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Objective To evaluate the utility of neovascularization grade of carotid plaque using contrast enhanced ultrasonography in the prediction of recurrent cerebral infarction by Logistic regression model analysis. Methods Eight-nine patients with first cerebral infarction were studied by conventional and contrast enhanced ultrasonography, then the two-dimensional echoic grade and neovascularization grade of carotid plaque was assessed. The condition of recurrent cerebral infarction in next year was followed up. The independent risk and predictive factors of recurrent cerebral infarction were analyzed by Logistic regression model and the utility of the independent risk and predictive factors in the prediction of recurrent cerebral infarction was evaluated by ROC curve. Results Both two-dimensional echoic grade of carotid plaque (P=0.028) and neovascularization grade of carotid plaque (P=0.006) were the risk and predictive factors of recurrent cerebral infarction in single-factor Logistic regression model. However, only the neovascularization grade of carotid plaque was the independent risk and predictive factor in multiple-factor Logistic regression model (P=0.043) with an OR value of 1.916. The sensitivity and specificity of the neovascularization grade of carotid plaque in prediction of recurrent cerebral infarction (cut-off value>Ⅱ) were 67.74% and 70.69% respectively and the area under ROC curve was 0.684(95%CI:0.577~0.779,P=0.0017).Conclusion The neovascularization grade of carotid plaques on contrast enhanced ultrasonography is the independent risk and predictive factor in prediction of recurrent cerebral infarction.
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ObjectiveTo evaluate the late-phase enhancement of carotid artery in patients with cerebral infarction by contrast-enhanced ultrasonography.MethodsSixty-eight patients whose bilateral carotid artery plaques were both wider than 1.5 mm with treatment in Zhejiang Provincial People?s Hospital from April to July in 2013 were enrolled in this study. Among the enrolled patients, there are 50 patients with cerebral infarction including 30 patients with unilateral cerebral infarction and 20 patients with bilateral cerebral infarction, and 18 patients without cerebral infarction. The enrolled patients underwent conventional and contrast-enhanced ultrasonography. The time-intension curve was obtained till 6 minutes after the injection of contrast agent. The late-phase enhancement intensity and relative intensity of maximal carotid plaque was measured and calculated. The differences of late-phase enhancement intensity and relative intensity between patients with cerebral infarction and patients without cerebral infarction, and between ipsilateral and contralateral side of cerebral infarction in patients with cerebral infarction were compared using two samplet test.ResultsThe late-phase enhancement intensity of carotid plaque in patients with cerebral infarction and in patients without cerebral infarction was (6.0±1.5) and (4.9±1.2) dB, respectively, and the relative late-phase enhancement intensity of carotid plaque was 0.9±0.2 and 0.8±0.2, respectively. The late-phase enhancement intensity and the relative intensity of carotid plaque was higher in patients with cerebral infarction compared with patients without cerebral infarction, and the differences had statistical significance (value oft was 2.132 and 2.258 respectively, value ofP were both less than 0.05). The late-phase enhancement intensity of carotid plaque in ipsilateral and contralateral side of cerebral infarction was (7.1±1.8) and (4.9±1.2) dB, respectively, and the relative late-phase enhancement intensity of carotid plaque was 1.2±0.3 and 0.8±0.2, respectively. The late-phase enhancement intensity and the relative intensity of carotid plaque was higher in ipsilateral side of cerebral infarction compared with contralateral side of cerebral infarction in patients with cerebral infarction, and the differences had statistical signiifcance (value oft was 3.132 and 2.953 respectively, value ofP were both less than 0.01).ConclusionThe late-phase enhancement of carotid plaque in patients with cerebral infarction is significantly different from that in patients without cerebral infarction.
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Objective To evaluate the asynchrony of right ventricle(RV) and its significance in idiopathic pulmonary artery hypertension(IPAH) patients by quantitative tissue velocity imaging.Methods Twenty-five normal people,26 IPAH patients were studied.RV structure parameter(thickness of lateral wall,late diastolic and systolic area and fractional area change) and function parameter [peak systolic velocity(Sa),early diastolic velocity(Ea),late diastolic velocity of tricuspid annulus of lateral wall and Tei index] were measured and calculated.Regional velocity profiles of 6 segments of RV were obtained.The time from onset of QRS complexes to Sa and Ea(T_(Q-S),T_(Q-E)) of 6 segments were measured.The maximal difference in T_(Q-S) and T_(Q-E) in the same wall(Intra-?T_(Q-S),Intra-?T_(Q-E)),the same segment(Inter-?T_(Q-S),Inter-?T_(Q-E)) and all 6 segments(Max-?T_(Q-S),Max-?T_(Q-E)) were calculated.Results Compared with controls,Inter-?T_(Q-S),Inter-?T_(Q-E),Max-?T_(Q-S) and Max-?T_(Q-E) were significantly prolonged in IPAH patients(P(0.05)).Max-?T_(Q-S) and Max-?T_(Q-E) were correlated with structure and function parameter in IPAH patients.Conclusions Asynchrony exists in RV and have good relation with RV structure and function in IPAH patients.
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Objective To evaluate the diastole asynchrony of the different segments of left ventricle(LV) and its relation with LV diastole function in the patients with hypertrophic cardiomyopathy (HCM) by quantitative tissue velocity imaging(QTVI).Methods Forteen normal controls,15 patients with non-obstructive HCM (HCM) and 12 patients with obstructive HCM (HOCM) were studied by QTVI.The regional velocity profiles of 18 segments of LV and mitral annulus of six walls along LV apical long axis view,apical two chamber view and four chamber view were obtained.The time (T_ Q-E ) from onset of QRS complexes to peak velocity during early diastole were measured.The maximal difference in T_ Q-E with in the same wall (Intra-?T_ Q-E ),the same segment (Inter-?T_ Q-E ),all 18 segments (Max-?T_ Q-E ) of LV and the mean ratio of mitral annulus early and late diastole peak velocity of six walls were calculated(Ea/Aa′).Interventricular septum basic thickness(IVSTh) and LV outflow tract gradient(LVOTPG) were measured.Results Inter-?T_ Q-E ,Intra-?T_ Q-E ,Max-?T_ Q-E were significantly prolonged and Ea/Aa′ was reduced in HCM and HOCM groups compared with control group.There was no statistically significant difference of Inter-?T_ Q-E ,Intra-?T_ Q-E ,Max-?T_ Q-E ,Ea/Aa′ between HCM and HOCM groups.In control group,HCM group,HOCM group,IVSTh and LVOTPG were increased little by little.Max-?T_ Q-E were correlated negatively with Ea/Aa′ in patients with HCM and HOCM.IVSTh and LVOTPG were mildly correlated with Ea/Aa′ in HOCM group,but not correlated with Ea/Aa′ in HCM.Conclusions Asynchrony diastole is a neccessary factor causing impairment of LV diastole function exists within the same wall and the same segment of LV in patients with HCM,but IVSTh and LVOTPG is not a neccessary factor causing impairment of LV diastole function.Asynchrony diastole in patients with HCM could be an appereance of cardiomyopathy.