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AIM To investigate the role of ginkgolide B on the ventricular wall motion and systolic function in acute myocardial infarction (AMI) patients after their revascularization.METHODS A total of 80 cases of AMI patients who underwent revascularization were divided into control group and ginkgolide B treatment group,with 40 patients per group.The two groups of patients both treated basically with routine western medicine were dosed with either placebo or ginkgolide B for 3 months.The cardiac function,normal myocardial percentages,ventricular wall motion,longitudinal peak systolic strain (LPSS) and rate (LPSSR) were evaluated by dobutamine stress echocardiography and these indexes were compared.RESULTS Compared to the control group,left ventricular ejection fraction (LVEF) (66.06 ± 8.39 vs.60.45 ± 13.35,P ＜0.05) and normal myocardial percentages (86.88 ±8.76 vs.79.84 ± 12.25,P ＜0.01) were significantly improved at the 2nd week in ginkgolide B treatment group,but no significant difference on ventricular wall motion was observed'between the two groups (P ＞ 0.05).For the patients with anterior wall AMI,the minus LPSS and LPSSR at basal,middle and apex segment were significantly improved at the 2nd week in ginkgolide B treatment group compared to the control group (P ＜ 0.05,P ＜ 0.01).Moreover,LPSS at apex segment was significantly improved at the 3rd month in ginkgolide B treatment group compared to the control group (P ＜ 0.05).For the patients with inferior wall AMI,minus LPSS at basal and apex segment were significantly improved at the 2nd week and the 3rd month in ginkgolide B treatment group compared to the control group (P ＜ 0.05),whereas minus LPSSR at basal and middle segment at the 2 nd week and basal segment at the 3rd month were significantly improved in ginkgolide B treatment group compared to the control group (P ＜0.05).CONCLUSION Revascularized AMI patients treated with ginkgolide B can expect an improved ventricular wall motion.
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Objective Using STI and WMSI to evaluate the change of the heart sarcomere local systolic function which suffered from coronary heart disease (CHD), to evaluate the improvement of ischemic heart sarcomere local systolic function after PCI. Methods There are 40 CHD patients after PCI called the treatment group and 40 healthy persons called the control group. Echocardiogram was used to evaluate the change of ventricular wall motion score in the treatment group which was before and 1 week after PCI , compared with the control group. STI is used to get the SLs, GSL and SrLe of the left ventricle six walls in basal segment,middle segmentand apical segment systole. Results The ventricular wall motion index of the left ventricular myocardium obviously rose in CHD patients which was after PCI, compared with the control group (P < 0.05). And it obviously reduced in CHD patients after PCI, compared with CHD patients before PCI(P < 0.05). The results of SLs,GSL and SrLe are reduced in myocardial ischemia segment of CHD patients before PCI,compared with the control group (P < 0.05). But they are significantly improved in the the treatment group 1 week after PCI, compared to which is before PCI(P < 0.05). Conclusion STI and WMS can be used to evaluate the abnormal of regional and global function of myocardium which is caused to coronary artery stenosis the effect of PCI. The left ventricular motion function of CHD is decreased, but the left ventricle regional systolic function of hypokinetic segments in patients with CHD after PCI is significantly increased.
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Objective To investigate the effect of early coronary artery bypass grafting (CABG)to the left ventricular wall motion state and the significance of CABG to awake hibernating myocardial in dogs with acute myocardial infarction.Methods The anterior descending coronary of all thirty dogs were ligated into MI model.According to the operation date,the experimental groups included the 1 st week (n =6),the 2nd week (n =4),the 4th week (n =6) and the 6th week (n =6) CABG,and established control group (n =2) for every experimental group.Operators marked hibernate myocardial and determined the room wall motion score by means of dobutamine ultrasound load test (DSE) combining with tissue doppler imaging (DTI)technology before CABG and after eight weeks CABG through thoracotomy surgery for the experimental group and the control group.Every dog was executed and detected the area of MI.Results Four dogs of experimental group and all dogs of control group survived to the end of the study.The change of ventricular room wall motion score in the 1st and the 2nd week CABG was smaller than that in the 4th and the 6th week CABG and MI group(0.03 ±0.06,0.05 ±0.09,0.23 ±0.08,0.27 ±40.06,0.32 ±0.05,P ＜0.05).The change of room wall motion score in all CABG groups was smaller than that in MI group(1.195 ±0.09,1.25 ±0.18,1.30 ±0.18,1.36 ±0.11,1.65 ±0.17,P＜0.05).The hibernate myocardial were more awaken in all CABG groups than that in MI group (0.27 ± 0.12,0.22 ± 0.04,0.31 ± 0.09,0.23 ± 0.03,0.03 ± 0.04,P ＜ 0.05).The area of MI became smaller in 1 and 2 weeks CABG than that in 4 and 6 weeks CABG and MI group(20.75 ± 2.63,21.25 ± 2.5,27.25 ± 1.71,27.75 ± 2.22,P ＜ 0.05).Conclusions Early CABG surgery for dogs acute MI could improve the ventricular room wall motion obviously and wake up more hibernate myocardial.Especially,CABG surgery among two weeks could lessen the effect of MI to the ventricular room wall motion and reduce the scope of myocardial infarction maximatily.
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Objective To detect the curve of ventricular wall motion features of regional wall abnor-malities in patients with coronary artery disease during each diastolic period, and its possibility to evaluate re-gional left ventricular diastolic function. Methods Fifty-four patients with anterior myocardial infarction (MI group) and 78 normal subjects (NOR group) underwent Doppler tissue imaging, which were performed in 2-chamber-view by the tracing technology of ventrieular wall motion synchronously. Isovolumic relax-ation period, rapid flow period, slow filling phase, atrial systole period were measured. Results In NOR group, distant value of 76 patients (97.44%) showed a gradually decreasing positive value from the apex to middle and from middle to base of left ventricle. While in MI group, such rules disappeared, 52 patients (96.30%) were negative in infarction area. In isevolumic relaxation period in NOR group, 76 patients (97.44%) showed palliative downward wave, but in MI group, 27 patients (50.00%) showed palliative downward wave(P<0.05). In rapid flow period, both NOR and MI group showed downward and steep waves,but in MI group, the gradient rule disappeared and distance of ventricular wall motion was negative in infarc-tion area. In slow filling phase, compared with NOR group, which had horizontal wave, MI group had no obvi-ously horizontal waves. Conclusion Regional myocardial ischemia and infarction can cause significant ab-normalities of regional ventricular wall motion in active diastolic phase, and it can be evaluated quantitatively and synchronously with high sensitivity by the curve of ventricular wall motion which has the potential value in regional left ventricular diastolic function.
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Objective To investigate the effects of puerarin(Pur)on myocardial perfusion and ventricular wall motion in patients withacute coronary syndrome(ACS).Methods Thirty-seven patients with ACS were randomly divided into two groups:conventionaltreatment group(n=17,11 males,range of age:32-80 years,average age:60.9±4.9 years)and Purtreatment group(n=20,12 males,rangeof age:40-76 years.average age:62.7±3.5 years).Patients in the conventional treatment group received standard treatment according tothe current guidelines,while patients in the Pur treatment group received intravenous administration of Pur(500 mg/day)for 10 daysplus conventional treatment.Real-time myocardial contrast echocardiography (RT-MCE) was performed to evaluate the change inmyocardial perfusion index (MPI)and veiltricular wall motion index(VWMI)at admission and 10 days after treatment.Results At10 days after treatment,MPI was significantly higher(P＜0.01)and VWMI significantly lower(P＜0.01)in the Pur group comparingwith those in the conventional group.Conclusions Puerarin might improve myocardial microcirculation perfusion and ventricularwall motion in patients with ACS.
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0.05).Compared with non-myocardial infarction group,the prevalence of normal segmental ventricular wall motion and ejection fraction in myocardial infarction group was significantly lower,while those of akinesia and paradoxical motion were significantly higher(P
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BACKGROUND: Assessment of segmental wall motion is one of the most challenging tasks in echocardiography. The diagnosis of ischemic heart disease by echocardiography depends on the accurate detection of segmental wall motion abnormalities. However, echocardiographic regional wall motion analysis is impaired by incomplete endocardial definition due to obesity, chronic obstructive lung disease, etc. The purpose of this study was to examine the value of tissue harmonic imaging for endocardial border definition. METHODS: We recorded echocardiograms in 30 consecutive patients, in which more than one segment of left ventricule were poorly visualized, by ATL HDI 3000 and analyzed left ventricular segmental wall motion and then recorded echocardiograms again by tissue harmonic imaging (THI) technique. Endocardial border definition for each segment was graded from grade A to C (grade A in which endocardium is clearly visualized, grade B in which endocardium is poorly visualized and grade C in which endocardium is not seen). Densitometric analysis was perfromed in 10 randomly selected patients. Mean density and dynamic range in histogram were obtained at septum, posterior wall and left ventricle cavity on parasternal long axis view with both techniques. RESULTS: Among total 480 segments, 237 segments (49.4%) were categorized as grade A, 152 segments (31.7%) were categorized as grade B and 91 segments (18.9%) were categorized as grade C in fundamental modes. However, 380 segments (79.2%) were categorized as grade A, 75 segments (15.6%) were categorized as grade B and 25 segments (5.2%) were categorized as grade C in tissue harmonic modes. Visualization of 37.7% (181 segments/480 segments) of all segments was improved in tissue harmonic imaging, with 5.2% (25 segments/480 segments) improved from "not seen" to "clearly visualized". Of these improved 181 segments in THI, 105 segments (58%) were the lateral and anterior walls on apical views. In densitometric analysis of septum, wall density and delta density (wall densityLV cavity density) were significantly higher in THI than fundamental modes (p<0.05). But, W/C ratio (wall density/LV cavity density) was not different between two imaging modalities. In densitometric analysis of posterior wall, all parameters were not significantly different between two imaging modalities. Also, W/C ratio of dynamic range (posterior wall dynamic range/LV cavity dynamic range) was not significantly different between two imaging modalities. CONCLUSION: Tissue harmonic imaging has significant value in endocardial border definition in the patients with poor echocardiographic windows and appears promising with the added advantage of no requirement for intravenous access.
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Humans , Axis, Cervical Vertebra , Diagnosis , Echocardiography , Endocardium , Heart Ventricles , Myocardial Ischemia , Obesity , Pulmonary Disease, Chronic ObstructiveABSTRACT
OBJECTIVES: Evaluation of left ventricular function and wall motion analysis is essential in patients with heart disease, especially ischemic heart disease. However, it is frequently limited by many factors ', obesity, chronic obstructive lung disease, etc. We conducted our study to know the feasibility of PMI technique, recently developed method to overcome these lirnitation. METHODS: We recorded echocardiography of consecutively admitted patients by ATL HDI 3000 and conducted LV wall motion analysis according to standardization of ASE and then recorded echocardiography again by PMI technique in 44 patients in which more than on left ventricular segments were poorly visualized. We compared the resolution of echocardiography of PMI technique with traditional echocardiography. We categorized the segments semiquantitatively ; grade A in which endocardium is clearly visualized, grade C in which endocardium is not discernible, grade B in which endocardium is suboptimally visualized. RESULTS: 1) 44 patients(30 males and 14 females) were studied and their rnean age was 63.4+/-10.5 years old. 2) 20 patients had myocardial infarction and 12 patients angina, 6 patients heart failure, 4 patients arrhythmia, and 2 patients other diseases. 3) Among total 704 segments, 462 segments(65.6%) were categorized as grade A, 203 segments(28.8%) as grade B, 39 segments(5.6%) as grade C. In 19 patients, more than one segments were categorized as grade C. In 6 patients, rnore than 3 segments were categorized as grade C. 4) With PMI technique, 557 segrnents(79.1%) were categorized as grade A, 126 segments (17.9%) as grade B, 21 segments(2.9%) as grade C with upgrade from grade C to A in 124 segments(17.6%) and grade C to B or B to A in 17 segments(2.4%). CONCLUSION: Echocardiography by PMI technique is feasible in left ventricular wall motion analysis in patients with poor echocardiographic windows.
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Humans , Male , Arrhythmias, Cardiac , Echocardiography , Endocardium , Heart Diseases , Heart Failure , Myocardial Infarction , Myocardial Ischemia , Obesity , Pulmonary Disease, Chronic Obstructive , Ventricular Function, LeftABSTRACT
We present the methods of analysis of left ventricular wall motion by 2-dimensional echocardiography using computerized system. Quantiative analysis of left ventricular wall motion abnormalities depents on the used reference method, because the heart shifts and rotates within thorax during the cardiac cycle. To access left ventricular wall motion abnormalities, we studied 60 subjects(normal; 30 subjects, abnormal; 30 subjects)with 5 different floating reference methods correcting for traslation and/or rotation in two echocardiographic views. (apical 4-chamber view and apical 2-chamber view) In the first the endocardial tracings of enddiastole and endsystole in 30 normal subjects were stored in VAX-11-780 main computer and the data of these 30 normal subjects were plotted to obtain a 95% confidence interval for measured normal fractional change every five degree according to 5 reference methods. In the second, 30 patients with abnormal left ventricular wall motion analyzed and the results were compared with a 95% confidence interval. We assessed that left ventricular wall motion by visual and computerized quantitative anlysis were in close relationship according to optimal reference method. We suggested that computerized quantitative analysis of left ventricular wall motion by 2-dimensional echocardiography was clinically useful method and translation of the midpoint of mitral anulus with rotation according to center of mass was the most specific and sensitive new method of evaluating left ventricular wall motion abnormalities.