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Abstract Background: The strain parameters of Real-Time Three-Dimensional Spot Tracking Echocardiography (RT3D-STE) are GLS, GAS, GRS, and GCS, while each index can significantly diagnose Acute Myocardial Infarction (AMI) patients, but none of them can distinguish between NSTEMI and STEMI. MicroRNAs (miRNAs) play essential roles in Acute Myocardial Infarction (AMI), but little is known about the value of exosome miRNA combined with RealTime Three-Dimensional Spot Tracking Echocardiography (RT3D-STE) between ST-segment Elevation Myocardial Infarction (STEMI) and Non-ST-segment Elevation Myocardial Infarction (NSTEMI). Aim: To estimate the exosomal miRNAs related to strain parameters of RT3D-STE as biomarkers for early detection of STEMI and NSTEMI. Methods: The present study collected plasma samples from thirty-four (34) patients with AMI (including STEMI and NSTEMI) and employed high-throughput sequence technology and real-time quantitative polymerase chain reaction (RT-qPCR) to identify the differentially expressed miRNAs. The Pearson correlation coefficient is used to measure the strength of a linear association between differentially expressed miRNAs and strain parameters of RT3D-STE. Results: Twenty-eight (28) differentially expressed exosomal miRNAs were universally identified between STEMI, NSTEM, and normal groups. Among them, there are 10 miRNAs (miR-152-5p, miR-3681-5p, miR-193a-5p, miR-193b-5p miR-345-5p, miR-125a-5p, miR-365a-3p, miR-4520-2-3p, hsa-miR-193b-3p and hsa-miR-5579-5p) with a Pearson correlation greater than 0.6 with RT3D-STE strain parameters. Especially, miR-152-5p and miR-3681-5p showed the most significant correlation with RT3D-STE strain parameters. Target genes of these 10 miRNAs are analyzed for Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways enrichment, and they were found to be mainly involved in the cellular metabolism processes and HIF-1 signaling pathway. RT-qPCR verified the significant differential expression of miR-152-5p and miR-3681-5p between STEMI and NSTEM groups. Conclusion: RT3D-STE and exosome miRNAs can be used as a hierarchical diagnostic system in AMI. If the RT3D-STE is abnormal, the exosome miRNAs can be detected again to obtain more detailed and accurate diagnostic results between STEMI and NSTEM groups. Exosomal miR-152-5p and miR-3681-5p may serve as potential biomarkers for ST-segment elevation myocardial infarction. HIGHLIGHTS RT3D-STE and exosome miRNAs can be used as a hierarchical diagnostic system in AMI. Exosomal miR-152-5p and miR-3681-5p function as potential biomarkers for ST-segment elevation myocardial infarction.
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Background: The Echocardiography is the mainstay investigation tool used in stroke patients. Stroke has acquired third place as leading cause of death with ischemic stroke being very common among all the types of the stroke.Objective of the study was to evaluate 2D Echo cardiography findings in the stroke (ischemic) patients.Methods: Hospital based cross sectional study was carried out among the confirmed 50 patients of ischemic stroke. Routine investigations has been done to all the patients included in the study, specific investigations like 2D echo and CT brain (Plain), Doppler study of carotids and fasting lipid profile has been done.Results: Majority of the study subjects belonged to the age group of 60-69 years i.e. 36% followed by the age group of 50-59 years. The most common risk factor for this ischemic stroke found out in the present study was hypertension in 66% of the cases. The prevalence of ischemic stroke was 70% in the males and 30% in the females. Out of 50 cases, 43 cases i.e. 86% were having abnormal lipid profile. Bilateral carotid atherosclerosis (64%) is more common than the unilateral carotid atherosclerosis (36%) on color Doppler study. Mitral annular calcification was the most common finding in 2D ECHO study in 52% of the cases.Conclusions: Males are more affected than females. Hypertension and smoking are two major and predominant risk factors for stroke. Elderly age group is commonly affected. Bilateral carotid atherosclerosis is common finding on color Doppler study and Mitral annular calcification the most common finding in 2D ECHO study.
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Background: Atrial fibrillation (AF) is the most common arrhythmia. It is associated with significant morbidity and mortality. The size and volume of left atrium is an important development of atrial fibrillation which land up subjects into various complications so present study was carried out to study echocardiography findings (size and volume) among AF Cases with various underlying aetiology. Material and methods: A cross-sectional observational study was conducted for duration of 2 years to measure left atrial size and volume by echocardiography in patients of atrial fibrillation in various diseases. Aproforma was designed to collect the desired information from the patients. The preformed structured proforma consisted of recording of investigations was used as data collection tool. All efforts were made to diagnose the aetiology of atrial fibrillation. Results: A total of 50 cases of AF were studied with mean age of study participants 53.68±12.74 yrs (range 25-80yrs) and F: M-1.3:1. Major risk factors found were RHD (44%) Hypertension (28%) IHD (24%) and DM (14%).Mean LAvolume and size on echo measurement was 78.16ml and 2 28.88cm .There was significant dilatation of LAamong RHD with p<0.05 among major risk factors found in study.
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Objective: To explore the application value and safety of low-dose dobutamine stress echocardiogram (LDDSE) in patients of low-flow/low-gradient aortic stenosis combining left ventricular dysfunction with transcatheter aortic valve replacement (TAVR). Methods: A total of 5 eligible consecutive patients with contradiction of routine surgical valve replacement and going to receive TAVR in our hospital from 2013-10 to 2016-07 were enrolled. The mean aortic valvegradient, maximum flow velocity, each stroke volume and ejection fraction were recorded before and during LDDSE examination. The patients having confirmed diagnosis of true severe aortic stenosis with left ventricular contractile reserve received TAVR, for those without left ventricular contractile reserve received drug therapy or TAVR conditionally. The changes of cardiac function and NT-proBNP level were observed after TAVR. Results: All 5 patients showed positive finding in LDDSE; the mean aortic valve gradient ≥40mmHg and stroke volume≥20% implied that the patients had true severe aortic stenosis with left ventricular contractile reserve. No adverse reaction occurred during and after LDDSE. TAVR was performed in 4 patients and 1 was waiting for TAVR or balloon dilatation since temporary lacking of valve. The post-operative cardiac function was improved in all patients and NT-proBNP level was declined continuously. Conclusion: LDDSE examination could be considered in patients of aortic stenosis combining left ventricular dysfunction, low-flow and low-gradient to clarify ventricular contractile reserve and the severity of aortic stenosis. If the patients with ventricular contractile reserve, TAVR was recommended which was the effective treatment for relevant patients.
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Objective To evaluate the fetal cardiovascular function in selective intrauterine growth restriction (sIUGR)in monochorionic diamniotic(MCDA)twins by using 2D and color Doppler ultrasonography. Methods Twenty - four sIUGR pregnancies and 20 normal MCDA twins pregnancies were enrolled at the First Affiliated Hospital of Sun Yat - Sen University from December 2013 to September 2014,and cardiac structure of fetus and Doppler patterns of the umbilical artery(UA),umbilical vein(UV),pulsatility index of ductus venosus(DV - PI),atrioventricular valve, semilunar valve,tricuspid annulus systolic displacement(TAPSE),fractional shortening of left ventricle short axis(FS) and myocardial performance index(Tei index)of both ventricles were assessed. Results Cardiothoracic ratio,heart rate,DV - PI,FS,TAPSE,Tei index of the left ventricle(0. 34 ± 0. 03,0. 34 ± 0. 04),Tei index of the right ventricle (0. 35 ± 0. 03,0. 35 ± 0. 03)were not significantly different compared with those of the normal MCDA twins(all P ﹥0. 05). Cardiothoracic ratio,ventricular wall thickness,isovolumetric relaxation time( IRT),isovolumetric contraction time(ICT),TAPSE and tricuspid regurgitation(TR)in the larger twins of sIUGR were significantly bigger than those in the smaller twins of sIUGR(all P ﹤ 0. 05),Tei index of both ventricles in the larger twin of sIUGR was significantly higher than that in the smaller twins of sIUGR(Tei index of left ventricle:0. 43 ± 0. 06 vs 0. 35 ± 0. 04,Tei index of right ventricle:0. 43 ± 0. 06 vs 0. 34 ± 0. 04,P ﹤ 0. 05),the peak E in early diastolic / the peak A in atrial contraction (E/ A),the percentage of inflow during of cardiac cycle length(inflow/ CCL)in larger twin of sIUGR were significantly lower than those in smaller twin of sIUGR(all P ﹤ 0. 05). Conclusions There was no difference of cardiac function in normal MCDA twins,at the beginning of the diagnosis of sIUGR,cardiac dysfunction were found in larger twin,follow -up examination are helpful to clinical decision.
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PURPOSE: This is a retrospective descriptive study to determine the incidence of congenital heart disease(CHD) in Jeju and to estimate the suitability of the Jeju population as the subject for a regional birth cohort study. METHODS: All patients with CHD diagnosed by two dimensional echocardiography in Cheju National University Hospital and Halla General Hospital from January 1999 to March 2003 were included in this study. RESULTS: From April 1999 to March 2002, the crude incidence rate was 10.06 per 1,000 live births (236 cases/23,464 live births). Among the 236 cases, the proportion of each type was as follows: Ventricular septal defect(44.9%), atrial septal defect(21.2%), pulmonary stenosis(11.0%), patent ductus arterios us(9.3%), tetralogy of Fallot(3.4%), transposition of great arteries(2.1%), aortic stenosis(1.3%), hypoplastic left heart syndrome(1.3%), coarctation of aorta(0.8%), total anormalous pulmonary venous return(0.8%), tricuspid atresia(0.8%), heterotaxia(0.4%), single ventricle(0.4%), atrioventricular septal defect(0.4%), Ebstein anomaly(0.4%). The male to female ratio was 1:1.380(P=0.011). For unknown reasons, females showed significantly higher incidence in VSD(P=0.005) and PDA(P=0.019). Mortality rate was 0.34 per 1,000 live births. The types of VSD were 72.1% of perimembranous, 16.4% of trabecular muscular, 5.7% of subarterial, and 5.7% of unknown. CONCLUSION: This is the first regional study on the incidence of CHD in Korea. The incidence of CHD in Jeju was 10.06 per 1,000 live births. Most of our cases were VSDs and ASDs. Jeju would be a good subject for a regional cohort study in the future.
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Female , Humans , Male , Cohort Studies , Echocardiography , Heart , Heart Defects, Congenital , Hospitals, General , Incidence , Korea , Live Birth , Mortality , Parturition , Retrospective StudiesABSTRACT
BACKGROUND: A left to right shunt through an iatrogenic atrial septal defect(ASD) is known to occur after percutaneous mitral valvuloplasty(PMV), however, its hemodynamic significance as well as methods for the quantitation and follow-up evaluation have not been well established. SUBJECTS AND METHOD: In order to compare the feasibilities of noninvasive diagnostic methods for the detection and quantitation of the left-to-right shunt after PMV. 35 patients(age 37+/-10 years) undertook either radionuclide angiography or transesophageal echocardiography or both within a week after PMV. Qp/Qs was calculated by Fick's oxygen method during cardiac catheterization and by indicator dilution method during radionuclide angiography. The left-to-right shunt was also quantified with transesophageal echocardiography(TEE) by calculating shunt flow rate(Q=2 pir2Vr) using isovelocity surface area. RESULT: TEE was the most sensitive to detect ASD(16 among 27 patients, 59%) compared to either RI angiography(5 among 27 patients, 18%, Qp/Qs>1.5) or cardiac catheterization(4 among 35 patients, 11%, oxygen step-up>7%). Calculated shunt flow rate by TEE showed significant linear correlation to the Qp/Qs by cardiac catheterization(r=0.73, p<0.001). Also there was a significant correlation between Qp/Qs by radionuclide angiography and by cardiac catheterization(r=0.49, p<0.01). CONCLUSION: Both radionuclide angiography and TEE appear useful for the detection and quantitation of the left to right shunt after PMV. Since TEE seems to be not only more sensitive to detect the presence of the ASD than either radionuclide angiography or cardiac catheterization but useful to quantify the left-to-right shunt, it appears to be useful method for the follow-up evaluation after PMV.