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Objective To explore the relationship between serum soluble semaphorin 4D(sSema4D),CXC chemokine ligand 12(CXCL12)levels and left ventricular diastolic function in young and middle-aged patients with essential hypertension.Methods A total of 148 young and middle-aged patients with essential hyperten-sion admitted to a hospital from November 2020 to November 2022 were selected as the study subjects,and were grouped into left ventricular diastolic dysfunction group(n=41)and normal left ventricular diastolic function group(n=107)according to their left ventricular diastolic function.The serum levels of sSema4D and CXCL12 were detected by enzyme-linked immunosorbent assay.Pearson correlation analysis was applied to analyze the correlation between the serum levels of sSema4D and CXCL12 and the left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricular septal thickness(IVST),left ventricular end-diastolic posterior wall thickness(LVPWT),left ventricular ejection fraction(LVEF),E peak/A peak(E/A)and maximum velocity of tricuspid regurgitation(TRVmax).The predictive value of ser-um sSema4D and CXCL12 levels in left ventricular diastolic dysfunction in young and middle-aged patients with essential hypertension was analyzed by receiver operating characteristic(ROC)curve.Results There were significant differences in diastolic blood pressure and gender between the left ventricular diastolic dys-function group and the left ventricular diastolic function normal group(P＜0.05).Compared with the normal left ventricular diastolic function group,serum levels of sSema4D,CXCL12 in the left ventricular diastolic dys-function group were obviously increased,and the difference was statistically significant(P＜0.05).Compared with normal left ventricular diastolic function group,IVST and LVPWT in the left ventricular diastolic dys-function group were significantly increased,and E/A was significantly decreased,with statistical significance(P＜0.05).Pearson correlation analysis showed that serum sSema4D and CXCL12 levels were positively cor-related with LVEDD,IVST and LVPWT(P＜0.05),and negatively correlated with E/A(P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of serum sSema4D and CXCL12 combined in pre-dicting left ventricular diastolic dysfunction in young and middle-aged patients with essential hypertension was 0.894(95％CI:0.833-0.939),which was significantly greater than that of sSema4D alone in predicting left ventricular diastolic dysfunction in young and middle-aged patients with essential hypertension(Z=3.142,P=0.002)and CXCL12 alone predicted the AUC of left ventricular diastolic dysfunction in young and middle-aged patients with essential hypertension(Z=3.268,P=0.001).Conclusion Serum sSema4D and CXCL12 levels are associated with left ventricular diastolic function in young and middle-aged patients with essential hypertension.
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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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Humanos , Fibrilación Atrial , Apéndice Atrial , Atrios Cardíacos/diagnóstico por imagen , Hipertensión/complicaciones , DiástoleRESUMEN
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 evaluate the impact of Z-score of early diastolic velocities using tissue Doppler imaging(TDI) in children with dilated cardiomyopathy(DCM) . Methods Fifty-eight children with DCM and 58 healthy children (control group) were selected ,tissue Doppler velocities were converted to Z-score on the basis of body-surface-area-adjusted . The Z-score head-to-head with the raw velocities were compared.Results ①Lateralwalle'velocitiesandinterventricularseptale'velocitieswerepositively correlated with age ( r = 0 .710 ,0 .622;all P < 0 .05 ) . Tissue Doppler velocities and Z-score of mitral annular in DCM children were lower than the normal children( P <0 .001) . ② The discriminant capacity was higher for the Z-score than for the e'raw velocities ,which were assessed by the area under the receiver operating characteristic curves . Conclusions The Z-score of early diastolic velocities are better than the raw velocities in evaluating left ventricular diastolic function in children with dilated cardiomyopathy
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Objective To evaluate the early injury and dynamic changes of the left ventricular diastolic function of patients with esophageal carcinoma after radiotherapy by using two-dimensional speckle tracking imaging (2D-STI).Methods From 2017 to 2018,echocardiography examinations were performed in 39 patients with esophageal carcinoma before,during and after the first thoracic radiotherapy to measure the left ventricular end diastolic volume (LVEDV),left ventricular end systolic volume (LVESV),left ventricular ejection fraction (LVEF),early diastolic mitral flow velocity/early diastolic mitral annular peak velocity (E/e'),left atrial volume (LAV),2D-STI parameters including the left ventricular global longitudinal strain (GLS),global systolic stain rate (GSRs),global early diastolic strain rate (GSRe),global late diastolic strain rate (GSRa) and E/GSRe ratio.According to the GLS of patients with esophageal carcinoma after radiotherapy (cumulative dose≥50 Gy),the patients were divided into good prognosis (n=23) and poor prognosis groups (n=16).The E/GSRe ratio was statistically compared between two groups.Results The E/e'and LAVI were increased significantly only after radiotherapy (both P＜0.05),and LVEF was decreased significantly only after radiotherapy (P＜0.05).The e' tended to decline before,during and after radiotherapy (all P＜0.05).GLS and GSRs were significantly decreased only after radiotherapy (both P＜0.05),whereas GSRa was considerably decreased during radiotherapy (P＜0.05).E/GSRe tended to increase (P＜0.05).Compared with the good prognosis group,E/GSRe was significantly increased after radiotherapy in the poor prognosis group (P＜0.05).Conclusions Diastolic dysfunction can occur in the early stage of radiation-induced heart injury.The global diastolic strain rate and E/GSRe obtained by 2D-STI can be used to assess the early left ventricular dysfunction.E/GSRe can be more sensitive to evaluate the clinical prognosis compared with the global diastolic strain rate.
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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 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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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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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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Adulto , Niño , Humanos , Instituciones de Atención Ambulatoria , Superficie Corporal , Desaceleración , Ecocardiografía , Ventrículos Cardíacos , Análisis Multivariante , PediatríaRESUMEN
Objective To investigate the effects of telmisartan in treatment of hypertrophy and diastolic function of left ventricular in patients with hypertension and left ventricular. Methods A total of 78 patients admitted to our hospital with primary hypertension and myocardial hypertrophy and left ventricular diastolic dysfunction from April 2013 to May 2014 were selected as the research objects, and they were given telmisartan tablets orally, the differences of diastolic blood pressure (DBP), systolic blood pressure (SBP) changes and the ultrasonic heartbeat of each index recorded before and after treatment, recorded the heart function classification as well were compared. Results ①After the treatment, systolic and diastolic blood pressure were (107.6±9.9) mmHg and (73.3±5.2) mmHg, compared with the data of before treatment (153.5±12.6) mmHg and(98.9±8.0) mmHg, decreased significantly and there were statistical differences(P<0.05); ②After the treatment, left ventricular posterior wall thickness, index interventricular septum thickness, left ven-tricular end diastolic diameter, left ventricular mass index and late diastolic mitral flow velocity A were significantly lower than that before treatment (P<0.05); Early diastolic mitral flow velocity peak E increased significantly (P<0.05);③After treatment, the number of grade Ⅰ from 24 patients before treatment increased to 62 cases, cardiac function significantly improved after treatment(P<0.05). Conclusion The significant effect on primary hypertension and myocar-dial hypertrophy and left ventricular diastolic dysfunction by oral telmisartan, is worth the clinical promotion.
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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 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 evaluate the change of left ventricular diastolic function and investigate the relation between left ventricular diastolic function and disease activity in rheumatoid arthritis (RA) without clinical manifestations of heart diseases. Methods Seventy consecutive active RA in-patients without clinical manifestations of heart disease were enrolled, while the control group was recruited from outpatient health physical check-up center and consisted of 60 age- and sex-matched healthy subjects. Cardiac related parame-ters were determined by echocardiography and the correlation between left ventricular diastolic function and the disease activity indexes were evaluated. Chi-square test, t test, Pearson or Spearman′s correlation test and Stepwise backward linear regression analysis were used for statistical analysis. Results RA patients had lower mitral inflow E/A ratio (1.2±0.4, 1.5±0.4, P<0.01), higher E/Em ratio (9.6±3.7, 7.8±2.0, P<0.01), longer isovolumetric relaxation time(IVRT)[(64±16) ms,(58±16) ms, P<0.05] than control group. Whilst, RA patients had higher pulmonary venous inflow A wave velocity-time integral (ArVTI) and A wave duration (DAr)[3.2±0.7,(2.8±0.6) cm; 117±11,(102±9) ms, P<0.05]. Moreover, the E/Em was positively corre-lated with C-reactive protein(CRP)(r=0.581, P<0.01), DAS28(r=0.456, P<0.01). Anti-CCP level was also associated with Em and early diastolic pulmonary venous inflow peak velocity(PVD)(r=-0.359, P<0.05;r=-0.305, P<0.05). In addition, multivariate analysis also revealed that there was linear regression relation-ship between E/Em and CRP, DAS28(t=3.266, P=0.002; t=2.949, P=0.005). Conclusion The study has revealed that left ventricular diastolic function is impaired in RA patients and the left ventricular diastolic function parameters is associated with the disease activity indexes. These results suggest that the decline of left ventricular diastolic function is associated with the inflammation activity in RA patients without clinical manifestations of heart disease.
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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.