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OBJECTIVES@#Early detection of asymptomatic diastolic dysfunction is essential to prevent the development of heart failure in hypertensive patients. Current studies suggest that left atrial strain contributes to the evaluation of left ventricular diastolic function, but there are fewer studies on the correlation between left atrial strain and diastolic function in hypertensive patients. In this study, we applied a two-dimensional speckle tracking technique to evaluate the changes in left atrial strain in hypertensive patients, and to investigate the relationship between left atrial strain and left ventricular diastolic function.@*METHODS@#A total of 82 hypertensive patients who were visited the Department of Cardiology at the Third Xiangya Hospital of Central South University from July 2021 to January 2022, were enrolled for this study, and 59 healthy subjects served as a control group. According to the number of left ventricular diastolic function indexes recommended by the 2016 American Society of Echocardiography Diastolic Function Guidelines (mitral annular e´ velocity: Septal e´<7 cm/s, lateral e´<10 cm/s, E/e´ ratio>14, left atrial volume index>34 mL/m2, peak tricuspid regurgitation velocity>2.8 m/s), the hypertensive patients were divided into 3 groups: Group Ⅰ (0 index, n=36 ), Group Ⅱ (1 index, n=39), and Group Ⅲ (2 indexes, n=7). Two-dimensional speckle tracking technique was used to measure left atrial reservoir strain (LASr), conduit strain, and contraction strain, and to analyze the correlation between left atrial strain and left ventricular diastolic function in hypertensive patients.@*RESULTS@#The LASr, left atrial conduit strain (LAScd), and LASr/(E/septal e´) of the hypertension group were lower than those of the control group, and E/LASr was higher than that of the control group. There was no significant difference in left atrium volume index between the 2 groups (P>0.05). Compared with Group Ⅰ, LASr, LAScd, and LASr/(E/septal e´) were decreased in Group Ⅱ and Group Ⅲ, LASr/(E/septal e´) was also decreased in Group Ⅲ compared with Group Ⅱ (all P<0.05). Compared with Group Ⅰ, E/LASr was increased in Group Ⅲ. LASr was positively correlated with septal e´, lateral e´, E, and E/A, and negatively correlated with E/septal e´.@*CONCLUSIONS@#The changes of left atrial function in patients with early hypertension are earlier than those of left atrial structure. Left atrial strain and its combination with conventional ultrasonographic indices [LASr/(E/septal e´)] of diastolic function are potentially useful in assessing left ventricular diastolic function in hypertensive patients.
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Humans , Atrial Fibrillation , Atrial Appendage , Heart Atria/diagnostic imaging , Hypertension/complications , DiastoleABSTRACT
Objective:To investigate the effect of ulinastatin injection on left ventricular diastolic function and prognosis in patients with sepsis.Methods:A total of 100 patients with sepsis admitted to the Intensive Care Unit from January 2021 to March 2022 were selected. According to the random number table, they were randomly (random number) divided into the control group (conventional treatment) and experimental group (conventional treatment + ulinastatin injection). The baseline data on admission were compared between the two groups. The echocardiographic indexes [mitral peak velocity of early filling/early diastolic mitral annular velocity (E/e'), early diastolic mitral annular velocity (e'), mitral peak velocity of early filling/ mitral peak velocity of late filling (E/A), and tricuspid regurgitation rate (TRV)], myocardial damage-related and cardiac function-related indicators [troponin I (cTnI), N terminal pro B type natriuretic peptide (NTproBNP)] and inflammation-related indicators [C-reaction protein (CRP), procalcitonin (PCT), erythrocyte sedimentation rate (ESR)], length of ICU stay, duration of infection control, duration of vasoactive drug use and 28-day mortality were observed and compared between the two groups on admission and 7 days after treatment.Results:On the 7th day after treatment, the levels of e 'and E/A in the experimental group were significantly higher than those in the control group, and the levels of E/e', TRV, cTnI, NTproBNP, CRP and PCT were significantly decreased ( P<0.05). There were no significant differences in duration of infection control and duration of vasoactive drug use between the experimental group and the control group ( P<0.05), but the length of ICU stay was shorter and 28-day mortality was significantly lower in the experimental group than in the control group ( P<0.05). Conclusions:Ulinastatin can reduce the degree of inflammatory response, relieve myocardial injury, improve left ventricular diastolic function, and reduce the length of ICU stay and 28-day mortality in patients with sepsis.
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Objective:To evaluate the characteristics of diastolic left intraventricular pressure differences(IVPD) and intraventricular pressure gradients(IVPG) among normal adults in different ages by vector flow mapping.Methods:From March 2019 to October 2020, 1 093 healthy volunteers were selected from the physical examination center of the Second Affiliated Hospital of Harbin Medical University, and they were divided into youth group (18-40 years old), middle-aged group (41-65 years old) and elderly group (>65 years old). IVPD and IVPG during isovolumetric relaxation(IR) period, rapid filling (RF) period, slow filling(SF) period, and atrial contraction(AC) period were measured by vector flow mapping, and were correlated with left ventricular diastolic function parameters.Results:①IVPD-IR, IVPD-AC, IVPG-IR, and IVPG-AC gradually increased while IVPD-RF, IVPD-SF, and IVPG-RF gradually decreased from the youth group to the elderly group(all P<0.05). ②IVPD-RF and IVPG-RF were positively correlated with E( r=0.391, 0.402, P<0.001, respectively). IVPD-AC and IVPG-AC were positively correlated with A( r=0.407, 0.425, P<0.001, respectively) and E/e′( r=0.268, 0.294, P<0.001, respectively) while negatively correlated with E/A( r=-0.510, -0.506, P<0.001, respectively) and e′/a′( r=-0.514, -0.511, P<0.001, respectively). Conclusions:IVPD and IVPG can quantitatively analyze the changes of left ventricular hemodynamics in normal subjects, which are expected to be new indexes to evaluate left ventricular diastolic function.
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Objective To analyze the correlation of the maximum myocardial stiffness (maxEav), maximum modulus of elasticity (Emax) with the E/A ratio of mltral annulus at the end of left ventricular systole for patients with essential hypertension. Methods 298 patients with essential hypertension were selected as research objects. The left ventricular mass index (LVMI) and relative wall thickness (RWT) of the patients were calculated. Based on LVMI and RWT indexes, the patients were divided into left ventricular normal (LVN) group, left ventricular concentric remodeling (LVCR) group, left ventricular eccentric hypertrophy (LVEH) group, left ventricular concentric hypertrophy (LVCH) group, respectively. In addition, 115 healthy subjects were selected into control group. The subjects were diagnosed by echocardiography, so as to analyze the correlation of maxEav, Emax with E/A. Results The maxEav, Emax and E/A in LVCR group, LVEH group and LVCH group were all negatively correlated. The differences of E/A between LVCR group, LVCH group and control group showed statistical significance. Compared with control groups, both the maxEav and Emax in hypertension group decreased, and the difference was statistically significant. Conclusions The maxEav and Emax are more sensitive and easy indexes to judge left ventricular diastolic function. The analysis on maxEav and Emax changes in patients with left ventricular remodeling and diastolic dysfunction in hypertension, as well as the exploration on pathogenesis of diastolic heart failure, can provide the theoretical basis for prevention and treatment of diastolic heart failure in the future.
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@#Objective To evaluate the changes of left ventricular structure and function by echocardiography and its grading of left ventricular diastolic function in patients with mitral valve prolapse treated by minimally invasive mitral valve repair. Methods By retrospective analysis, 37 patients including 25 males and 12 females aged 53.49±11.02 years with mitral valve prolapse who underwent minimally invasive mitral valve repair were as an operation group, and 34 healthy persons including 19 males and 15 females aged 54.26±8.33 years matched by age and sex were selected as a control group. Ultrasound parameters of every participant were routinely collected before operation, 1 month, 3 months, 6 months and 1 year after operation, and left ventricular diastolic function was graded. The ultrasound parameters between the two groups were compared. Results The diameters of left ventricular end systolic and diastolic phase, left atrial diameter and left ventricular volume in the operation group were significantly smaller than those before operation. The diameters of left ventricle and left atrium after operation were significantly shorter than those before operation, but they were still larger than those of the control group. The ejection fraction value decreased significantly at one month after the operation and then returned to normal level. The incidence of left ventricular diastolic dysfunction at 6 months and 1 year after operation was significantly lower than that before operation (P<0.05). Conclusion Minimally invasive repair for patients with mitral valve prolapse can significantly improve systolic and diastolic functions of left ventricle while reconstructing left atrial and left ventricular structures.
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Objective To investigate the correlation between serum lectin like oxidized low density lipoprotein receptor-1 ( sLOX-1 ) and left ventricular diastolic function in patients with essential hypertension. Methods From January 2016 to July 2017, one hundred and forty-six patients with essential hypertension were selected and divided into two groups according to the ratio of E/ A,the left ventricular diastolic function group (76 cases) and the left ventricular diastolic function group (70 cases),the sLOX-1 level of the patients was detected by ELISA method, and the left ventricular diastolic function was evaluated by echocardiography. The correlation between sLOX-1 and left ventricular diastolic function was analyzed. Results The serum sLOX-1 levels in left ventricular diastolic function group (( 208. 12 ± 13. 48 ) μg/ L ) were significantly higher than those inthe left ventricular diastolic function group ((152. 12 ± 12. 96) μg/ L) . The difference between the two groups was statistically significant (t= 6. 586,P= 0. 000). Logistic regression analysis showed that serum sLOX-1 was a influence factor of left ventricular diastolic function (OR= 2. 42,95%CI 1. 42-2. 82,P = 0. 036) . Conclusion The levels of serum sLOX-1 can be used as a indicator of left ventricular diastolic function.
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Objective:To discuss the clinical assessment value of comprehensive echocardiographic parameters in detecting the left ventricular diastolic function in patients with hypertension. Methods: 60 hypertensive patients (30 cases without left ventricular hypertrophy (non-LVH), 30 cases with left ventricular hypertrophy(LVH) were divided into hypertension group, and 60 healthy subjects were in control group. All of the subjects were underwent M type, color ultrasound and tissue Doppler imaging (TDI). And to compare their comprehensive echocardiographic parameters.Results: Compared with the healthy control group, the IVSd, LVPWd, LVMI, LAD and LVD of hypertension group were significantly enlargement; the s', e', E peak and LVEDP of hypertension group also significantly increased, while a' and A peak were significantly reduced; compared with non-LVH, e', E peak and LVEDP of LVH group were significantly increased, and a' and A peak were significantly reduced, and these differences were statistically significant (t=-4.39,t=-4.39,t=5.47,t=-8.02, t=6.20,t=18.95, t=16.12;P<0.01).Conclusion: The comprehensive echocardiographic parameters can evaluate the extent of damage for left ventricular diastolic function of patients with hypertension, and they can be as the assessment standard of left ventricular hypertrophy. In clinical practice, TDI can be used as a new means in the evaluation of ventricular diastolic function.
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Objective To investigatethe clinical value of troponin-I(cTnI)in patientswith septic shocka-nd left ventricular diastolic dysfunction. Methods As a retrospective analysis ,38 patients with left ventricular di-astolic dysfunction and septic shock(Sa group),as well as 20 patients with normal cardiac function(Sn group) were enrolled in this study. Moreover ,20 patients with left ventricular diastolic dysfunction and without septic shock were used as control group(Ca group). The ratio of early diastolic mitral inflow velocity to early diastolic mi-tral annulus velocity(E/e′)was measured as the evaluation index of left ventricular diastolicfunction by echocar-diography within 72 hours after admission to ICU. Level of cTnI was detected in all cases and the relationship was evaluated by E/e′. Receiver operating characteristic curve(ROC)was constructed to indicate the predictable value of left ventricular diastolic dysfunction in patients with septic shock. Results The level of cTnI was significantly elevated in both Sa group and Sn group(P<0.05),while the level of cTnI and E/e′in Sa group were significantly higher than those in Sn group(P < 0.05). cTnI was positively correlated with E/e′(r = 0.367 ,P = 0.004). The area under the curve(AUC)of cTnI was 0.834,with the cut-off value of 0.49 ng/mL(sensibility=77.6,specificity=80.7). Conclusion The level of cTnI was significantly higher in patients with septic shock. cTnI was significantly correlated to left ventricular diastolic dysfunction in patients with septic shock. cTnI ≥ 0.49 ng/mL could be an available predictor for left ventricular diastolic dysfunction in patients with septic shock.
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Objective To investigate the expression of cardiac troponin-Ⅰ (cTnⅠ) levels in patients diagnosed with sepsis-associated myocardial dysfunction and explore the relationship between cTn Ⅰ and cardiac systolic and diastolic function.Additionally,we evaluated the prognostic value of cTn Ⅰ as a valuable biomarker.Methods We admitted 65 patients with sepsis.Using echocardiography,the ratio of early diastolic mitral inflow velocity to early diastolic mitral annulus velocity (E/e') and the left ventricular ejection fraction (LVEF) were measured as an evaluation index of left ventricular diastolic and systolic function,respectively.Patients were divided into a cardiac dysfunction and a normal cardiac function group.The cTn Ⅰ level was measured and compared between the two groups,and we determined the correlation between cTn Ⅰ levels and cardiac diastolic and systolic function.Based on assessment of 28-day mortality,cases were divided into a survivor and a death group.A receiver operating characteristic curve was constructed to predict the prognostic value of cTn Ⅰ.Results The cTn Ⅰ level in the cardiac dysfunction group was significantly higher than that observed in the normal cardiac function group (P ＜ 0.05) and showed a positive correlation with E/e'(r =0.421,P =0.008).However,there was no correlation noted between the cTn Ⅰ level and LVEF (P ＞ 0.05).Compared to the survivor group,the level of cTn]Ⅰ was significantly higher in the death group (P ＜ 0.05).The prognostic value of cTn Ⅰ area under the curve was 0.892,with a cut-off value of 0.82 ng/mL (sensitivity =88.0％ and specificity =82.5％).Conclusion The cTn Ⅰ level is noted to be significantly elevated in patients with sepsis-associated cardiac dysfunction and shows a positive correlation with left ventricular diastolic function.A cTn Ⅰ level ≥ 0.82 ng/mL can be used as a valuable predictor of mortality in patients with sepsis.
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BACKGROUND: In adults, tissue Doppler imaging (TDI) is a recommended component of routine echocardiography. However, TDI velocities are less accepted in pediatrics, due to their strong variability and age dependence in children. This study examines the distribution of myocardial tissue Doppler velocities in healthy children to assess the effect of age with cardiac growth on the various echocardiographic measurements. METHODS: Total 144 healthy children were enrolled in this study. They were recruited from the pediatric outpatient clinic for routine well-child visits. The statistical relationships between age and TDI values were analyzed. Also, the statistical relationships between body surface area (BSA) and TDI values, left ventricle end-diastolic dimension (LVEDD) and TDI values were analyzed. Also, we conducted multivariate analysis of cardiac growth parameters such as, age, BSA, LVEDD and TDI velocity data. RESULTS: All of the age, BSA, and LVEDD had positive correlations with deceleration time (DT), pressure half-time (PHT), peak early diastolic myocardial velocity, peak systolic myocardial velocity, and had negative correlations with peak late diastolic velocity (A) and the ratio of trans-mitral inflow velocity to early diastolic velocity of mitral annulus (E/E'). In the multivariate analysis, all of the age, BSA, and LVEDD had positive correlations with DT, PHT, and negative correlations with A and E/E'. CONCLUSION: The cardiac growth parameters related alterations of E/E' may suggest that diastolic myocardial velocities are cardiac growth dependent, and diastolic function has positive correlation with cardiac growth in pediatric group. This cardiac growth related myocardial functional variation would be important for assessment of cardiac involvement either in healthy and sick child.
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Adult , Child , Humans , Ambulatory Care Facilities , Body Surface Area , Deceleration , Echocardiography , Heart Ventricles , Multivariate Analysis , PediatricsABSTRACT
Objective: To explore the relationship between myocardial ischemia and left ventricular diastolic function (LVDF) by fractional lfow reserve (FFR) evaluation in patients with coronary artery disease (CAD). Methods: A total of 57 patients with chest pain were studied, the diagnosis of CAD was confirmed by coronary angiography, which indicated 50%-70%of coronary stenosis. All patients received FFR examination and they were divided into 2 groups:Experimental group, the patients with FFR Results: The patients’ gender, age, history of hypertension, diabetes, blood levels of cholesterol, TG, LDL-C, HDL-C and glucose were similar between 2 groups, P>0.05. Compared with Control group, the Experimental group had the increased LVEDD, LAD and E/e ' value and decreased LVEF, all P Conclusion: The impact of CAD on early diastolic function depends on functional myocardial ischemia in relevant patients.
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Objective: To explore the relationship between strain rate parameter and left ventricular diastolic function (LVDF) in patients with cardiac resynchronization therapy (CRT) by two-dimensional speckle tracking echocardiography (2D-STE). Methods: A total of 70 heart failure (HF) patients with CRT were studied. The early left ventricular diastolic strain rate was obtained by 2D-STE technology, the differences of left ventricular diastolic functional parameters to various CRT echocardiographic responses were observed. The area of relevant parameters under ROC curve was calculated by early left ventricular diastolic strain rate for predicting CRT echocardiographic response. Results: There were 41 patients presented as CRT echocardiographic responders at 12 months of follow-up period, 29 patients were non-responders. The most parameters of LVDF were signiifcantly improved than the base line in 41 responders. The maximum area of 2D-STE derived parameters under ROC curve was obtained by LSRE predicted CRT echocardiographic response Conclusion: LSRE had greater value for predicting CRT echocardiographic response, it might be used as a sensitive index for evaluating LVDF in HF patients.
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Objective To explore the effect of the severity of coronary artery on left ventricular diastolic function in patients with unstable angina (UA).Methods One hundred and seventy-two patients with UA consecutively from December 2010 to August 2011 were enrolled.All patients underwent coronary angiography (CAG) and echocardiography.The patients were divided into four groups according to left ventricular diastolic function by echocardiography:Thirty-eight subjects with normal(Non-HFNEF),45 subjects with mild dysfunction (Grade Ⅰ),57 subjects with moderate dysfunction(Grade Ⅱ) and 32 subjects with severe dysfunction grade (Grade Ⅲ).The effect of the severity of coronary artery on the left ventricular diastolic function was analyzed.Results There were significant difference on left atrial dimension (3.24 ± 0.50) nn vs (3.40 ±0.41) mmvs (3.56±0.44) mm vs (3.78 ±0.36) mm (F=21.454,P＜0.001),left ventricular posterior wall (0.84 ±0.11) mm vs (0.90 ±0.12) mm vs (0.92 ±0.09) ram vs (0.94 ±0.15) mm (F =10.743,P ＜ 0.001) and left ventricular mass index (105.63 ± 33.13) g/m2 vs (113.09 ± 21.55) g/m2 vs (122.26 ±41.52) g/m2 vs (132.96 ± 31.06) g/m2(F =9.746,P ＜ 0.001) among the four groups.Diastolic function was significantly correlated with the severity of coronary artery(r =0.466,P ＜ 0.001).Conclusion In the patients with UA,left ventricular diastolic function was significantly influenced by the extent of coronary artery stenosis.
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Objective To explore the relationship between left ventricular diastolic function and the dynamic changes of myocardial ultrastructure and argyrophilic fiber in diabetic rats on the different periods of lesions(week 4,12 and 24).Methods The diabetes mellitus(DM)in healthy male Sprague-Dawley rats was induced by a single injection of streptozotocin(STZ,Sigma)into intraperitoneal at a dose of 65 mg/kg body weight.The left ventricular diastolic function was measured by Color Doppler Flow Imaging-Pulsed Wave(CDFIPW)and Doppler Tissue Imaging(DTI)echocardiography.Heart tissue at the apex was obtained rapidly for transmission electron microscope study.Argyrophilic staining was used in the study of argyrophilic fiber volume fraction(APFVF)in heart interstitial tissue.Results Diastolic dysfunction of left ventricle was detected in STZinduced diabetic rats by CDFI-PW(E/A ＜ 1)at week 4,and progressed gradually.Pseudonormal filling (E/A ＞ 1)was found in diabetic rats at week 24,which could be identified by DTI(Ea/Aa ＜ 1).Diastolic function of normal rats was not impaired(E/A ＞ 1 and Ea/Aa ＞ 1).Transmission electron microscopy revealed a spectrum of subcellular remodeling in myocardium which was characterized by myofibril content decrease,disorganization,mitochondrial degeneration,sarcoplasmic reticulum,structural disorder.Compared with the control group,APFVF in myocardium was increased significantly in diabetic rats(P ＜ 0.05).Conclusion The diastolic dysfunction in STZ-induced diabetic rats correlates with damage of ultrastructure and increase of myocardial argyrophilic fiber.
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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.
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PURPOSE: To analyze the effect of maintenance hemodialysis on left ventricular diastolic function in patients with end-stage renal disease. METHODS: Study population consisted of 42 patients with end-stage renal disease. Before an arteriovenous fistula was surgically created, the patients were evaluated by conventional and Doppler echocardiography and Doppler tissue imaging. Then, the patients undergoing hemodialysis treatment when the arteriovenous fistula was compleated. After the first hemodialysis session (mean 76.14 ± 11.37 days) the second echocardiographic evaluations were performed. RESULTS: Mean age was 58 ± 13 years and 21 ( percent50) of the patients were female. After maintenance hemodialysis treatment; peak early (E) and peak late (A) diastolic mitral inflow velocities and E/A ratio were not significantly change however the deceleration time of E wave and left atrial diameter were significantly increased. Also there was no change in the early (Em) and late (Am) diastolic myocardial velocities and Em/Am ratios of lateral and septal walls of left ventricular. E/Em ratio was decreased insignificantly. Pulmonary vein velocities and right ventricular functions are remained almost unchanged after hemodialysis treatment. DISCUSSION: The acute and long-term effect of hemodialysis on left ventricular diastolic function is unclearly. Patients with end-stage renal disease treatment with hemodialysis via arteriovenous fistula experience a variety of hemodynamic and metabolic abnormalities that predispose to alterations in left and right ventricular functions. The present study showed that left ventricular diastolic function except left atrial diameter and right ventricular functions were not significantly change, however left ventricular systolic functions were impaired after maintenance hemodialysis treatment in patients with end-stage renal disease. CONCLUSION: It has been suggested that echocardiographic parameters are useful markers for evaluation of left ventricular and right ventricular functions in patients with end-stage renal disease. However, in patients with endstage renal disease treated with hemodialysis, repeated assessment of echocardiographic examinations to observe serial changes in left and right ventricular functions are not yet well established. In this study, we showed that acute changes of volume status and electrolytes and autonomic regulation by hemodialysis session did not affect left ventricular diastolic and right ventricular functions in a relatively long term.
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Female , Humans , Male , Middle Aged , Diastole/physiology , Kidney Failure, Chronic/therapy , Renal Dialysis/adverse effects , Ventricular Dysfunction, Left/physiopathology , Ventricular Function, Left/physiology , Arteriovenous Shunt, Surgical , Echocardiography, Doppler , Kidney Failure, Chronic/complications , Kidney Failure, Chronic/physiopathology , Prospective Studies , Renal Dialysis/methods , Statistics, Nonparametric , Time Factors , Ventricular Dysfunction, Left/etiology , Ventricular Dysfunction, LeftABSTRACT
AIM: To analyze and compare the changes of pressure phase plane(PPP) derived τ and K on isolated rat heart during ischemia/reperfusion, and to explore the value of PPP derived τ and K for evaluation of left ventricular diastolic dysfunction. METHODS: LVEDP, -d(p/dt)_(max), τ and K were measured and calculated during ischemia/reperfusion in Sprague-Dawley rat hearts. Meanwhile, the level of lactate dehydrogenase (LDH) in the coronary effluent was measured, and the ultrastructure changes in myocardium were observed under electron microscope. RESULTS: Compared with control group, τ increased and K reduced significantly in each ischemic group in a time dependent manner (P<0.05). With prolonged ischemia, τ was even higher and K was even lower (P<0.05). Compared with control group, except ischemia 15 min, LDH in other groups increased significantly at 10 min and 20 min after reperfusion (P<0.05). Compared with ischemia 30 min, LDH of ischemia 45 min and ischemia 60 min were even higher at 10 min and 20 min after reperfusion (P<0.05). With prolonged ischemia, the abnormal changes of the myocardial ultrastructure were observed. CONCLUSION: PPP derived τ and K may be promising indexes for quantitative assessment of left ventricular diastolic function on isolated) rat heart during ischemia/reperfusion, and indication of the severity of ischemia/reperfusion injury.
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Objective To assess the characteristics of heart rate turbulencer (HRT) in elderly patients with decreased left ventricular diastolie function.Methods 40 patients were divided into two groups:20 patients with enlarged left atrium and 20 patients without enlarged left atrium.20 healthy people were selected as controls. Turbu1ence onset (TO) and turbulence slope (TS) were measured,and correlation was analyzed between TO,TS and the E/A,index of Macruz and heart rate variability (HRV).Results TO was higher (P<0.05) and TS was lower in patients (P<0.01),TO was higber in patients with enlarged left atrium than in with out enlarged lef atrium people (P<0.05) and TS was lower (P<0.01).TO was positively (P<0.01) and TS Was negatively (P<0.05),correlated with the index of Macruz.TO Was negatively (P<0.05) and TS was positively (P<0.05) related to SDNN and SDANN.Conclusion HRT can be used as a potential risk predictor in decreased left ventricular diastolic function patients.
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AIM:To detect and compare the longitudinal mitral annulus diastolic velocity and time interval changes by pulsed Doppler tissue imaging(DTI)in patients with angina pectoris(AP)and myocardial infarction(MI),and to explore the value of mitral annulus diastolic velocities and time intervals for evaluation of global left ventricular diastolic dysfunction.METHODS:Fifty patients with established coronary artery disease were divided into AP group(16 cases)and MI group(34 cases).Sixteen age-matched healthy individuals served as the control group.The septum,lateral,anterior and inferior walls of the mitral annulus were displayed,and selected for DTI spectrum sampling.Peak early and late diastolic velocities and their ratio,time to the onset and peak of the early diastolic wave,and regional isovolumic relaxation time were measured,and the average values of the four mitral annular sites were calculated and presented as Em,Am,Em/Am,QEm,TEm and IVRTm,respectively.RESULTS:Compared with the control group,Em and Em/Am were significantly lower in both the AP and the MI groups(P＜0.01).Em was even lower in the MI group than that in the AP group(P＜0.01).QEm,TEm and IVRTm were significantly longer in the AP and the MI groups than those in control group(P＜0.01 or P＜0.05).IVRTm was even longer in the MI group than that in AP group(P＜0.01).IVRTm had significantly negative correlation with Em(r=-0.64,P＜0.01).CONCLUSION:Em,Em/Am,QEm,TEm and IVRTm as measured by pulsed DTI may be promising indexes for quantitative assessment of global left ventricular diastolic dysfunction in patients with coronary artery disease.Em and IVRTm may indicate the severity of ischemic myocardial damage.
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@#Objective To explore the relationship between obstructive sleep apnea syndrome(OSAS)and the left ventricular diastolic dysfunction.Methods 20 consecutive newly diagnosed middle-aged OSAS patients(OSAS group)with neither controllable factors nor conditions affecting left ventricular diastolic function and 15 healthy control subjects(control group)were examined with echocardiography.Results The OSAS group exhibited left ventricular diastolic dysfunction compared with the control group,including increase of isovolumic relaxation time(P<0.05)and mitral deceleration time(P<0.05),decrease of E/A.There was no difference between tow groups in interventricular systolic thickness,posterior wall thickness,left ventricular systolic diameter,left ventricular diastolic diameter and others.Conclusion OSAS may be related with the left ventricular diastolic dysfunction.