytes. Conclusions Crotonaldehyde may inhibit cardiomyocyte contraction by suppressing SERCA activity and compromising intracellular Ca2+handling.
ABSTRACT
[ ABSTRACT] AIM:To observe the effect of endogenous nitric oxide synthase ( NOS) inhibitor asymmetric dimeth-ylarginine ( ADMA ) and its signaling pathways on NO levels and skeletal muscle contractility in 4-week running rats. METHODS:The 4 weeks running rat model was established.The twitch tension, tetanic tension and the fatigue test of sole-us muscle induced by electrical stimulation ex vivo were detected.The ATP content, mitochondrial DNA levels and the mR-NA expression of peroxisome proliferator-activated receptor γcoactivator-1α(PGC-1α), nuclear respiratory factor (NRF) were measured to reflect the mitochondrial function and biosynthesis in the skeletal muscle.Serum ADMA concentration was detected by high performance liquid chromatography.The endogenous ADMA enzymes PRMT1 and 2 subtypes of ADMA me-tabolism enzyme DDAH, 3 subtypes of NOS protein expression in the skeletal muscle were determined by Western blot.NOS activity and nitric oxide ( NO) content were analyzed by colorimetric method.RESULTS: Compared with normal control group, the twitch tension, tetanic tension and the anti-fatigue capability of soleus muscle in running group were significantly enhanced, ATP content, mitochondrial DNA content and the mRNA expression of PGC-1αand NRF were significantly in-creased (P ance of soleus muscle.The mechanism may be that increased cNOS expression feedbacks to increase ADMA concentration, thus maintaining the increase in NO synthesis at a relatively low level, and resulting in promoting skeletal muscle mitochon-dria biosynthesis and mitochondrial function.
ABSTRACT
@#Objective To investigate the impact of detrusor hyperactivity with impaired contractile function(DHIC)on voiding function in benign prostatic hyperplasia(BPH).Methods68 patients with BPH accepted the test of urodynamics.The urodynamic parameters between DHIC group and no DHIC group were compared statistically.ResultsThe residual urine in DHIC group was larger and the detrusor pressure at Qmax,the bladder volume were smaller than that in no DHIC group(P<0.01).ConclusionDHIC worsens the voiding function of the patients with BPH,and the test of urodynamic is helpful to diagnose and to treat it.
ABSTRACT
Objective To explore the possible effects of hepatocyte growth factors (HGF) on prevention and therapy of disused gastrocnemius atrophy in rats by observing their effects on the wet weight and contractile function of the gastrocnemius of fixed hind limbs. Methods Twenty-four Wister male rats were randomly divided into a blank group, a contrast group and an experimental group. Their right hind limbs were fixed for four weeks with plastic piaster from metatarsus to 1 cm up the knee. Their knee joint was fixed in 100?flexion and their ankle joint in 60?plantar flexion. Rats in the contrast group were injected with 0. 2 mL of normal saline, and rats in the ex- perimental group were injected with HGF (10 mg/kg, 10 mg/mL). Their whole gastrocnemius of the right hind limb was dissected four weeks later to measure its contractile function and wet weight. Results Compared with the blank group, single maximal contraction, maximal tetanus, and wet weight of the gastrocnemius in the contrast and experimental groups decreased significantly (P＜0. 05), and fields of electric stimulation also decreased signifi- cantly (P＜0. 05). Compared with the contrast group, single maximal contraction, maximal tetanus, and wet weight of the gastrocnemius in the experimental group were significantly superior (P＜0.05), and fields of electric stimulation significantly increased. Conclusion Since after a local injection of HGF, the contractile function and wet weight can be significantly increased, HGF may have a preventive effect on disused atrophy.
ABSTRACT
The status of left ventricular (LV) intrinsic contractile function in pure rheumatic mitral stenosis is an unsettled issue. Although the overall LV ejection performance is reduced in a number of patients with MS, it is the product of the interaction of four variables; intrinsic myocardial contractile state, end-diastolic myocardial length(preload), afterload and LV myocardial mass. Although LV intrinsic contractility in MS has been found to be normal in previous studies, we found it to be decreased on the basis of newer techniques for assessing cardiac mechanics. Reliable load-independent indexes of intrinsic contractility using M-mode echocardiography are end-systolic pressure or end-systolic meridian wall stress to end-systolic volume or dimension ratio and fractional fiber shortening to end-systolic stress relations. We assessed LV intrinsic myocardial contractile state as measured by the aforementioned methods in patients with pure rheumatic MS. The results were as follows; 1) The clinical characteristics are no statistical significance of differences between the 2 groups. 2) Preload (LV end-diastolic volume index) was increased in patients with MS(77+/-23 VS 67+/-21 ml/m2, p<0.05). Fractional fiber shortening and LV ejection fraction were significantly lower in patients with MS(31+/-7 VS 40+/-7%, 66+/-9 VS 77+/-8%, p<0.001). 3) End-systolic stress was significantly elevated in the patient population compared with the control subjects (70.1+/-18 VS 50.5+/-10 dynes-cm2x103, p<0.001) The increased in end-systolic stress in the presence of reduced systolic blood pressure(106+/-8 VS 116+/-7mmHg, p<0.001) was due to a higher end-systolic volume index(26+/-12 VS 15+/-6ml/m2 p<0.005) and reduced systolic wall thickening (1.13+/-0.2 VS 1.54+/-0.2cm, p<0.001). 4) The end-systolic stress to volume index ratio and systolic pressure to end-systoli volume ratio were significantly lower in patients with MS(p<0.001). Relation between LV end-systolic wall stress and fractional shortening in patients with MS superimposed on 95% confidence limits of values in 105 normal control subjects derived from a previous study(r=-0.58, p<0.005). Thirty-six(75%) patients were below the 95% confidence limits of normal values.
Subject(s)
Humans , Blood Pressure , Echocardiography , Mechanics , Mitral Valve Stenosis , Reference ValuesABSTRACT
The contractile function of gall-bladder and the cardioautonomic nervous dysfunction were tested in 49 normal controls and 83 diabetics, among these patients 51 had autonomic neuropathy and the others did not. The results showed that the contractile dysfunction of gall-bladder was increased in 37 of 83(44,6%) and normol in the controls. It was higher in the diabetic patients with symptpms of autonomic neuropathy than in those without, and the difference was significant (p