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Objective To evaluate the echocardiographic features of apical hypertrophic cardiomyopathy( ApHCM). Methods Twenty-seven patients with ApHCM including 21 men and 6 women, average age (42.7 ± 5. 1 ) years old were followed up from 1995 to 2008 to investigate the clinical, electroeardiographic and echocardiographic features. Results The major features of ECG were increased R amplitude( V_4 > V_5 > V_3)and inverteted T wave(especially in V_(3-5) leads and the voltage of the inverteted T waves may be up to ≥10 mm). The major feature of echocardiography was the thickening of left ventricular apical wall to 15 - 37 ( 18. 0± 3. 3 ) mm. The final follow up showed that the mean thickness of the apical wall was ( 19. 7 ±3. 7) mm. The ratio of the thickness of left ventricular apical wall to posterior wall before and after the follow up was 1. 7 ±0. 3 and 1. 9 ±0. 9 respectively, with significant statistical difference ( P < 0. 05). There was no difference in the left ventricular end-diastolic dimension and left ventricular ejection fraction. The main cardiovascular events were atrial fibrillation ( 16 cases) , heart failure of NYHA ID-IV class (3 cases) , anterior wall myocardial infarction ( 1 case) and sudden death ( 1 case). Conclusions The final diagnosis of ApHCM depends on the characteristic inverteted T wave in ECG and apical hypertrophy in echocardiography. The prognosis of ApHCM is rather good for its progression is relatively slow.
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This study evaluated the change in regional left ventricular myocardial function in rats following acute occlusion of the left anterior descending coronary artery (LAD) by using two-dimensional speckle tracking imaging (2D-STI). Sixty Wistar rats were randomly divided into two groups,a myocardial infarction (MI) group,in which 50 rats were subjected to LAD occlusion for 30-45 min,and a sham-operated (SHAM) group that contained 10 rats serving as control. Echocardiography was performed at baseline and 1,4 and 8 week(s) after the operation. High frequency two-dimensional images of left ventricular short axis at papillary muscle level were recorded. Peak systolic radial strain (PRS) and circumferential strain (PCS) were measured in the mid-ventricle in short-axis view by using EchoPAC workstation. Left ventrieular internal diameter at diastole (LVIDd)and systole (LVIDs),fractional shortening (FS),ejection fraction (EF) and left ventricular mass (LVM)were measured by anatomical M-model echocardiography. Infarct size was measured using triphenyl tetrazolium chloride (TTC) staining 1 week and 8 weeks after the operation. Fibrosis of left ventricular myocardium was displayed using Van Gieson staining 1 week after the infarction. In terms of the TTC staining results,the left ventricle fell into three categories:infarcted,peri-infarcted and remote myocardial regions. Compared with those at baseline and in the SHAM group,(1) PRS and PCS in the infarcted,peri-infarcted and remote myocardial regions were significantly decreased in the MI group within 1 week after the operation (P＜0.05) and the low levels lasted 8 weeks;(2) Compared with those at baseline,LVIDd,LVIDs,FS,EF and LVM in the MI group showed no significant difference 1 week after the operation (P＞0.05). However,LVIDd,LVIDs and LVM were increased significantly 4 and 8 weeks after the operation (P＜0.05),and FS and EF were decreased substantially (P＜0.05). Van Gieson staining showed that fibrosis developed in all the three myocardial regions to varying degrees. It is concluded that 2D-STI is non-invasive and can be used to assess regional function of myoeardium with different blood supply in rats following acute occlusion of the LAD,and can be used as a sensitive and reliable means to follow up the process of left ventricular remodeling.
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Objective To evaluate left ventricular torsion in patients after coronary artery bypass graft(CABG) surgery by velocity vector imaging(VVI). Methods Twelve patients who were scheduled to have CABG surgery were enrolled. VVI offline software was used to evaluate myocardial rotation in both basal and apical segment before and three months after CABG. The rotation and rotation rate of each a counterclockwise rotation at the apex and a clockwise rotation at the base, and the absolute value of CABG the rotation at the base was significantly improved than that before CABG (P <0.001), and the rotation in the segment of anterior septum, anterior wail and inferior septum at the base was higher than that rotation in the apical and basal segment three months after CABG was also significantly higher than that negative peak rotation rate in the early diastolic period at the apex were significantly higher than those at the improved than that before CABG (P <0.001). And the positive peak rotation of the systolic period in the segment of anterior septum,anterior wall,lateral wall and inferior septum and the negative peak rotation of the diastolic period in the segment of anterior and inferior septum at the base were also higher than those before CABG (P <0.001). Conclusions VVI is a useful method which can quantitatively assess left ventrieular torsion in patients before and after CABG surgery.
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Objective To evaluate myocardial coronary flow reserve of syndrom X by real-time myocardial contrast echocardiography(MCE). Methods Ten patients with syndrome X and seven normal subjects were involved in the study. Real-time MCE was performed with acoustic contrast SonoVue,and the peak video density (A), and re-turgor velocity of microvessel (β), and the product of A ×β of quiescent condition and after adenosin loading were detected,and also the coronary flow reserve (CFR, the ratio of A xβ circa-adenosin loading). Results There was no significant difference of A between syndrom X and contrast group in quiescent condition, the β and product of A x β of patients with syndrome X were lower than those of contrast group, the CFR of syndrome X was obviously less than that of contrast group.Conclusions Myocardial microvessel function is abnormal in syndrome X, real-time MCE is useful for evaluate myocardial coronary flow reserve.
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Objective To explore the corresponding relationship between isolated Q waves in lead Ⅲ on the electrocardiography(ECG) and echocardiographie segmental diagnosis of myocardial infarction(MI).Methods The shape magnitude of Q waves of 27 patients with MI and the relationship with eehocardiographie features were investigated. Results Twenty-four patients with inferior wall myocardial infarction had close relationship with isolated Q waves in lead Ⅲ on the ECG. Conclusions There is definite corresponding relation between isolated Q waves in lead Ⅲ and inferior wall myocardial infarction.
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BACKGROUND: Systemic lupus erythematosus(SLE) frequently has cardiovascular complications. Pericardial inflammation and effusion. ventricular dysfunction, valvular disease and coronary atherosclerosis may result in morbidity. While the pathologic findings in SLE have been well described, the antemortem documentation of the cardiac complications has been less frequent than the postmortem findings would support, we therefore sought to study how echocariography may improve the clinical assessment of cardiac involvement in 40 consecutive patients with SLE. SUBJECTS AND METHODS: This study began in 1990 with a prospective design. An appointment was scheduled with all patients whose SLE was diagnosed at the outpatient clinic and during the admission of the internal medicine service at the Kang Nam St Mary's hospital These were 40 female patients, with a mean age of 32+/-11 years(+/-SD). The average duration of disease was 37+/-32months, the average dosage of prednisolone per day was 20+/-17mg. M-mode and 2-D echocardiogram were carried out to the 40 SLE patients. RESULT: Seventeen(43%) of the SLE patients had pericardial effusion. Reduced left ventricular contractility was evident in 8 patients(20%). Abnormality of diastolic dysfunction to be checked by A/E ratio was in 3 patients(8%). No patients had echocardiographic evidence of pulmonary arterial hypertension. Clinical findings of myocardial dysfunction in these patients included dyspnea(30%), jugular venous distension(20%), rales(10%) and S3 gallop(8%). Valvular abnormality of SLE patients included mitral regurgitation in five patients(13%) and aortic regurgitation in two patients(5%). Electrocardiogram showed myocardial ischemia, atrial fibrillation and sick sinus syndrome in 3, 1 and 1 patients respectively. CONCLUSION: In this study, pericardial effusion were the most common echocardiopraphic abnormalities in Patients with SLE. The incidence of valvular and myocardial disease were relatively common.