Qualidade de Vida de pacientes submetidos à revascularização do miocárdio / Quality of Life of patients undergoing coronary artery bypass grafting

OBJETIVO: Determinar o impacto da cirurgia de revascularização do miocárdio na Qualidade de Vida dos pacientes; analisar e comparar dimensões da Qualidade de Vida antes e após a intervenção cirúrgica; comparar variáveis sociodemográficas e clínicas aos aspectos de depressão e ansiedade, pré e pós-operatórios. MÉTODOS: Estudo descritivo exploratório no qual foram incluídos 78 pacientes no pré e pós-operatório. Foram utilizados instrumentos de pesquisa internacionais e validados para avaliar a qualidade de vida e os aspectos de depressão e ansiedade. RESULTADOS: Houve melhora significativa em todos os domínios da Qualidade de Vida, depressão e ansiedade (p=0,05). Domínios físico e social do 36-Item Short-Form Health Survey apresentaram menor pontuação dos escores (13,46 e 3,03, respectivamente), bem como o domínio social do instrumento Macnew (3,03). CONCLUSÃO: Cirurgia de revascularização ocasionou impacto positivo na Qualidade de Vida desses pacientes.

OBJECTIVE: Determining the impact of coronary artery bypass grafting on the Quality of Life of patients, analyzing and comparing dimensions of Quality of Life before and after surgery; comparing sociodemographic and clinical variables with the aspects of depression and anxiety, in the pre and postoperative periods. METHODS: A descriptive exploratory study in which 78 patients were included in the pre and postoperative periods. International instruments of research were used and validated to assess quality of life and the aspects of depression and anxiety. RESULTS: There was significant improvement in all domains of the Quality of Life, depression and anxiety (p=0.05). The physical and social domains of the 36-Item Short-Form Health Survey showed lower scores (13.46 and 3.03, respectively), as well as the social domain of the Macnew instrument (3.03). CONCLUSION: Coronary artery bypass surgery caused positive impact on the Quality of Life of these patients.

Clinical study on the left ventricular function in hypertrophic cardiomyopathy patients / 中国基层医药

Objective To explore the left ventricular overall systolic and diastolic function in hypertrophic cardiomyopathy (HCM) patients with echocardiography.Methods 30 normal people and 30 hypertrophic cardiomyopathy patients were examined by routine echocardiography and examine the results of LVDd,IVSd,LVPW,LVFE and E/A.Results The results of IVSd [(16.47 ± 2.08) cm],LVPW [(10.28 ± 0.56) cm] and LVEF [(62.18 ±6.74) ％] in HCM patients were superior than control group [(9.56 ± 0.45) cm,(9.30 ± 0.98) cm,(57.66 ±5.22) ％] (t =-17.809,-4.756,-2.91,all P ＜ 0.05) while the results of LVDd [(40.28 ± 3.80) cm] and E/A[(0.99 ±0.17)] of HCM patients were obviously lower than control group [(45.15 ±3.84) cm,(1.10 ±0.24)](t =4.899,2.132,all P ＜ 0.05) and LVEF was obviously larger than control group (P ＜ 0.05).Conclusion Echocardiography can exactly evaluate left ventricular overall systolic and diastolic function in hypertrophic cardiomyopathy (HCM) patients and guide the diagnosis and treatment.

Molecular imaging in myocardial fibrosis / 中华核医学与分子影像杂志

With the development of life science and medical technology,myocardial fibrosis is being increasingly recognized as a new therapeutic target for heart diseases.However,traditional methods for detection of myocardial fibrosis,such as myocardial biopsy and laboratory assay of serum metabolites or enzymes,are not satisfactory in meeting the clinical demands because of their intrinsic limitations.Molecular imaging may non-invasively and quantitatively evaluate the presence/absence,degree and turnover of myocardial fibrosis in vivo with good specificity,thus being useful for clinical assessment and intervention.Currently,the commonly used molecular imaging modalities for evaluation of myocardial fibrosis include SPECT,PET and MRI.It is hopeful that the molecular probe for targeted ultrasound technology may also be developed in the near future.This review highlights the current status and future trends of molecular imaging in myocardial fibrosis.

Cardiomiopatia dilatada / Dilated cardiomyopathy

A cardiomiopatia dilatada é a doença do miocárdio mais comum, sendo responsável por 25 por cento dos casos de insuficiência cardíaca, é a terceira causa mais comum de falência miocárdica e a indicação mais comum de transplante cardíaco na América do Norte. A cardiomiopatia dilatada (CMD) é caracterizada principalmente pela disfunção sistólica do ventrículo esquerdo, com aumento associado da massa e do volume. Várias doenças podem cusar CMD, porém em muitos casos, não se encontra nenhuma etiologia e a cardiomiopatia é chamada de idiopática (até 50 por cento dos casos).

The dilated cardiomyopathy is the most important myocardial disease and represent 25% of all heart diseases. It is the third cause of myocardial failure and the most common cause of heart transplantation in North America. Its feature is the left ventricle systolic dysfunction with mass and volume increase. Several diseases may cause dilated cardiomyopathy, but in 50% the cause is unknown.

Cardiomiopatias: conceito e classificação / Definition and classification of cardiomyopathies

Cardiomiopatias compõem um grupo heterogêneo de doenças do músculo cardíaco vinculadas a múltiplas etiologias e uma variedade de expressões fenotípicas. Em 1995, a Organização Mundial de Saúde as definiu como sendo "doenças do miocárdio associadas com disfunção cardíacas", e classificadas em: dilatada, hipertrófica, restritiva e cardiomiopatia arritmogênica do ventrículo direito. Um comitê de especialistas da American Heart Association (AHA) em 2006 conceituou que as cardiomiopatias compreendem um "grupo heterogêneo de doenças do miocárdio associadas com disfunção mecânica e/ou elétrica, e que usualmente (mas não invariavelmente) exibem dilatação ou hipertrofia ventriculares inapropriadas", e são devido a uma variedade de causas, frequentemente genéticas. Foram divididas em 2 tipos: primárias e secundárias (Tabela 1). Foi incluída ainda uma importante subcaracterização das cardiomiopatias primárias, dividida em 3 grupos principais: genético, misto e adquirido (Tabela 2). Em 2007, um posicionamento do comitê europeu mudou a conceituação: uma afecção miocárdica na qual o músculo cardíaco é funcionalmente e estruturalmente anormal, em ausência de doença coronariana, hipertensão arterial, doença valvular, defeito cardíaco congênito, suficiente para causar a anormalidade miocárdica observada...

The cardiomyopathies are an important and complex group of heart muscle diseases with multiple tiologies and heterogeneous phenotypic expression. The WHO classification published in 1995 proposed “ Cardiomyopathies are defined as diseases of the myocardium associated with cardiac dysfunction”, and they are classified as dilated, hypertrophic, restrictive, and arrhythmogenic right ventricular cardiomyopathy. In 2006 AHA scientific statement, the original distinction into primary and secondary forms was reintroduced. A sub classification of cardiomyopathies into familial/genetic and non-familial/non-genetic was considered of help in orienting towards genetic mutational analysis and creening. All this was changed in 2007 by ESC, when they clearly stated that cardiomyopathy is ‘a myocardial disorder in which heart muscle is structurally and functionally abnormal in the absence of coronary artery disease, hypertension, valvular disease, and congenital heart diseases’. While accepting and reinforcing the idea advanced by the AHA statement to separated cardiomyopathies into familial/genetic and non-familial/non-genetic, the traditional separation of primary and secondary (specific) cardiomyopathies was abolished...

Diagnosing left ventricular noncompaction by cardiac MRI and its differential diagnosis on left ventricular hypertrabeculation / 中华放射学杂志

Objective To define the diagnostic criteria of cardiovascular magnetic resonance imaging in distinguishing isolated left ventricular noncompaction (LVNC) from lesser degrees of hypertrabeculation. Methods Twenty-five patients with LVNC, 39 with dilated cardiomyopathy ( DCM), 16 with aortic stenosis(AS), 15 with aortic regurgitation(AR) , 19 with hypertension (HT) and 22 normal subjects were enrolled in this study. Cardiac magnetic resonance imaging was performed to evaluate the left chamber diameter, functional parameters and noncompaction or hypertrabeculation of the left ventricle in diastole with one-way ANOVA. The left ventricle was divided into 17 segments for localizing all involved segments in this present study. Results The LVNC patients had the commonest myocardial segments involved (10±2)in all subjects. Each patient with LVNC was unexceptionally associated with apical noncompaction (17th segment) , which was seldom found in the other subjects. The lateral walls including 16th, 12th and 11th segments were the most vulnerable segments in all subjects, but nobody was found to involve the basal and mid septum including 2nd, 3rd, 8th and 9th segments. The end-diastolic NC/C (noncompaction/compaction) ratio was, on average, the greatest in patients with LVNC (3.3±0.6), compared with all other subjects(AS:1.0 ±0.3, AR:1.0 ±0.3,HT:0.8 ±0.1,healthy volunteers:0.9 ±0. 2) (F = 169. 62,P <0.05). Receiver operating characteristics analysis identified the end-diastolic NC/C ratio of>2.5 as a valuable parameter to distinguish LVNC from DCM.with values for sensitivity of 96.O%(24/25)and specificity of 94.9%(37/39),respectively.The mean number of NC/C ratio>2.5 segments in the LVNC patients was 4.0 ±2.0.while 8 of 39 patients with DCM had only one segment of NC/C ratio >2.5.Conclusions MRI is all exceUent imaging modality to diagnose LVNC and distinguish LIVNC from hypertrabeeulation.The criteria of LVNC is the NC/C ratio>2.5 in two or more than two segments of free ventricular walls associated with the left ventrieular apex involved.

Clinical application of 64-slice spiral CT for apical hypertrophic cardiomyopathy / 中华放射学杂志

Objective To evaluate the clinical application values of 64-row MSCT for apical hypertrophic cardiomyopathy(AHCM).Methods Twenty-one patients with AHCM were included in this study,14 patients were diagnosed by echocardiography(UCG),and 7 patients were diagnosed by MRL AU patients underwent MSCT exam,and 5 patients also had ventriculography and coronary angiography.The left ventricular wall thickness in end-systole and end-diastole phases were measured at MSCT workstation,the left ventricular apex thickening rate(LVAT)and the ratio of maximum wall thickness of the left ventrieular apex(LVA)to the left ventricular posterior wall thickness(LVA/LVPW)in end-diastole phase were calcdated.The left ventricular end-diastolie volume(LVEDV)and left venueular ejection fraction (LVEF)were quantitively evaluated with cardiac functional analysis software.The results were compared with the measurement results from the normal control group(30 volunteers).The independent-samples t test was used for the statistics.At the same time.the coronary stenosis was measured.Results Diffuse or partial thickening of the LV apical myocardium were found in the four-chamber view and two-chamber view of MSCT images.which leaded to the deformation of the left ventricle chamber.The LVEDV were(82.6±11.4)and(108.5±10.6)ml in the AHCM group and the control group,respectively;the LVA were (20.6±3.4)and(9.9±1.5)mm;LVA/LVPW were 2.1±0.5 and 1.1±0.2;the LVAT were(25.6±4.7)%and(81.5±8.5)%.There were significant differences in LVEDV,LVA,LVA/LVPW and LVAT between the two groups(t=8.32 and 15.29,P＜0.05;t=9.91 and 27.30,P＜0.05;respectively),but there were no statistical differences in LVPW and LVEF between the two groups(t=0.26 and 1.13.P＞0.05).Five patients had myocardium bridging and 4 patients had coronary stenosis.Conclusion AHCM can be diagnosed accurately with MSCT,and the cardiac anatomy.function and coronary artery are also assessed simultaneously.

The relationship between isolated nocturnal hypertension and left ventricular hypertrophy / 中华内科杂志

Objective To investigate the relationship between isolated nocturnal hypertension and left ventricular hypertrophy. Methods In the inhabitants of 14 villages in Jingning County, Zhejiang Province, we performed 24-hour ambulatory blood pressure monitoring with SpaceLab monitors and measured 12-lead resting electrocardiogram using an electronic recording system of GE company, Left ventrieular hypertrophy was diagnosed with the criteria of Sokolow-Lyon voltage amplitude and Cornell product. Isolated nocturnal hypertension was defined as a nighttime ( from 22:00 to 4:00) blood pressure of ≥ 120/70 mm Hg( 1 mm Hg = 0. 133 kPa). Isolated daytime ( from 8:00 to 18:00) hypertension was a diurnal blood pressure of ≥ 135/85 nun Hg. When both conditions were present or absent, subjects were classified either as having combined day-night hypertension or as normotensive on ambulatory measurement. Analysis of variance and multiple regressions were used for statistical analysis. Results 647 participants (53.9% being female,average age 47. 8 years) included 72 patients with isolated nocturnal hypertension, 33 with isolated daytime hypertension and 248 with day-night sustained hypertension. Compared with normotensive subjects, patients with isolated nocturnal hypertension and day-night sustained hypertension had a higher Sokoiow-Lyon voltage amplitude and Comell product. However, after adjustment for sex, age, body mass index, drinking and smoking habits, serum total cholesterol, fasting blood glucose and the use of antihypertensive drugs, only day-night hypertensive patients had a significantly higher Sokolow-Lyon voltage (32. 8 mV, P =0. 0003 ) and Cornell product (1371 mV×ms, P =0.0004) than normotensive subjects (29.0 mV, 1114 mV×ms).Regardless of whether Sokolow-Lyon or Cornell criteria were used, both nighttime and daytime systolic and diastolic blood pressure were independent risk factors of left ventricular hypertrophy (P < 0. 01 ). However,the prevalence of left ventricular hypertrophy in patients with isolated nocturnal hypertension ( 23.6% ) study was not statistically different from that in normotensives ( 17.4%, P = 0. 24). Conclusion In our current cross-sectional study, isolated nocturnal hypertension was not independently related to left ventricular hypertrophy diagnosed with ECG criteria.

A Clinical Study on the Relationship of C-reactive Protiein with Diabetic Cardiomyopathy / 中国慢性病预防与控制

Objective To investigate the relationship of serum levels of C-reactve protein (CRP) with diabetic cardiomyopathy (DCM). Method Thirty-six patients with DCM were recruited as DCM group and thirty healthy people as the control. Serum levels of CRP in all subjects were determined by immunoturbidimetry. Results Compared with control group, the serum levels of CRP in patients with DCM were singnificantly increased by about 3.7 folds[(6.95?1.37)mg/dL vs.(1.89?0.38) mg/dL, P

Comparative study between echocardiographic manifestations and pathological examinations in noncompaction of ventricular myocardium / 中华超声影像学杂志

Objective By exploring echocardiographic ch aracters and pathologic examination of noncompacted ventricular myocardium(NVM), to prevent life-threatening arrhythmias and embolism. Methods Echocardiographic examinations included four-chamber view, two-chamber view and short axis view of left ventricle, with an emphasis on observing left ventricular myocardium and endocardium approach to one-third of apex of heart. Results All 24 patients showed obvious echocardiographic findings characterized by prominent and excessive myocardial trabeculations and deep intratrabecular recesses in the affected ventricular cavity. Three cases complicated with other congenital heart malformations, 20 cases with congestive heart failure and only 2 cases were asymptomatic. Coronary arteriography was performed in 13 cases and revealed normal findings. Two cases eventually underwent heart transplantation because of severe congestive heart failure. Gross and histological findings demonstrated prominent muscular trabeculations, with deep intratrabecular recesses into lesion heart. Serial section from the base of the ventricle toward the apex revealed gradually weaker myocardium. Noncompaction of ventricular myocardium showed a thin, compacted epicardial and an extremely thickened endocardium by fibrous tissue. Conclusions Noncompaction of ventricular myocardium has characteristic echocardiographic manifestations and specific pathologic changes, which are different from those of primary enlarged type of cardiomyopathy.

The Origin of Proinflammatory Cytokines in Patients with Idiopathic Dilated Cardiomyopathy

Proinflammatory cytokines and their receptors are increased in the peripheral blood of patients with heart failure. We measured cytokines and their receptors in systemic artery (SA), coronary sinus (CS) and infra-renal inferior vena cava (IVC), in order to investigate their origin and influential factors. Thirty patients with idiopathic dilated cardiomyopathy were performed echocardiography at admission, and right heart catheterization after stabilization. Blood was drawn from 3 sites for measurement of tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6) and soluble tumor necrosis factor- receptor (sTNFR) I, II. TNF-alpha at CS (3.25+/-0.34 pg/mL) was higher than those of SA (1.81+/-0.39 pg/mL) and IVC (1.88+/-0.38 pg/mL, p<0.05). IL-6 at CS (18.3+/-3.8 pg/mL) was higher than that of SA (5.8+/-1.2 pg/mL, p<0.01). The levels of sTNFR I, II showed increasing tendency in sequence of SA, IVC and CS. TNF-alpha and sTNFR I, II from all sites were proportional to worsening of functional classes at admission (p<0.05). E/Ea by Doppler study at admission, which reflects left ventricular end-diastolic pressure (LVEDP) was positively correlated with TNF-alpha from SA (R=0.71, p<0.01), CS (R=0.52, p<0.05) and IVC (R=0.46, p<0.05). Thus, elevated LVEDP during decompensation might cause cytokine release from myocardium in patients with idiopathic dilated cardiomyopathy.

Arrhythmogenic right ventricular cardiomyopathy with left ventricular involvement:histopathology and MRI features / 中华放射学杂志

Objective The aim of the present investigation was to confirm histopathology and MR features of arrhythmogenic right ventricular cardiomyopathy(ARVC),particularly with the left ventricular involvement.Methods Nine patients(4 male,5 female;13 to 54 years old,mean age 40.44?15.99), with a pathologic diagnosis of ARVC at heart transplantation,were included,of which 7 patients were scanned for MR imaging before transplantation.Results Severe dilation of right ventricular(RV)cavity and left ventricular one(LV)were observed in 7 and 8 hearts,respectively.All hearts showed severe and transmural RV muscle loss,where RV wall was almost completely filled with either fatty tissue(3 cases)or fibrofatty tissue(6 cases).LV involvement was diagnosed histologically in all cases.Both the septum and the LV free wall were affected in 2 cases;7 cases disclosed selective free wall involvement.LV fatty or fibrofatty substitution was predominantly located in the subepicardial and mediomural wall layers in 5 hearts. a diffuse interstitial fibrosis with patchy infiltration was noted in the other 4 hearts.7 patients underwent MR scanning.MR scanning demonstrated global RV severe dilation and thinning in 5 cases,of which linear fatty infiltration was found in 3 cases.RV presented wall thickness preservation and normal cavity in the remaining 2 cases,in which left involvement existed.LV was dilated in all cases(mildly in 3,moderately in 2,severely in 2).The LV ejection fraction was(21.66?7.05)%,and subepicardial fatty infiltration was found in 2 patients,selectively involving posterolateral wall.4 patients showed the LV wall thinning diffusely in free wall,and the other 3 mainly involved septum,apex and posterolateral wall,respectively.All 5 patients with delayed enhancement showed varying degrees of hyperenhancement,mainly involving the posterolateral wall(transmural in 2 and epicardial in 2),septum(mediomural in 2)and apex in 2(focal or transmural).Additionally,transmural hyperenhancement was also found in the RV wall,involving free wall in 2,RV apex in 1 and posterior wall in 1 case,respectively.Conclusions ARVC with reference to left ventricular involvement had severe cardiomegaly and heart failure.MRI can partially reveal tissue characteristics,including fatty infiltration and fibrosis,as well as morphologic features.

Sress cardiomyopathy:clinical features and imaging findings / 中华放射学杂志

Objective One typical case with stress cardiomyopathy was reported and the current knowledge of the syndrome was reviewed to improve relevant knowledge.Methods A 71-year-old female patient presented dyspnea and chest pain due to emotional stress.ECG,echocardiography,selective coronary artery angiography,left ventriculography,~(99)Tc~m-MIBI single photon emission computed tomography (SPECT),~(18)F-FDG SPECT and MRI were performed.Results Electrocardiogram at admission showed ST segment elevation and T wave inversion in leads V1—V4.Pathological Q wave occurred 1 week later,it disappeared 1 month later however and severe T wave inversion occurred.Normal or slightly elevated cardiac enzymes in the blood were found during the course.Left ventriculogram at admission showed left ventricular apical ballooning with LVEF of 30%.The ballooning volume was about 3/4 of left ventricular volume, without any corresponding coronary artery diseases found in coronary angiogram.The abnormal apical ballooning decreased significantly in the follow-up left ventriculogram performed one month later.The LVEF rose up to 63.6%.~(99)Tc~m-MIBI and ~(18)F-FDG SPECT showed mismatch of perfusion and metabolism in the corresponding region,indicating presence of viable myocardium.MRI showed left ventricular apical ballooning without perfusion defect and late enhancement,indicating viability of corresponding myocardium. Conclusions Emotional stress can cause transient left ventricular apical ballooning called"stress cardiomyopathy".Either ~(99)Tc~m-MIBI SPECT associated with ~(18)F-FDG SPECT or delayed enhancement MRI plays an important role in identification of myocardial viability,which can efficiently guide clinical treatment.

REMODELLING OF CARDIAC COLLAGEN IN CHRONIC HEART FAILURE AND ITS RELATIONSHIP TO CARDIAC FUNCTION / 解放军医学杂志

To study cardiac function in an ovine model of chronic heart failure in relation to cardiac collagen and its phenotype, 11 sheep were developed into chronic heart failure by sequential microembolisation. Cardiac collagen contents and phenotypes were determined after hemodynamic evaluation at 6 months. The results showed that collagen contents and type Ⅰ /type Ⅲ collagen ratio in the left ventricle were increased significantly in heart failure group as compared with those in the normal group. Collagen concentration in left ventricle correlated significantly to left ventricular ejection fraction, left ventricular end diastolic pressure, dP/dt min , left ventricular diastolic diameter, and diastolic interventricular septum thickness.Our conclusion is increase in collagen content and type Ⅰ/Ⅲ collagen ratio may be partly responsible for the reduction of cardiac function seen in this model of heart failure.

RISK FACTORS OF IMPAIRED CARDIAC DIASTOLIC FUNCTION IN PATIENTS WITH ABNORMALITIES OF GLUCOSE METABOLISM / 解放军医学杂志

To investigate the clinical risk factors of cardiac diastolic dysfunction in type 2 DM, Doppler echocardiographic examinations were performed on 63 male patients.With a routine 2 dimensional echocardiograph, mitral and pulmonary venous flow velocity were recorded. The patients were classified into DM, IGT and NGT based on well standardized criteria of WHO. All analyses were performed by the SPSS/PC or Windows Release 9.0 Statistical Package. The risk factors of impairment of diastolic function were analyzed by regression. Results showed that the levels of blood glucose and insulin were independent risk factors for diabetic cardiac diastolic dysfunction.

Therapeutic effects of carvedilol in patients with uremic cardiomyopathy / 解放军医学杂志

Objective To explore the therapeutic effects of carvedilol on renal and heart function,and on heart structure of patients with uremic cardiomyopathy.Methods One hundred and four patients with uremic cardiomyopathy were randomly divided into two groups(52 each).Patients in control group were treated with routine therapy,and in carvedilol group were treated with carvedilol 12.5-50mg/d in addition to routine therapy.The total course of treatment was 6 months.The related data of left ventricle were determined by echocardiography,and blood urea nitrogen(BUN),serum creatinine(Scr)and clearance rate of creatinine(Ccr)were measured before and after the treatments.Results After the treatment,the stroke volume(SV),cardiac output(CO)and ejection fraction(EF)were increased,and left ventricular end-diastolic diameter(LVEDD),left ventricular mass(LVM),left ventricular mass index(LVMI),end-diastole interventricular septum thickness(IVST)and end-diastolic left ventricular wall thickness(LVPWT)were decreased in both groups compared with those before the treatment(P0.05).Conclusion Carvedilol may effectually inhibit the ventricular remodeling of the patients with uremic cardiomyopathy,improve their left ventricular function and structure,but has no obvious effect on the renal function.

Efficacy of Amiodarone in Tachycardia Induced Cardiomyopathy due to Non-Valvular Atrial Fibrillation

BACKGROUND AND OBJECTIVES: Drug therapy to treat atrial fibrillation has been achieved unsatisfactory results due to the frequent failure to maintain a sinus rhythm as well as the occurrence of adverse side effects. This study investigated the efficacy of amiodarone for the treatment of tachycardia-induced cardiomyopathy due to non-valvular atrial fibrillation. SUBJECTS AND METHODS: We treated twenty-seven patients with tachycardia-induced cardiomyopathy due to non-valvular atrial fibrillation with amiodarone in order to convert to and maintain the sinus rhythm. We followed up and compared the functional status, electrocardiography and parameters of echocardiography before and after treatment with amiodarone. RESULTS: Patients treated with amiodarone showed cardiac functional improvement based on New York Heart Association classification. Eighteen patients (66.7%) out of the total 27 converted to sinus rhythm. The pulse rate decreased from 109.0+/-34 bpm (beats per min) before the administration of amiodarone to 70.3+/-13.0 bpm after medication. The size of the left atrium decreased from 50.7+/-6.7 (mm) to 46.9+/-5.6 (mm). The ejection fraction (EF) improved from 36.2+/-14.9 (%) to 51.2+/-17.7 (%). CONCLUSION: Amiodarone is effective in the conversion to sinus rhythm as well as ventricular rate control in patients with atrial fibrillation induced cardiomyopathy. The cardiac functional status and the echocardiographic parameters of left ventricular function in patients with tachycardia-induced cardiomyopathy due to atrial fibrillation improved with amiodarone therapy.

Changes in cardiac troponin I during extracorporeal circulation / 中华检验医学杂志

Objective To detect the changes in cTnI and CK MB during extracorporeal circulation and the myocardial injury by extracorporeal circulation. Methods The value of cTnI and CK MB was determined in 30 persons during extracorporeal circulation. We divided them into 6 groups according to pre operation, 6, 12, 24, 48 and 72 hours after operation. Modified method (Bodor et al) was used to detect cTnI, and immune suppression method to detect CK MB. Results cTnI and CK MB were, cTnI ( ?s ) (5.20?2 80) ?g/L,CK MB ( ?s ) (10.75?4.70) U/L in 28 persons. They elevated 6 hours after operation. 12 24 hours after operation cTnI and CK MB increased to the maximum, cTnI 28.80 71.30 ?g/L,CK MB 55.60 71.30 U/L. During 48 72 hours, CK MB decreased to normal, 49.70 22.80 U/L. cTnI was 9.40 19.80 ?g/L 72 hours after operation. Conclusion Extracorporeal circulation may cause myocardial diseases. cTnI is a more sensitive biochemical marker for myocardial diseases.

Study on association premature ventricular contraction and myocardium injury with microvascular leakage in contrasted aided echocardiography / 中华超声影像学杂志

Objective To examine the relationship between premature ventricular contraction(PVC) and microvascular leakage in the myocardium due to microvascular contrast echocardiography(MCE). Methods Thirty eight rats were randomized into 5 groups: control, ultrasound exposure only, contrast agent only, real time MCE and trigger imaging MCE. Anesthetized rats with tail vein catheter were imaged in a 37℃ water bath at left ventricular parasternal short axis view. Optison was injected at a dosage of 5 ml/kg. Frequency was 1.7 MHz, MI= 1.7 and the depth of image at 10 cm. Results PVC was detected in all ultrasound exposure groups, together with petechial hemorrhages and Evans Blue leakage in the scan band. The triggered imaging showed worse effects than real time imaging. No PVC or microvascular leakage was noticed in controls or sham exposed rats. Conclusions Induction of PVC during contrast added echocardiography is associated with microvascular leakage.

Research on the protection of myocardial ultrastructure of diabetic rats by aminoguanidine(AG) / 中国糖尿病杂志

Objective To observe the protective effects of AG on the myocardial ultrastructure of diabetic rats.Methods STZ-induced diabetic male SD rats were divided into two groups: aminoguanidine(AG group,50 mg?kg~(-1) body weight by daily gavage) and diabetes mellitus groups(DM group).Age-matched normal male SD rats served as normal control(NC group).After 10 weeks of treatment the level of blood glucose was measured and the rats were killed.Cardiac muscle were observed by transmission electronic microscope.Results The changes of cardiac ultrastructure had no significant difference between AG-group and NC-group and were better in AG group than in DM group as following:(1) Myofibril arranged tidily with intact regular edge;(2) Mitochodria were big and normomorph with crests arranging densely,some mitochondria gathered locally;(3)Base membrane of blood vessels didn′t thicken with lumen not narrowed;(4) The collagenous fiber in stroma reduced but amorphous material didn′t reduced. Conclusions The ultrastructure pictures of diabetic cardiomyopathy is inhibited or delayed by AG,which suggests that AGEs may play some role in the development of diabetic cardiomyopathy.