ABSTRACT
Objective:To investigate the effect and relationship of coronary microvascular dysfunction (CMD) on cardiac mechanical indices in patients with non-obstructive coronary artery disease(NOCAD) in the resting state.Methods:This study was a single-center retrospective study. Seventy-nine NOCAD patients who hospitalized in Qilu Hospital of Shandong University from July 2017 to March 2022 were recruited. All patients underwent conventional echocardiography examination and the examination of coronary flow velocity reserved by transthoracic Doppler echocardiography (TTDE-CFVR). Based on the results of TTDE-CFVR, patients were divided into CMD group (CFVR<2.5, 32 cases) and a control group (CFVR≥2.5, 47 cases). Clinical data, routine echocardiographic parameters, regional mechanical indices including regional myocardial work index(RWI) and regional longitudinal strain(RLS), global mechanical indices including left ventricular global longitudinal strain(GLS), global longitudinal strain in the endocardial layer(GLS-endo), global longitudinal strain in the epicardial layer(GLS-epi), left ventricular global work index(GWI), global contractive work(GCW), global waste work(GWW), global work efficiency(GWE) were compared between two groups. Binary logistic regression was used to analyze the risk factors of CMD. ROC curve was used to construct a prediction model for CMD.Results:There was no significant difference in sex ratio, BMI, smoking history, diabetes, hypertension and dyslipidemia between CMD group and control group. Age was significantly higher in the CMD group than in the control group. RWI, GWI, GCW, GWE and the absolute values of RLS, GLS, GLS-endo and GLS-epi were significantly lower in the CMD group than in the control group. Logistic regression analysis showed that the decrease of absolute value of GLS was an independent risk factor for the CMD( OR=1.335, 95% CI=1.041-1.713, P=0.023). ROC curve showed that myocardial strain-related indexes had a good decrease value for the CMD. Conclusions:For patients with NOCAD, the presence of CMD is associated with the decrease of left ventricular regional and global systolic function.
ABSTRACT
Objective:To assess the configuration and systolic function of the left ventricle in patients with chronic thromboembolic pulmonary hypertension (CTEPH) by routine ultrasound, two-dimensional speckle tracking imaging and three-dimensional echocardiography, and to observe the recovery after pulmonary endarterectomy (PEA).Methods:The patients who were diagnosed with CTEPH, underwent PEA and had no left heart disease were enrolled as the CTEPH group ( n=30) in the China-Japan Friendship Hospital from November 2016 and June 2021. The right heart catheterization data before and after surgery were recorded. In the meantime, gender- and age-matched healthy individuals who sought for physical examination during the same period were included as the control group ( n=23). Echocardiography findings before and after PEA were comparatively analyzed and compared between the two groups, including left ventricular end-diastolic diameter (LVEDd), right and left ventricular cross-section ratio (RVd/LVd), left ventricular global longitudinal strain (LVGLS), left ventricular end-diastolic/systolic volume index (LVEDVi/LVESVi), left ventricular ejection fraction (LVEF) and left ventricular stroke volume (LVSV). Associations between the mean pulmonary arterial pressure (mPAP)/pulmonary vascular resistance (PVR) and left ventricular function were discussed. Results:When compared with the control group, the LVEDd, LVEDVi, LVESVi, LVSV, LVGLS and the mitral early to late diastolic flow velocity ratio (E/A) in the CTEPH group were lower (all P<0.05). There were no significant differences between the two groups regarding LVEF, cardiac output (CO), and cardiac index (CI) (all P>0.05). There were no statistical differences of the left ventricular volume and LVSV between PEA group and the control group (both P>0.05), while the LVGLS and E/A remained lower (both P<0.05). Correlation analysis showed negative associations between mPAP and LVSV as well as E/A ( r=-0.490, -0.455; both P<0.05). Conclusions:There are changes in left ventricular configuration with abnormal filling pattern and potential systolic dysfunction in CTEPH patients. The PEA surgery could lead to recovery of the left ventricular configuration and volume, but the filling pattern and LVGLS at follow-up can not recover completely.
ABSTRACT
OBJECTIVES@#The high prevalence and high fatality rate of coronary heart disease seriously endanger the safety of human life. The key to its treatment is to restore the perfusion of the narrowed coronary arteries as soon as possible. Two-dimensional echocardiography is limited for assessment of postoperative myocardial function. Myocardial contrast echocardiography (MCE) and 2-dimensional speckle tracking imaging (2D-STI) possess good value in assessing myocardial perfusion and systolic function. We used MCE and 2D-STI to explore the changes of myocardial perfusion and systolic function after percutaneous coronary intervention (PCI) in patients with coronary heart disease, and to evaluate the clinical value of MCE and 2D-STI.@*METHODS@#Twenty patients with coronary heart disease undergoing PCI were selected. MCE was performed before and one day after PCI, and 2D-STI and conventional ultrasound were performed before and a month after PCI. The recovery of left ventricular wall motion was used as a standard to evaluate the ability of MCE semi-quantitative analysis and to predict the recovery of myocardial segment motion.@*RESULTS@#The quantitative value of MCE (signal intensity of contrast medium in plateau phase, slope of curve, and their product) one day after PCI and the contractile function of one month after PCI were significantly improved (all @*CONCLUSIONS@#MCE and 2D-STI can evaluate the improvement of myocardial perfusion and systolic function in patients with coronary heart disease after PCI, and MCE semi-quantitative analysis can effectively predict the ability of ventricular wall recovery.
Subject(s)
Humans , Contrast Media , Coronary Circulation , Coronary Disease/diagnostic imaging , Echocardiography , Myocardial Infarction , Percutaneous Coronary Intervention , Perfusion , Predictive Value of Tests , Sensitivity and SpecificityABSTRACT
Subject(s)
Adult , Humans , Coronary Artery Disease , Diagnosis , Echocardiography , Heart Diseases , Hemodynamics , Hospital Mortality , Intensive Care Units , Mortality , Prognosis , Retrospective Studies , Sepsis , Shock, Septic , Stroke VolumeABSTRACT
Objective To monitor and analyze the cardiac morphology and functional status at early stage after transcatheter aortic valve implantation (TAVI) by two-dimensional echocardiography. Methods A total of 33 patients with TAVI were selected from Dec. 2017 to Dec. 2019 in the Department of Cardiovascular Surgery of our hospital. The age, gender, New York Heart Association (NYHA) cardiac function classification, previous cardiac surgery history, Society of Thoracic Surgeons (STS) score, surgical approach, complication, other basic data, as well as echocardiography data were collected before and after TAVI (0-2 months). Results Thirty-three patients met the inclusion criteria, including 20 patients with severe aortic stenosis (SAS group), eight patients with severe aortic regurgitation (SAR group), and five patients with SAS combined with SAR (combined group). In the early postoperative period, one patient in SAS group was hospitalized twice for heart failure aggravated by arrhythmia, four patients in SAS group had tiny perivalvular leakage and one patient had large perivalvular leakage; moderate perivalvular leakage occurred in one patient in SAR group, and mild perivalvular leakage occurred in one patient in the combined group. Compared with the preoperative values, early after operation 33 cases had decreased left ventricular end-diastolic volume (LVEDV), left atrial volume (LAV), and maximum aortic valve pressure gradient (AVPGmax), increased effective aortic valve area (AVA) (all P0.01), and unchanged left ventricular ejection fraction (LVEF), interventricular septum thickness (IVST), and posterior wall thickness (PWT) significantly (all P0.05). In SAS group, LVEF and AVA increased, while LAV and AVPGmax decreased significantly (P0.05 or P0.01). In SAR group, LVEDV and LAV decreased, while IVST increased significantly (P0.05 or P0.01). In combined group, LVEDV, LAV and AVPGmax decreased, while AVA increased significantly (P0.05 or P0.01). Conclusion Early after TAVI, the cardiac remodeling and systolic function are improved to different degrees in patients with SAS, SAR, and SAS combined with SAR. High risk patients with SAR alone or combined with SAS can benefit from TAVI.
ABSTRACT
Background/Aim Despite the well-established benefits of cardiac resynchronization therapy (CRT) in heart failure (HF) patients with left ventricular ejection fraction (LVEF) ≤35%, many patients with less reduced EF remain refractory to optimized medical treatment and at high risk of morbidity and mortality. The objective of the study is to evaluate the effects of CRT in optimally treated patients with New York Heart Association (NYHA) classes II–IV, LVEF of 36–45%, and left bundle branch (LBBB), including clinical, structural and biochemical response. Methods A selected group of HF patients have been implanted with CRT-P devices and were followed up for 6 months at 4, 12 and 24 weeks. Clinical assessment included NYHA class, quality of life and 6-min walk distance (6 MWD) test. Echocardiographic assessment included LV dimensions and function and left atrial volume. Serum N-terminal pro b-type natriuretic peptide (NT-ProBNP) was measured at the same intervals. Results This prospective single center study included 23 patients. NYHA functional class significantly improved after CRT-P (p < 0.0001), associated with improvement in QOL (p < 0.0001) and 6 MWD, which increased, from 145.7 ± 20.1 m to 219.5 ± 42.2 m (p < 0.0001). Mean QRS duration showed significant shortening from 164.4 ± 13.2 ms to 126.4 ± 13.6 ms (p < 0.0001). CRT induced reverse remodeling with reduction in both left ventricular end diastolic diameter (LVEDD) from 68.95 ± 5.05 mm to 62.8 ± 4.47 mm, p = 0.0002 and left ventricular end systolic diameter (LVESD) from 54.1 ± 4.5 mm to 46.5 ± 4.1 mm, p < 0.0001, and significant increase in LVEF (from 40.3 ± 2.8 to 48.3 ± 4.2 mm, p < 0.0001). The biochemical response to CRT showed significant reduction in serum NT-ProBNP from 1025.6 ± 363.1 pg/ml to 594.9 ± 263.5 pg/ml (p < 0.0001). Conclusions Symptomatic HF patients on maximal optimized medical treatment who have LBBB and baseline LVEF 35–45% appeared to derive significant clinical and structural benefit from CRT.
ABSTRACT
Objective To quantitatively evaluate the changes of left ventricular myocardial work indices by pressure-strain loops (PSL) using echocardiography in patients undergoing coronary artery bypass grafting(CABG).Methods Thirty patients undergoing CABG from October 2018 to May 2019 in Henan Provincial People's Hospital were chosen as the case group,and 30 healthy subjects were selected as the control group.The myocardial work indices of left ventricle,including global work index(GWI),global constructive work (GCW),global work waste (GWW) and global work efficiency (GWE) were measured by PSL,the differences in myocardial work indices between the two groups,including controls,patients before surgery,1 month,and 3 months after CABG were compared.Results Compared with the control group,GWI,GCW,GWE of the left ventricle in each case groups were decreased before and after CABG, while GWW was increased significantly(all P <0.05);Compared with the preoperation,GWI,GCW, GWW,GWE of left ventricle of the postoperative 1-month were decreased,but the differences were not statistically significant(all P >0.05),while GWI,GWE of left ventricle of the postoperative 3-month were increased,and the differences were statistically significant (all P <0.05);the differences of GWI,GCW, GWE between the postoperative 1-month and 3-month were statistically significant (all P <0.05).GWI, GCW,GWW,GWE were significantly related to left ventricular ej ection fraction (LVEF) or global longitudinal strain(GLS)(all P =0.00).Bland-Altman drawing plots showed that the measurements of GWI,GCW,GWW,GWE between the observers and within the same observer exhibited goodreproducibility.Conclusions PSL can quantitatively evaluate left ventricular myocardial work and provide a new method for the evaluation of left ventricular systolic function in patients undergoing CABG.
ABSTRACT
Objective@#To quantitatively evaluate the changes of left ventricular myocardial work indices by pressure-strain loops (PSL) using echocardiography in patients undergoing coronary artery bypass grafting (CABG).@*Methods@#Thirty patients undergoing CABG from October 2018 to May 2019 in Henan Provincial People′s Hospital were chosen as the case group, and 30 healthy subjects were selected as the control group. The myocardial work indices of left ventricle, including global work index (GWI), global constructive work (GCW), global work waste (GWW) and global work efficiency (GWE) were measured by PSL, the differences in myocardial work indices between the two groups, including controls, patients before surgery, 1 month, and 3 months after CABG were compared.@*Results@#Compared with the control group, GWI, GCW, GWE of the left ventricle in each case groups were decreased before and after CABG, while GWW was increased significantly(all P<0.05); Compared with the preoperation, GWI, GCW, GWW, GWE of left ventricle of the postoperative 1-month were decreased, but the differences were not statistically significant (all P>0.05), while GWI, GWE of left ventricle of the postoperative 3-month were increased, and the differences were statistically significant (all P<0.05); the differences of GWI, GCW, GWE between the postoperative 1-month and 3-month were statistically significant (all P<0.05). GWI, GCW, GWW, GWE were significantly related to left ventricular ejection fraction (LVEF) or global longitudinal strain (GLS) (all P=0.00). Bland-Altman drawing plots showed that the measurements of GWI, GCW, GWW, GWE between the observers and within the same observer exhibited good reproducibility.@*Conclusions@#PSL can quantitatively evaluate left ventricular myocardial work and provide a new method for the evaluation of left ventricular systolic function in patients undergoing CABG.
ABSTRACT
Objective: Shengmai Recipe (SMR) is a Chinese patent medicine used for the treatment of chronic heart disease. In order to further assess the renal-protective effect against ischemia lesion of SMR, the cardioprotective effect of SMR on pressure overload-induced left ventricular (LV) systolic dysfunction and the potential mechanism on alleviating myocardial damage, myocardial fibrosis, and renal ischemia lesion in chronic heart failure (CHF) rats were investigated. Methods: Rats with partially ligated abdominal aorta were randomly divided into model, Sham, and SMR groups. One week after recovery from surgery, animals were preventively ig administered with SMR at the dose of 810 mg/kg once daily for 8 weeks. Cardiac function and structure, endogenous biomarkers (CK-MB and LDH), myocardial fibrosis, and organ pathological change were estimated by echocardiography, immunodepression and velocity method, hematoxylineosin staining, and masson's trichrome staining, respectively. Results: The administration of SMR significantly decreased serum CK-MB and LDH levels and reduced myocardial fibrosis. Interestingly, SMR not only improved cardiac function but also ameliorated kidney injury induced by ischemia in CHF rats. Conclusion: SMR could enhance the LV contractile function, reduce myocardial necrosis, and reverse LV remodeling in CHF rats, and most importantly, SMR could be used to treat the renal ischemia injury in pressure overload rats.
ABSTRACT
Objective To assess the left ventricular systolic function (LVSF) in patients with implanted dual-chamber(DDD) mode cardiac pacemakers using Two-dimensional Echocardiography (2DE),Real-time Tri-plane Echocardiography (RT-3PE)and Full-volume Three Dimensional Echocardiography (FV-3DE).Methods A total of 30 patients with DDD mode cardiac pacemaker were ex-amined by 2DE, RT-3PE and FV-3DE separately.Left ventricle end diastolic volume (LVEDV), left ventricle end systolic volume (LVESV), and ejection fraction (EF) were measured and compared within the three methods above .Results The measurement of EF with patients of post-operation was higher than the patients of pre-operation.The measurements of EF with 2DE were higher than RT-3PE.The measurements of LVEDV , LVESV and SV with 2DE and RT-3PE were lower than FV-3DE, and EF was higher .There were statistically significant differences in above measurements ( P 0.05).Conclusions Implanting DDD mode cardiac pace-maker can evaluate LVSF of patients obviously .FV-3DE can evaluate LVSF in patients with DDD mode cardiac pacemaker accurately . The LVEDV, LVESV and SV are underestimated by 2DE and RT-3PE, and EF is overestimated by 2DE and RT-3PE.
ABSTRACT
Objective To determine the baseline echocardiographic characteristics and the time course and degree of recovery of left ventricular (LV) systolic dysfunction in patients with tachycardia-induced cardiomyopathy ( TCM ) . Methods Seven hundred and fifteen patients received radiofrequency cather ablation ( RFCA ) for tachycardiarrhymias from July 2010 to July 2013 were screened in this study. Only 33 patients with reduced left ventricular ejection fraction (LVEF) (LVEF<50% and improved≥15%) were diagnosed with tachycardia-induced cardiomyopathy and were included in the study. Patients with early improvement (over 25%increase in LVEF at 1-week follow-up compared to the baseline ) were enrolled in the improved group , and the rest patients were enrolled in the improved group. All Patients received transthoracic echocardiography for LV size and function detection at 1 week and at 3,6,12 months follow-up. Results The average baseline of the LV end-diastolic diameter, and the LVEF were (55 ± 10.7)mm and (38 ± 4.6)%, repectively. Early improvement ( over 25%increase in LVEF at 1-week follow-up compared to the baseline ) in the improved group was observed in 16 patients. Patients with early improvement had higher LVEF at 12-month follow-up compared to the patients without early improvement [(69.2± 4.2)% vs (58.1 ± 6.9)%, P < 0.001]. Conclusions RFCA is proved to be a relatively safe and effecient treatment method. Atrial fibrillation related to TCM , rhythm control is superior to the rate control. The early improvement in LVEF may potentially predict the complete reversibility of LV systolic dysfunction.
ABSTRACT
Objective To assess the clinical value of serum uric acid levels in patients with acute ST-elevation myocardial infarction(STEMI).Methods A total of 502 consecutive patients with STEMI were enrolled from January 2005 to December 2010 for retrospective study.The level of serum lipid,echocardiographic data and in-hospital major adverse cardiovascular events(MACE)in patients with hyperuricemia(n =119)were compared with those in patients without hyperuricemia(n =383).The relationship between the level of serum uric acid and the degree of diseased coronary artery was analyzed.All data were analyzed with SPSS version 17.0 software to make t test and x2 test and Pearson correlation analysis.Results Serum uric acid level was positively correlated with serum triglyceride level.Compared with non-hyperuricemia patients,hyperlipidemia was more commonly found among hyperuricemia patients (43.7％ vs.33.7％,P =0.047),and serum triglyceride level was significantly higher in hyperuricemia patients[(2.11 ± 1.24)mmol/L vs.(1.78 ± 1.38)mmol/L,P =0.014].But a significant association between serum uric acid level and one or more diseased vessels was not observed(P ≥ 0.05).Leftventricular end-diastolic diameter(LVEDd)was found to be larger in hyperuricemia patients than non-hyperuricemia patients[(53.52 ±6.19)mm vs.(52.18 ±4.89)mm,P =0.041].Higher incidence in left systolic dysfunction and diastolic dysfunction was discovered in hyperuricemia patients(36.4％ vs.15.1％,P ＜0.01; 68.2％ vs.55.8％,P =0.023).Also,hyp-eruricemia patients had more in-hospital MACE(P ＜ 0.05).Conclusions Serum uric acid level is positively correlated with serum triglyceride level,but not with the severity of coronary artery disease.Hyperuricemia patients after STEMI tended to have higher incidence in left systolic dysfunction and diastolic dysfunction,and have more in-hospital MACE.
ABSTRACT
Objective To evaluate left ventricular function in patients with hypertensive hypertrophic cardiomyopathy(HHC)using real-time 3-dimensional echocardiography(RT-3DE).Methods Thirty patients with HHC and 32 control subjects were studied.Full-volume RT-3DE data from apical window were acquired,and regional volumetric time curves of 17 segments were obtained by fast 3-dimensional border detection software.Several left ventricular function parameters were calculated semiautomatically,including global left ventricular end-diastolic volume(EDV),end-systolic volume(ESV),left ventricular ejection fraction(LVEF),the ratio of ESV/EDV of 17 segments,the standard deviation(SD)and difference(Dif)(adjusted by the R-R interval) of time to minimum systolic volume(Tmsv)in 16 segments(Tmsv16-SD and Tmsv16-Dif).Results EDV and ESV were significantly larger in patients with HHC than that in control subjects[(88±29)ml vs (72±15) ml,t=-2.680,P=0.008;(28±10)ml vs (22±6 )ml,t=-2.613,P=0.01].HHC had a higher ratio of ESV/EDV at interventricular septum(IVS)compared with control group[mid-segments of anterior IVS:(40.51±20.28)% vs (26.43±10.10)%,t=-3.378,P=0.002;mid-segments of posterior IVS:(41.44±23.55)% vs (24.46±8.12)%,t=-3.688,P=0.001;apical segments of IVS:(30.96±21.31)% vs (19.53±7.33)%,t=-2.745,P=0.01].In patients with HHC,Tmsv16-SD and Tmsv16-Dif were significantly longer[(2.48±1.38)% vs (1.16±0.26)%,t=-5.117,P＜0.001;(7.67±5.07)% vs (3.95±1.48)%,t=-3.865,P＜0.001].And the prevalence of left ventricular dyssynchrony was higher than that in control subjects(43% vs 3%).Conclusions HHC patients may have regional left ventricular systolic dysfunction before global changes,and have a higher prevalence of left ventricular dyssynchrony.RT-3DE is a useful imaging modality for assessing left ventricular systolic function.
ABSTRACT
Objective To explore the association between subclinical hypothyroidism and the left ventricular functions under conventional 2D Doppler echocardiography and to provide evidence for the protection of heart function.Methods Literatures regarding the association of subclinical hypothyroidism and the left ventricular functions were retrieved in large databases from home and abroad for the last 12 years.The left ventricular systolic function was assessed by left ventricular ejection fraction and the shortening of left ventricular fraction.The left ventricular diastolic function was assessed by left ventricular early diastolic filling flow velocity,late diastolic filling flow velocity,their ratios(E/A),and the left ventricular isovolumic relaxation time.The relationship between subclinical hypothyroidism and the left ventricular functions were assessed by Meta-analysis with Stata 11 software.The weighted mean difference(WMD)and 95％ confidence interval(CI)were calculated,and the publication bias was assessed by Begg' s test.Results 1 3 eligible papers were included.(1)Statistics on the combined data showed that in the evaluation of left ventricular diastolic function indicators.There were significant differences in left ventricular late diastolic filling flow velocity(WMD=4.51,95％CI:2.41 to 6.61)and E/A(WMD=-0.22,95％CI:-0.30 to-0.13),as well as the left ventricular isovolumic relaxation time(WM D=6.13,95％ CI:2.79 to 9.48)between patients with subclinical hypothyroidism and normal controls but,no significant difference was found in left ventricular early diastolic filling flow velocity.Looking at the left ventricular systolic function indicators.There were no significant differences in the left ventricular ejection fraction and left ventricular fractional shortening between patients with subclinical hypothyroidism and normal controls.(2)Data from the subgroup analysis showed that the differences of left ventricular late diastolic filling flow velocity,E/A and left ventricular isovolumic relaxation time were significantly different between patients with subclinical hypothyroidism and normal controls in the mean heart rate ≥72 bpm group.The difference of left ventricular isovolumic relaxation time was significantly different in the mean heart rate ＜72 bpm group,and the difference of left ventricular late diastolic filling flow velocity was significant in the mean age ＜60-year-old group.Conclusion Subclinical hypothyroidism was associated with the left ventricular diastolic dysfunction,but not associated with the left ventricular systolic dysfunction.The results suggested that subclinical hypothyroidism might change the heart function which could be evaluated by Doppler echocardiography.
ABSTRACT
Objective Anovel index based on frequency-domain analysis of heart rate variability (HRV) was tested on patients with reduced left ventricular systolic function.This index,namely VHFI,was defined as the very high frequency (VHF) component of the power spectrum normalized to represent its relative value in proportion to the total power minus the very low frequency component.Methods Patients (n=130) were divided into a study group,consisting 66 patients with decreased left ventricular systolic function,and a control group,consisting 64 patients with normal heart structure and function and without severe coronary artery stenosis (＜50%).Results VHFI in the study group was significantly higher than that in the control group (19.17±13.35 vs 11.37±10.77,P＜0.001).Cardiac events occurred in 18 patients during follow-up (33.34±3.26 months).Defining the positive test as VHFI =15 and negative test as VHFI ＜15,achieved a sensitivity of 57.58% and a specificity of 78.13% for predicting decreased left ventricular systolic function,and achieved a sensitivity of 66.67% and a specificity of 64.29% for predicting cardiac events.Univariate Cox regression analysis showed that positive VHFI test was an independent variable in predictive cardiac events.Conclusions The results suggest that VHFI is a useful tool for quick evaluation of left ventricular systolic function and prediction of prognosis.
ABSTRACT
@#Objective To investigate left ventricular systolic function with mitral annulus motion velocity(Sa) with pulsed-wave Doppler tissue imaging(PW-DTI) in patients with coronary arteriosclerosis disease(CAD) after percutaneous coronary intervention(PCI).Methods 52 patients with CAD,who were determined by coronary artery angiography,were divided into two groups,PCI group(n=33) and non-PCI group(n=19).They were followed up with PW-DTI and conventional echocardiography before and 5 d,3 months and 6 months after intervention in PCI ones,before and 6 months after angiography in non-PCI ones.In PCI group,the patients were divided two subgroups: EF≥50% and EF=30%～50%.Results The Sa improved significantly in PCI group 6 months after intervention(P<0.001).EF correlated with Sa(r=0.705,r=0.770 pre-and post-intervention respectively,P<0.0001).Conclusion Sa can be used to evaluate left ventricular systolic function of CAD patients.
ABSTRACT
PURPOSE: Obesity is a risk factor for cardiovascular morbidity and is frequently associated with coronary artery disease, hypertension, and diabetes mellitus. Conventional Doppler technique is limited by the absence of an adequate apical window to assess the transmitral flow in obese patients. Tissue Doppler imaging(TDI) and strain rate imaging(SRI) were performed to assess the influence of obesity on left ventricular systolic function. METHODS: In 13 obese and 15 normal adolescents aged 16 to 17 years, height, weight, body mass index(BMI), and obesity index(OI) were measured. Fat mass, body fat percent, and abdominal fat percent were estimated by bioelectrical impedance. Ejection fraction(EF) and myocardial performance index(MPI) were estimated by conventional echocardiography to evaluate left ventricular systolic function. Systolic myocardial velocity and strain rate were estimated by TDI and SRI. RESULTS: EF(63.8+/-6.4% vs 55.7+/-3.4%) was significantly lower in obese adolescents than normal controls. MPI(0.34+/-0.03 vs 0.48+/-0.06) was significantly higher in obese adolescents than normal controls. Systolic myocardial velocity and strain rate were significantly lower in obese adolescents than normal controls. Strain rate showed a negative correlation with arm circumference(r=-0.558, P<0.05) and BMI(r=-0.332, P<0.05). Strain rate was positively correlated with EF(r=0.557, P<0.05) at the base of left ventricle by SRI CONCLUSION: Significant decrease in left ventricular systolic function was noted in the moderate degree of obesity. SRI may be a more useful diagnostic tool in evaluating systolic dysfunction in patients with moderate degree of obesity.
Subject(s)
Adolescent , Humans , Abdominal Fat , Adipose Tissue , Arm , Body Weight , Coronary Artery Disease , Diabetes Mellitus , Echocardiography , Electric Impedance , Heart Ventricles , Hypertension , Obesity , Risk FactorsABSTRACT
PURPOSE--To compare the doses of 750,000 and 1.5 million units (U) of streptokinase (SK), relatively to the left ventricular (LV) systolic function analyzed through contrasted ventriculography. METHODS--We included 110 patients with acute myocardial infarction (AMI) within 6h of the onset (mean-age 60 years, 83.6 men), that were randomized to receive 750,000U of SK in 15 min (55 patients), or 1.5 million U in 30 min (55 patients). The study main goal was the comparison between the groups relatively to LV ejection fraction, global and regional shortening, obtained at the fifth day of the AMI. RESULTS--The 750,000 and 1.5 million groups were homogeneous relatively to 15 analyzed variables. Relatively to the main goal of the study, it was found respectively: a) ejection fraction analysis (median): 64 and 60.5 for the total population (p = 0.25, 95 CI -2.7 to 10), 64 and 57.5 for anterior AMI (p = 0.2, 95 CI -3.6 to 16.3), 65 and 65 for inferior AMI (p = 0.99, 95 CI -8.4 to 8.4); b) global shortening analysis: -2.53 and -2.66 for the total population (p = 0.3, 95 CI -0.47 to 0.87), -2.27 and -2.53 for anterior AMI (p = 0.18, 95 CI -0.3 to 1.4), -1.82 and 1.72 for inferior AMI (p = 0.9, 95 CI -0.82 to 0.75); c) regional shortening analysis: anterior AMI -2.6 and -2.67 (p = 0.47, 95 CI -0.7 to 1.5), inferior AMI -2.3 and -2.32 (p = 0.9, 95 CI -0.82 to 0.75). CONCLUSION--The dose of 750,000U was as efficacious as the 1.5 million relatively to LV systolic function, one of the best survival predictors of short-medium and long-term survival post AMI.
Objetivo −Comparar as doses de 750.000 e 1,5 milhão de unidades (U) de estreptoquinase (EQ), em relação à função sistólica do ventrículo esquerdo (VE), analisada através da ventriculografia contrastada. Métodos − Incluíram-se 110 pacientes com infarto agudo do miocárdio (IAM) <6h de evolução (idade mediana 60 anos, 83,6% homens) que receberam, aleatoriamente, 750.000U de EQ em 15min (55 pacientes), ou 1,5 milhão em 30min (55 pacientes). A meta principal do estudo foi a comparação entre os grupos em relação à fração de ejeção (FE), encurtamento global e regional do VE, obtidas no 5º dia do IAM. Resultados − Os grupos 750.000 e 1,5 milhão mostraram-se homogêneos em relação a 15 variáveis analisadas. Em relação à meta principal do estudo, encontraram-se, respectivamente para os grupos: a) análise da FE (mediana): 64% e 60,5% para o total da população (p=0,25, 95% IC -2,7 a 10), 64% e 57,5% para os IAM anteriores (p=0,2, 95% IC -3,6 a 16,3), 65% e 65% para os IAM inferiores (p=0,99, 95% IC -8,4 a 8,4); b) análise do encurtamento global: -2,53 e -2,66 para o total (p=0,3, 95% IC -0,47 a 0,87), -2,27 e -2,53 para os IAM anteriores (p=0,18, 95% IC -0,3 a 1,4), -1,82 e -1,72 para os IAM inferiores (p=0,9, 95% IC -0,82 a 0,75); c) análise do encurtamento regional: IAM anterior -2,6 e -2,67 (p=0,47, 95% IC -0,7 a 1,5), IAM inferior -2,3 e -2,32 (p=0,9, 95% IC -0,82 a 0,75). Conclusão − A dose de 750.000U mostrou-se tão eficaz quanto a de 1,5 milhão no que se refere à função sistólica do VE, um dos melhores preditores de sobrevida a curto, médio e longo prazos pós IAM
Subject(s)
Humans , Male , Female , Middle Aged , Streptokinase , Ventricular Function, Left/drug effects , Myocardial Infarction/drug therapy , Streptokinase , Prospective Studies , Myocardial Infarction/physiopathology , Infusions, Intravenous , Stroke Volume/drug effectsABSTRACT
The left ventricular systolic function before and after right ventricular pacing was studied in 26 patients by Doppler and M-mode echocardiography. The results showed that there were increases in cardiac output and heart rate, respectively (P
ABSTRACT
0.05) and systolic velocity of regional myocardium, the difference between Ven and Vep, and mitral valve annulus have improved during the follow up study( P