Relationship of Microvascular Obstruction with Global and Regional Myocardial Function Determined by Cardiac Magnetic Resonance after ST-Segment Elevation Myocardial Infarction / 中国医学科学杂志(英文版)

Objective To investigate the impact of microvascular obstruction (MVO) on the global and regional myocardial function by cardiac magnetic resonance feature-tracking (CMR-FT) in ST-segment-elevation myocardial infarction (STEMI) patients after percutaneous coronary intervention.Methods Consecutive acute STEMI patients who underwent cardiac magnetic resonance imaging 1 - 7 days after successful reperfusion by percutaneous coronary intervention treatment were included in this retrospective study. Based on the presence or absence of MVO on late gadolinium enhancement images, patients were divided into groups with MVO and without MVO. The infarct zone, adjacent zone, and remote zone were determined based on a myocardial 16-segment model. The radial strain (RS), circumferential strain (CS), and longitudinal strain (LS) of the global left ventricle (LV) and the infarct, adjacent, and remote zones were measured by CMR-FT from cine images and compared between patients with and without MVO using independent-samples t-test. Logistic regression analysis was used to assess the association of MVO with the impaired LV function.Results A total of 157 STEMI patients (mean age 56.66 ± 11.38 years) were enrolled. MVO was detected in 37.58% (59/157) of STEMI patients, and the mean size of MVO was 3.00 ±3.76 mL. Compared with patients without MVO (n =98 ), the MVO group had significantly reduced LV global RS (t= -4.30, P < 0.001), global CS (t= 4.99, P < 0.001), and global LS ( t= 3.51, P = 0.001). The RS and CS of the infarct zone in patients with MVO were significantly reduced (t= -3.38, P = 0.001; t= 2.64, P = 0.01; respectively) and the infarct size was significantly larger (t= 8.37, P < 0.001) than that of patients without MVO. The presence of LV MVO [OR= 4.10, 95%CI: 2.05 - 8.19, P<0.001) and its size [OR=1.38, 95%CI: 1.10-1.72, P=0.01], along with the heart rate and LV infarct size were significantly associated with impaired LV global CS in univariable Logistic regression analysis, while only heart rate (OR=1.08, 95%CI: 1.03 - 1.13, P=0.001) and LV infarct size (OR=1.10, 95%CI: 1.03 - 1.16, P=0.003) were independent influencing factors for the impaired LV global CS in multivariable Logistic regression analysis.Conclusion The infarct size was larger in STEMI patients with MVO, and MVO deteriorates the global and regional LV myocardial function.

Isolated obesity resistance condition or associated with aerobic exercise training does not promote cardiac impairment

Mechanisms involved in cardiac function and calcium (Ca2+) handling in obese-resistant (OR) rats are still poorly determined. We tested the hypothesis that unsaturated high-fat diet (HFD) promotes myocardial dysfunction in OR rats, which it is related to Ca2+ handling. In addition, we questioned whether exercise training (ET) becomes a therapeutic strategy. Male Wistar rats (n=80) were randomized to standard or HFD diets for 20 weeks. The rats were redistributed for the absence or presence of ET and OR: control (C; n=12), control + ET (CET; n=14), obese-resistant (OR; n=9), and obese-resistant + ET (ORET; n=10). Trained rats were subjected to aerobic training protocol with progressive intensity (55-70% of the maximum running speed) and duration (15 to 60 min/day) for 12 weeks. Nutritional, metabolic, and cardiovascular parameters were determined. Cardiac function and Ca2+ handling tests were performed in isolated left ventricle (LV) papillary muscle. OR rats showed cardiac atrophy with reduced collagen levels, but there was myocardial dysfunction. ET was efficient in improving most parameters of body composition. However, the mechanical properties and Ca2+ handling from isolated papillary muscle were similar among groups. Aerobic ET does not promote morphological and cardiac functional adaptation under the condition of OR.

Rehabilitation of Moderate Intermittent Hypoxia on Clinical Related Diseases (review) / 中国康复理论与实践

Objective:To systematically review the rehabilitation effects of moderate intermittent hypoxia on clinical related diseases. Methods:Literatures about rehabilitation effects of moderate intermittent hypoxia on clinical related diseases from 2004 to 2021 were searched in PubMed, ScienceDirect, CNKI and Wanfang databases using a systematic review method. Results:A total of 27 literatures were included, which focused on the effects on neural system, respiratory system, and cardiovascular diseases, as well as the regulation of metabolic and the improvement of exercise ability. Conclusion:Moderate intermittent hypoxia could improve the cognitive function, alleviate the symptoms of ischemic stroke, accelerate the recovery of spinal cord injury, resist depression and reduce blood pressure; regulate metabolism, improve aerobic capacity, enhance respiratory function and myocardial function. However, more researches are needed to make it clear that the standard on the duration of hypoxia within episodes, the number of hypoxia/reoxygenation cycles (episodes) per session every day, the pattern of presentation, and the cumulative duration of exposure.

Left-sided vagus nerve stimulation improves cardiopulmonary resuscitation outcomes in rats as effectively as right-sided vagus nerve stimulation / 世界急诊医学杂志（英文）

@#BACKGROUND: Our group previously reported that right-sided vagus nerve stimulation (RVNS) significantly improved outcomes after cardiopulmonary resuscitation (CPR) in a rat model of cardiac arrest (CA). However, whether left-sided vagus nerve stimulation (LVNS) could achieve the same effect as RVNS in CPR outcomes remains unknown. METHODS: A rat model of CA was established using modified percutaneous epicardial electrical stimulation to induce ventricular fibrillation (VF). Rats were treated with LVNS or RVNS for 30 minutes before the induction of VF. All animals were observed closely within 72 hours after return of spontaneous circulation (ROSC), and their health and behavior were evaluated every 24 hours. RESULTS: Compared with those in the RVNS group, the hemodynamic measurements in the LVNS group decreased more notably. Vagus nerve stimulation (VNS) decreased the serum levels of tumor necrosis factor-alpha (TNF-α) and the arrhythmia score, and attenuated inflammatory infiltration in myocardial tissue after ROSC, regardless of the side of stimulation, compared with findings in the CPR group. Both LVNS and RVNS ameliorated myocardial function and increased the expression of α-7 nicotinic acetylcholine receptor in the myocardium after ROSC. Moreover, a clear improvement in 72-hour survival was shown with VNS pre-treatment, with no significant difference in efficacy when comparing the laterality of stimulation. CONCLUSIONS: LVNS may have similar effects as RVNS on improving outcomes after CPR.

Layers-strain on assessing myocardial function in acute coronary syndrome patients after percutaneous coronary intervention / 中国医学影像技术

Objective: To explore the clinical value of longitudinal layers-strain technology for assessing myocardial function in acute coronary syndrome (ACS) patients after percutaneous coronary intervention (PCI). Methods: Twenty-five ACS patients who underwent successful PCI (PCI group) and 25 normal subjects (control group) were collected. M-mode echocardiography, biplane Simpson, tissue Doppler imaging and longitudinal layers-strain were used to analyze left ventricular function and myocardial function respectively in both groups. Results: Longitudinal layers strain and global longitudinal layers strain in PCI group decreased gradually from endocardium to epicardium, and all parameters reduced compared with those of control group (all P<0.05). The gradient of global longitudinal strain between endocardium and epicardium (△GLS) existed in both groups, while the absolute value of △GLS apparently reduced in PCI group compared with control group (P<0.05). Conclusion: Longitudinal strain decreased from endocardium to epicardium in ACS patients after PCI. Longitudinal layers-strain might be a sensitive index of myocardial and left ventricular dysfunction in ACS patients after PCI.

Alteraciones cardíacas subclínicas detectadas por ecocardiografía en escolares Mexicanos con sobrepeso y obesidad / Subclinical cardiac alterations detected by echocardiography in Mexican schoolchildren with overweight and obesity

Resumen Objetivo: El propósito de este estudio fue evaluar los cambios tempranos en la función miocárdica en niños con sobrepeso y obesidad, sin hipertensión arterial. Métodos: Estudio transversal en el que se incluyeron 150 participantes de ambos sexos entre 6 y 15 años. Se realizaron evaluaciones antropométricas, bioquímicas y de función ventricular mediante métodos ecocardiográficos convencionales y análisis de deformación miocárdica con ecocardiografía bidimensional speckle tracking. La comparación global entre los grupos de estudio (niños con peso normal, sobrepeso y obesidad) se llevó a cabo con la prueba de análisis de varianza (ANOVA) de una vía y análisis post hoc con corrección de Bonferroni para las comparaciones múltiples, y se consideró a los niños con peso normal como grupo de referencia. Resultados: La muestra final fue de 142 participantes, 50 (35%) con peso normal, 39 (28%) con sobrepeso y 53 (37%) con obesidad. El diámetro diastólico del ventrículo izquierdo (VI) y el septum interventricular, y el diámetro de la aurícula izquierda (AI) y la masa del VI fueron significativamente más altos en el grupo con obesidad en comparación con el grupo con peso normal. No se observaron diferencias significativas en los indicadores convencionales de la función sistólica y diastólica ventricular izquierda. Se observaron diferencias significativas en la deformación miocárdica regional entre los tres grupos. La media de deformación miocárdica longitudinal global fue más baja en los pacientes con obesidad (−20.9% vs. −23.5%; p menor 0.05) en comparación con los niños con peso normal. Conclusiones: La obesidad infantil se asoció a alteraciones en la deformación miocárdica, incluso en presencia de fracción de expulsión normal. La evaluación de la deformación miocárdica es relevante en los pacientes pediátricos con obesidad.

Abstract Objective: The purpose of this study was to evaluate early changes in myocardial function in overweight and obese children without hypertension. Methods: Cross-sectional study involving 150 participants of both sexes between 6 and 15 years old. Anthropometric and biochemical evaluations were performed. Ventricular function was assessed by conventional echocardiographic methods and myocardial deformation analysis by two-dimensional speckle tracking echocardiography. One-way analysis of variance was employed for the global comparison of study variables between groups (children with normal weight, overweight and obesity), and post hoc analysis with Bonferroni correction was used for multiple comparison, considering normal-weight children as the reference category. Results: Overall, 142 participants were included, 50 (35%) with normal weight, 39 (28%) overweight and 53 (37%) obesity. Diastolic diameter of the left ventricular (LV) and interventricular septum, diameter of the left atrium and LV mass were significantly higher in children with obesity compared to those with normal weight. No significant differences in the conventional indicators of LV systolic and diastolic function were found between groups. Significant differences in the regional myocardial deformation between the three groups were observed. Mean global longitudinal myocardial deformation was smaller in patients with obesity (−20.9% vs. −23.5%, p less 0.05) compared to children with normal weight. Conclusions: The childhood obesity was associated with altered myocardial deformation, even in the presence of normal ejection fraction. Myocardial deformation evaluation is relevant in the assessment of pediatric patients with obesity.

Progresses of ultrasound in evaluation of myocardial function for sick sinus syndrome / 中国介入影像与治疗学

Sick sinus syndrome (SSS) is a disease of multiple arrhythmias and symptoms.It has great impact on patients in the quality of life for the symptoms of high incidence.The asynchrony of myocardial electromechanical movement caused by the SSS electrophysiological changes are focused.The ultrasound can not only observe the electrical physiological activity,but also measure the mechanical movement caused by electrophysiological delay.The research progresses of ultrasound in quantitative evaluation of myocardial function in SSS patients was reviewed in this article.

Myocardial velocities obtained by pulsed tissue Doppler in English Cocker Spaniels with dilated cardiomyopathy and congestive heart failure / Velocidades miocárdicas obtidas por meio de Doppler tecidual pulsátil em cães da raça Cocker Spaniel Inglês com cardiomiopatia dilatada e insuficiência cardíaca congestiva

Dilated cardiomyopathy (DCM) is characterized by systolic myocardial dysfunction which is identified by low myocardial velocities obtained by pulsed tissue Doppler (PTD). However, increased preload is known to increase myocardial velocities which could overestimate myocardial function and turn dysfunction characterization into a challenge in dogs with DCM and congestive heart failure. To test the hypothesis that increased preload could hamper identification of low myocardial velocities in dogs with DCM and congestive heart failure the present study prospectively evaluated 32 English Cocker Spaniel dogs, being 16 with clinical DCM and 16 healthy for control purpose. The PTD analysis of regional velocities were performed in both longitudinal and radial myocardial displacements and systolic (Sm), early (Em) and late diastolic (Am) velocities were obtained in left ventricular free wall (LVFW) and interventricular septum (IVS). Peak radial subendocardial and subepicardial Sm velocities were lower in DCM group compared to control (0.065±0.018 vs. 0.102±0.020m/s and 0.059±0.014 vs. 0.094±0.025m/s respectively; p<0.001). Peak longitudinal Sm velocities were lower in basal and medial portions of LVFW (0.093±0.034 vs. 0.155±0.034m/s and 0.091±0.033 vs. 0.134±0.037m/s respectively; p<0.001) and IVS (0.063±0.021 vs. 0.136±0.039 and 0.066±0.026 vs. 0.104±0.032m/s respectively; p<0.001). Most of diastolic velocities were not significantly different between groups, although advanced myocardial disease and dysfunction are expected in DCM group. Reduction in systolic basal and medial longitudinal myocardial velocities and in radial myocardial velocities was the most significant PTD findings. Increased preload did not represent a problem to evaluate systolic dysfunction by PTD in English Cocker Spaniels with DCM, but influence of preload on assessment of diastolic velocities should be better elucidated.(AU)

A cardiomiopatia dilatada (CMD) é caracterizada por disfunção miocárdica sistólica, a qual pode ser identificada pelas baixas velocidades miocárdicas obtidas por meio de Doppler tecidual pulsátil (DTP). Contudo, sabe-se que a elevada pré-carga aumenta as velocidades miocárdicas, o que poderia superestimar a função miocárdica e tornar desafiadora a caracterização da disfunção nos cães com CMD e insuficiência cardíaca congestiva. Para testar a hipótese de que a elevada pré-carga pode mascarar a identificação de baixas velocidades miocárdicas nos cães com CMD e insuficiência cardíaca congestiva, o presente estudo avaliou prospectivamente 32 cães da raça Cocker Spaniel Inglês, sendo 16 com manifestações clínicas de CMD e 16 hígidos para efeito de grupo controle. A análise DTP das velocidades regionais foi realizada tanto no deslocamento miocárdico longitudinal quanto radial e foram obtidas as velocidades sistólica (Sm), diastólica inicial (Em) e tardia (Am) na parede livre do ventrículo esquerdo (PLVE) e no septo interventricular (SIV). Os valores de Sm radial subendocárdicos e subepicárdicos foram menores no grupo CMD em comparação com o grupo controle (0,065±0,018 vs. 0,102±0,020m/s e 0,059±0,014 vs. 0,094±0,025m/s, respectivamente; p<0,001). Os valores de Sm longitudinais foram menores nas porções basal e intermediária da parede do ventrículo esquerdo (0,093±0,034 vs. 0,155±0,034m/s e 0,091±0,033 vs. 0,134±0,037m/s, respectivamente; p<0,001) e do septo interventricular (0,063±0,021 vs. 0,136±0,039 e 0,066±0,026 vs. 0,104±0,032m/s, respectivamente; p<0.001). A maioria dos índices diastólicos não apresentou diferença significativa entre os grupos, apesar de a doença miocárdica avançada e a disfunção serem esperadas no grupo CMD. A redução nas velocidades sistólicas longitudinais nos segmentos basais e intermediários e nas velocidades radiais representaram os achados mais relevantes no estudo com DTP. Nos cães da raça Cocker Spaniel Inglês com CMD e insuficiência cardíaca congestiva a pré-carga elevada não representou empecilho para a avaliação da disfunção sistólica por meio de DTP, porém a influência da pré-carga na avaliação das velocidades diastólicas deve ser mais bem investigada.(AU)

Effects of Shengmai Injection on Myocardial Function of Patients with General Anesthesia of Hysterectomy / 中国药房

OBJECTIVE:To investigate the effect and safety of Shengmai injection on myocardial function of patients with gen-eral anesthesia of hysterectomy. METHODS:40 patients underwent hysterectomy were randomly divided into observation group and control group with 20 cases in each group. Both groups received general anesthesia induction of fentanyl citrate and rocuroni-um,and inhalation anesthesia of propofol. Observation group was given Shengmai injection 1 ml/kg,ivgtt;control group was given same dose of 0.9%Sodium chloride injection,ivgtt,before anesthesia. Mean arterial pressure(MAP),heart rate(HR),central ve-nous pressure(CVP),blood oxygen saturation(SpO2),the levels of MDA,SOD and NOS were compared between 2 groups be-fore operation(T0),before anesthesia induction(T1),reaction during(T2),after operation(T3). The occurrence of ADR was also observed. RESULTS:There was no statistical significance in MAP and HR between 2 groups at T0 and T1 (P>0.05). MAP and HR of observation group was significantly higher than those of control group at T2 and T3,with statistical significance(P0.05). There was no statistical significance in MDA,SOD and NOS levels between 2 groups at T0(P>0.05). MDA and NOS levels of 2 groups increased signifi-cantly at T1,T2 and T3,while SOD level decreased significantly;MDA and NOS level of observation group were lower than the control group while SOD level was higher than control group at T1,T2,with statistical significance (P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Shengmai injection can maintain stable HR and MAP,and reduce the oxide in patients underwent hysterectomy surgery so as to protect myocardial function with good safety.

Effect of sodium ferulate injection on myocardial function in rat model with myocardial ischemia and reperfusion / 局解手术学杂志

Objective To explore the effect of sodium ferulate injection on myocardial function in rat model with myocardial ischemia and reperfusion. Methods Selected 60 rats aged 7 ~8 weeks (7. 26 ± 0. 36 weeks averagely) and randomly divided them into the sham group, myocardial reperfusion group, and the sodium ferulate group, with 20 rats in each group. Observed the changes of the cardiac func-tion indexes of the two groups after perfusion. Results Compared with the sham group,the degree of LVESP and ± dp/dmax decreased sig-nificantly (P<0. 05) in the myocardial reperfusion group and the sodium ferulate group. The descending degree of LVESP and ± dp/dmax 2 hours after reperfusion in the reperfusion group was significantly higher than that in the sodium ferulate group (P<0. 05). Compared with the sham group,the LVEDP of the other two groups showed a rising trend,and it was significantly lower 2 hours after reperfusion in the sodium ferulate group compared to the reperfusion group (P<0. 05). Proportion of apoptosis cells increased in the reperfusion group and the sodium ferulate group,and positive expression rate of Fas in the sodium ferulate group was significantly lower than the reperfusion group (P<0. 05). LDH and CK-MB of content in the blood of rats were significant increased,and it was higer in the reperfusion group compared with the sodium ferulate group (P<0. 05). Compared with the sham group,SOD content in the reperfusion group and the sodium ferulate group decreased obviously (P<0. 05). The MDA content increased,but the degree of increase was lower in the sodium ferulate group (P<0. 05). Conclu-sion Sodium ferulate could protect the myocardial function in rat model with myocardial ischemia and reperfusion to a certain degree.

The effect of stress-related hyperglycemia on myocardial function of patients with cardiac disease after non-cardiac surgery / 中国中西医结合急救杂志

Objective To investigate the effect of stress-related hyperglycemia on myocardial function of patients with cardiac disorder after non-cardiac surgery.Methods The clinical data of 211 patients having undergone thoracic or abdominal operations in Department of Critical Care Medicine of Sun Yat-sen University Cancer Center were retrospectively analyzed. According to the postoperative average blood glucose level in the following 3 days after surgery and the patients' history of cardiac disorder, they were divided into four groups: without hyperglycemia (blood glucose ≤ 10 mmol/L) and cardiac disorder group (HG0CV0 group), without hyperglycemia but with cardiac disorder group (HG0CV1 group), with hyperglycemia (blood glucose > 10 mmol/L) but without cardiac disorder group (HG1CV0 group) and with hyperglycemia and cardiac disorder group (HG1CV1 group). The correlations between the blood glucose and each level of the following items: high-sensitivity cardiac troponin I (hs-cTnI), brain natriuretic peptide (BNP), myocardial zymogram aspartate aminotransferase (AST), creatine kinase (CK), MB isoenzyme of creatine kinase (CK-MB), lactic dehydrogenase (LDH), lactic dehydrogenase isoenzyme (LDH-1), myoglobin (MYO), α- hydroxybutyrate dehydrogenase (HBDH) in each group were analyzed.Results The postoperative blood glucose levels of all 211 patients were significantly higher than those before operation (mmol/L: 8.7±0.2 vs. 5.7±0.2,P 0.05). In HG0CV1 group, the postoperative blood glucose level was negatively correlated with hs-cTnI level (r = -0.609, 95%CI = -0.810 to -0.264,P = 0.001). There were no correlations between postoperative blood glucose level and the levels of BNP, MYO, AST, LDH, LDH-1, HBDH, CK and CK-MB (allP > 0.05). In HG1CV0 group, there were no correlations between postoperative blood glucoselevel and hs-cTnI, BNP, MYO, AST, LDH, LDH-1, HBDH, CK and CK-MB (allP > 0.05). In HG1CV1 group, the postoperative blood glucose level was positively correlated with hs-TnI level (r = 0.837, 95%CI = 0.476 - 0.984,P = 0.001). There were no correlations between postoperative blood glucose level and the levels of BNP, MYO, AST, LDH, LDH-1, HBDH, CK and CK-MB (allP > 0.05).Conclusion The early stress-related hyperglycemia after non-cardiac surgery may have a protective effect on myocardial function of patients with cardiac disorder.

Phenylephrine postconditioning increases myocardial injury: Are alpha-1 sympathomimetic agonist cardioprotective.

Objective: We studied effects of phenylephrine (PHE) on postischemic functional recovery and myocardial injury in an ischemia-reperfusion (I-R) experimental model. Materials and Methods: Rat hearts were Langendorff-perfused and subjected to 30 min zero-fl ow ischemia (I) and 60 min reperfusion (R). During R PHE was added at doses of 1 μM (n = 10) and 50 μM (n = 12). Hearts (n = 14) subjected to 30 and 60 min of I-R served as controls. Contractile function was assessed by left ventricular developed pressure (LVDP) and the rate of increase and decrease of LVDP; apoptosis by fl uorescent imaging targeting activated caspase-3, while myocardial injury by lactate dehydrogenase (LDH) released during R. Activation of kinases was measured at 5, 15, and 60 min of R using western blotting. Results: PHE did not improve postischemic contractile function. PHE increased LDH release (IU/g); 102 ± 10.4 (Mean ± standard error of mean) control versus 148 ± 14.8 PHE (1), and 145.3 ± 11 PHE (50) hearts, (P < 0.05). PHE markedly increased apoptosis. Molecular analysis showed no effect of PHE on the activation of proapoptotic c-Jun N-terminal kinase signaling; a differential pattern of p38 mitogen activated protein kinase (MAPK) activation was found depending on the PHE dose used. With 1 μM PHE, p-p38/total-p38 MAPK levels at R were markedly increased, indicating its detrimental effect. With PHE 50 μM, no further changes in p38 MAPK were seen. Activation of Akt kinase was decreased implying involvement of different mechanisms in this response. Conclusions: PHE administration during reperfusion does not improve postischemic recovery due to exacerbation of myocardial necrosis and apoptosis. This fi nding may be of clinical and therapeutic relevance.

Review of positive acceleration exposure-induced myocardial and brain injuries in animals and the mechanisms / 中国比较医学杂志

The prevention of myocardial and brain dysfunction induced by positive acceleration (+Gz) exposure is the focus in the field of aerospace medicine research topic .The characteristics and mechanisms that +Gz exposure caused damages to vital organs such as heart and brain remain to be further elucidated .The research literature about +Gz acceleration exposure-induced heart and brain injuries in experimental animals and its mechanisms at home and abroad was reviewed in this paper .

Implante de células progenitores en cardiología: su eficacia es aún incierta / Stem cell implantation in cardiology: its efficacy remains uncertain

Para superar la capacidad endógena limitada de regeneración de miocardiocitos post infarto del miocardio, se formuló la hipótesis de que al repoblar la zona infartada con células progenitoras autólogas se podría restablecer la función cardíaca, iniciándose una intensa investigación preclínica y luego clínica. La mejoría inicial, pequeña, en la función cardíaca no se correlaciona con la diferenciación de células progenitores a miocitos. Se han propuesto efectos auto y paracrinos como alternativas para explicar efectos beneficiosos del implante de células progenitoras. Se han usado diferentes protocolos y técnicas para investigar mecanismos de acción y eficacia de los implantes mencionados pero sus resultados no son claros. Se requiere de estudios más extensos y específicos para resolver la pregunta planteada al inicio de este editorial.

In order to overcome the limited regenerative capacity of cardiac myocytes following a myocardial infarction, the implant of stem cells was proposed as a means of restablishing cardiac function. Thus, an extensive line of preclinical and clinical investigation was developed. Initial improvements, admittedly small, in cardiac function do not correlate with differentiation of stem cells to myocytes. Autocrine and paracrine effects have been proposed as an alternative way to explain beneficial effects of BMC implantation. There have been many approaches, protocols and techniques used to investigate the mechanisms of action and efficacy of BMC implant but their result continue to be controversial. Therefore, larger and more specific studies are needed to solve the question posed at the beginning of this editorial.

Impact of Arterial Stiffness on Regional Myocardial Function Assessed by Speckle Tracking Echocardiography in Patients with Hypertension

BACKGROUND: Arterial stiffening may affect regional myocardial function in hypertensive patients with normal ejection fraction (EF). METHODS: Brachial-ankle pulse wave velocity (PWV) was measured in 70 patients, of mean age 48 +/- 14 years, with untreated hypertension and EF > 55%. Using two-dimensional-speckle tracking echocardiography, we measured longitudinal and circumferential strain (epsilon) and strain rate (SR). Basal and apical rotations were measured using short axis views. RESULTS: The mean systolic and diastolic blood pressure in these patients was 152 +/- 15 mmHg and 92 +/- 11 mmHg, respectively. The mean value of PWV was 1578 +/- 274 cm/s. PWV significantly correlated with age (r = 0.682, p 1700 cm/s compared to those with PWV < or = 1400 cm/s or those with PWV 1400-1700 cm/s. CONCLUSION: In hypertensive patients with normal ejection fraction, arterial stiffening contributes to impaired systolic and diastolic function of the regional myocardium. Compensatory increases in ventricular twist were diminished in patients with advanced stage of vascular stiffening.

Kappa-opioid receptor activation during reperfusion limits myocardial infarction via ERK1/2 activation in isolated rat hearts / 대한마취과학회지

BACKGROUND: We investigated whether p42/p44 extracellular signal-regulated kinases (ERK1/2) and/or phosphatidylinositol-3-OH kinase (PI3K)-Akt play a crucial role in cardioprotection by kappa-opioid receptor (KOP) activation. METHODS: Langendorff perfused rat hearts were subjected to 30 min of regional ischemia and 2 h of reperfusion. Antagonists of ERK1/2 and PI3K were perfused in hearts treated with the KOP agonist U50488H (U50). Infarct size was measured after 2 h of reperfusion. The phosphorylation states of ERK1/2 and Akt by Western immunoblots were determined. Drugs were perfused for a period of 5 min before and 30 min after reperfusion. RESULTS: Inhibition of ERK1/2 (26.8 +/- 2.9%, P 0.05 vs. U50) completely abrogated the anti-infarct effect of U50488H. Western blot analysis revealed a significant increase in ERK1/2 but not Akt phsophorylation in U50488H-treated hearts as compared to control hearts when measured immediately after reperfusion. CONCLUSIONS: KOP activation effectively reduces myocardial infarction. The anti-infarct effect of U50488H is mediated by the ERK1/2, but not the PI3K-Akt pathway.

Evaluating myocardial function of a cardiomyopathy rabbit model following bone marrow stromal cell transplantation by tissue Doppler echocardiography / 中国组织工程研究

BACKGROUND: Tissue Doppler echocardiography (TDE) has been proved to evaluate general and local function of heart but less reported on adriamycin-induced cardiomyopathy following bone marrow stromal cell (BMS) transplantation.OBJECTIVE: To evaluate myocardial function of an adriamycin-induced cardiomyopathy rabbit model following BMS transplantation using TDE.DESIGN, TIME AND SETTING: A randomized animal control study was performed at Laboratory of Ultrasound, Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology from September 2002 to December 2003.MATERIALS: A total of 28 male adult Japanese rabbits weighing (2.0+0.2) kg were used in this study. Adriamycin was used to induce cardiomyopathy model in 20 rabbits.METHODS: Twenty-eight male Japanese rabbits were randomly divided into three groups: cell transplantation group (n=10),PBS group (n=10), and sham operation group (n=8). BMSs were isolated from cell transplantation group at the 8th day. On the 12th week, cells were labeled with 4, 6-diamidino-2-phenylindole (DAPI), and then epicardial directly injected into the myocardium of the same rabbits in thoracotomy surgery. Non-cell only culture fluid PBS was injected in PBS group. Sham operation group underwent thoracotomy surgery with the same volume of saline injection.MAIN OUTCOME MEASURES: Left ventricular function was assessed by conventional and tissue Doppler echocardiography before and 4 weeks after surgery. Histological examination including apotisis study and DAPI fluorescent were assessed after sacrificed.from (4.0+1.1) cm/s to (5.3+1.2) cm/s (P ＜ 0.05) around the inject site, but the improvement of global myocardial function was not found by conventional echocardiography. In PBS and sham operation group there were no differences in global and myocardium at 4 weeks after transplantation. Histological findings showed that the injury of the myocardium around the injection site was relieved with less apoptosis.

Isovolumic relaxation strain rate evaluation of myocardial function and the coronary stenosis extent in coronary heart disease / 中国医学影像技术

Objective To quantitatively analyze myocardial function and the degree of myocardial ischemia with strain rate imaging (SRI). Methods SRI was performed in 34 patients with left anterior descending coronary artery disease diagnosed with coronary angiography and compared with 35 healthy volunteers. Isovolumic relaxation strain rates (SRivr) of anterior wall and anterior septal were measured. Results There was no significant cut-off value for LAD＜50%. A cut-off value of SRivr=-0.42 s~(-1) (sensitivity 84.85%, specificity 80.36%) for LAD 50%-74% stenosis. A cut-off value of SRivr=-0.91 s-1 (sensitivity 91.07%, specificity 89.91%) for LAD＞75% stenosis. Conclusion SRivr can quantitatively differentiate LAD 50%-74% or LAD＞75% stenosis. SRI can evaluate the coronary stenosis extent quantitatively.

The values of detecting cardiac function in fetal distress by Tei index / 重庆医科大学学报

Objective:To investigate the values of detecting cardiac function in fetal distress by Tei index.Methods:Study consisted of 32 cases of fetal distress and 80 matched normal subjects.We recorded the Doppler sample volume at mitral valve in the cardiac four-chamber view of the heart.Respectively,population below and above the aortic valve.Mitral A peak measured E peak to the beginning of the end of time a,aortic ejection time b,measured for 2~3 cycles,then chosing the average.According to the formula ICT + IRT/ET = a-b/b,we caculated the Tei index.Results:It showed Tei index of cases the fetal distress significantly larger than normal fetuses(P

Evaluation of Myocardial Function by Tissue Doppler Imaging in Children with Kawasaki Disease

PURPOSE: The objective of this study was to assess myocardial function before and after IVIG treatment by tissue Doppler imaging in children with Kawasaki disease. METHODS: This study was conducted on 43 patients with Kawasaki disease from April 2005 to February 2006 at Dongsan Medical Center, Keimyung University. Myocardial function of all patients was examined using echocardiography before (time 1) and after intravenous gamma-globulin (IVGG, time 2) treatment. Deceleration time (DT), isovolumic relaxation time (IVRT), fractional shortening (FS), and peak early diastolic (E), peak late diastolic (A) velocity of transmitral flow were measured by M-mode and pulsed wave Doppler. Systolic (Sm), peak early diastolic (Em), peak late diastolic (Am) velocity in apical 4-chamber and 2-chamber views were measured by tissue Doppler imaging. The author calculated modified Tei index, E/A, E/Em ratio by using measured values. RESULTS: Forty three patients were 27 boys and 16 girls. The average age of patients was 3 years and 1 month. There was 5 patients treated IVGG more than twice and no patient with definite coronary dilatation. All conventional Doppler parameters showed no significant difference statistically between control and time 1, 2. Among tissue Doppler parameters measured at time 2 in comparison to control and time 1, modified Tei index in septum, E/Em and modified Tei index in inferior wall decreased significantly and Am in inferior wall increased significantly. CONCLUSION: Although the results did not show consistency throughout all measured areas, it showed significant difference between patients and control in some areas' myocardiac function in relative recovery phase. This results are thought that the change in myocardial function may be derived from the Kawasaki disease during acute phase and recovery phase. There should be more investigations both in number and in diversity of patients with Kawasaki disease and there also should be studies to find how the changes mentioned above are different from persistent febrile group without the Kawasaki disease and whether they are temporal changes in the acute phase due to IVIG volumic overload.