Clinical research progress of tricuspid annular plane systolic excursion in the evaluation of right ventricle systolic function in children with congenital heart disease / 中华胸心血管外科杂志

The hemodynamics of children with congenital heart disease (CHD) often changes during the perioperative period. Unfortunately, the evaluation of cardiac function in children with CHD is mainly focused on the left ventricle. With the further understanding of cardiac hemodynamics, the monitoring of RV function has gradually become an important part of cardiac intensive care department. We totally searched five databases including Pubmed, Embase, Cochrane, Wanfang Med, as well as China National Knowledge Infrastructure (CNKI) and reviewed the clinical research progress of the application of TAPSE in the evaluation of RV systolic function in children with CHD to provide a theoretical basic for the monitoring of RV function before and after operation in children with CHD.

Study on tricuspid annular plane systolic excusion(TAPSE) after congenital heart disease surgery / 中华胸心血管外科杂志

Objective:To explore the tricuspid annular plane systolic excusion(TAPSE) in children with left-to-right shunt after congenital heart disease surgery and to understand the early systolic function of right heart in thesepatient.Methods:From June 2018 to December 2018, a prospective study was conducted in 20 infants after repair of left-to-right shunt congenital heart disease, including 10 males(50%) and 10 females(50%) , aged from 1 to 12 months, with a median of 4.5(2.0, 6.8) months, a body mass of 3.0-9.0 kg with median of 6.0(3.7, 7.7) kg.On the first postoperative day, blood was taken from central venous for N-terminal pro-B-type natriuretic peptide(NT pro-BNP) test, TAPSE and left ventricular ejective fraction(LVEF) was measured by echocardiography.The effects of aortic occlusion time, cardiopulmonary bypass time, preoperative pneumonia and preoperative heart failure on TAPSE were compared. The relationship between TAPSE and heart rate, systolic pressure, central venous pressure, vasoactive drug score, endotracheal intubation time, detention time in intensive care unit, NT pro-BNP and LVEF after operation was analysed.Results:The aortic cross-clamping time was 15-87 minutes, with median 31(28, 50) minutes. The cardiopulmonary bypass time was 35-117 minutes, with an average of(68±22)minutes. The time of tracheal intubation was 4-117 hours, with an average of(50±35) hours. The stay time in CICU was 1-14 days, with a median of 5(2, 7) days.The LVEF was 0.18-0.66, with median 0.53(0.42, 0.57). The TAPSE was 2.0-10.0 mm, with an average of(5.2±2.0) mm. On the first day after operation, NT pro-BNP was 1 548-35 000 pg/ml, with an average of(9 446±8 130) pg/ml.TAPSE was negatively correlated with postoperative intubation time( r=-0.576, P= 0.007) and detention time in ICU( r=-0.765, P=0.000), and positively correlated with postoperative LVEF( r=0.461, P=0.041)( P<0.05). TAPSE was negatively correlated with heart rate( r=-0.303, P=0.193), central venous pressure( r=-0.425, P=0.062), vasoactive drug score( r=-0.418, P=0.067) and NT Pro BNP( r=-0.348, P=0.132), and positively correlated with systolic pressure( r=0.146, P=0.54), but there was no statistical significance in each item.Compared with patients with TAPSE≥5mm, the detention time and tracheal intubation time were longer than those TAPSE<5 mm, the central venous pressure and NT-pro BNP was higher than those TAPSE<5 mm( P<0.05), the difference was statistically significant, other indicators had no significant difference. Conclusion:It is simple and feasible to measure TAPSE by echocardiography in children after operation with left-to-right shunt congenital heart disease.TAPSE decreased postoperatively suggested that the function of right ventricle decreased at the early stage after surgery, and with left ventricle systolic function decreased, which eventually led to the increase of NT pro-BNP, the need for higher doses of vasoactive drug support, longer tracheal intubation time and the stay time in CICU.Attention should be paid to the right heart function of children after congenital heart surgery.

Effect of granulesten on hs-CRP and lipid in patients with stroke / 中国生化药物杂志

Objective To investigate the effect of granulesten on hs-CRP and lipid in patients with stroke.Methods 76 patients with acute ischemic stroke were selected and randomly divided into two groups.38 cases in the control group were treated by conventional therapy, 38 cases in the experiment group were treated on the basis of the control group with granulesten.hs-CRP, IL-6, Hcy, and lipid fat were detected and the clinic effect were compared after the treatment.ResuIt Compared with control group, hs-CRP, IL-6, and Hcy of the experiment group were lower(P<0.05), TC, TG and LDL-C were lower, HDL-C was higher ( P<0.05 ) , the clinic effect was higher ( P<0.05 ) , the rate of side effect was higher ( P<0.05 ) . ConcIusion Granulester can significantly reduce serum hs-CRP, IL-6 and Hcy levels, improve blood lipid metabolism, improve the clinical efficacy, and adverse reactions are mild, it has important significance for patients with acute ischemic stroke.

Protein interacting with kinase Cα mediates the down-regulation of myocardial norepinephrine transporter expression in mice with adriamycin-induced congestive heart failure / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the interaction between myocardial norepinephrine (NET) and protein interacting with kinase Cα (PICK1), and examine the myocardial expression pattern of NET and PICK1 in mice with adriamycin-induced congestive heart failure.</p><p><b>METHODS</b>(1) Cellular experiments: 293T cells were transfected with NET, GFP-PICK1, NET+GFP-PICK1 or NET+GFP-PICK1(KD-AA), respectively. Immunofluorescence staining was performed 48 h after the transfection. (2) Animal experiments: 40 male C57BL/6J mice were divided into control group and adriamycin group (intraperitoneal injection of 2 mg/kg adriamycin with a cumulative amount of 22 mg/kg). The myocardial mRNA and protein expression level of NET, PICK1 and adrenergic receptor (β1-AR) were detected by real-time PCR and Western blot after 10 weeks.</p><p><b>RESULTS</b>(1) PICK1 mediates the intracellular trafficking of NET. (2) Compared to controls, cardiac mRNA expression of NET remained unchanged, but PICK1 and β1-AR mRNA level were significantly reduced in the heart failure mice. (3) Myocardial NET protein expression level was significantly reduced, whereas tyrosine hydroxylase (TH) protein expression was significantly upregulated in heart failure mice. (4) The myocardial density of sympathetic nerve fibers remained unchanged in heart failure mice.</p><p><b>CONCLUSIONS</b>Cardiac expression of NET and PICK1 are down-regulated in heart failure mice. Reduced PICK1-mediated intracellular trafficking of NET may be involved in the impairment of NET function in this congestive heart failure mice model.</p>

Diagnosis of aortic coarctation combined with hypoplastic aortic arch by echocardiography / 中华超声影像学杂志

Objective To study the diagnosis accuracy and features of echocardiography on aortic coarctation combined with hypoplastic aortic arch. Methods The echocardiographic characteristics of seven patients who were diagnosed as aortic coarctation combined with hypoplastic aortic arch were analyzed and compared with results of cardiac catheterization, CT scan and operation. The diagnostic features of echocardiography were summarized. Results Besides the echocardiographic characteristics of aortic coarctation,other specific echocardiographic characteristics of hypoplastic aortic arch were:distinct stenoses of transverse and decsending part of aortic arch were visualized in supra-sternal long-axis view; the range of hypoplastic part started from innominate artery beginning or left common carotid artery beginning; the ratio of diameter of hypoplastic aortic arch over that of descending aorta at diaphragm was less than 0. 5; the blood flow speed detected by Doppler at the site of aortic coarctation was in the normal range. The echocardiographic characteristics of the aortic coarctation combined with hypoplastic aortic arch were correspondent to the results of cardiac catheterization, CT scan and operation results. Conclusions There is high accuracy of echocardiography in diagnosis of aortic coarctation combined with hypoplastic aortic arch. Hypoplastic aortic arch should be paid more attention in diagnosis of aortic coarctation.

Value of transesophageal echocardiography in the operation of Ebstein' s anomaly / 中华超声影像学杂志

Objective To study the value of transesophageal echocardiography(TEE) in the operation of Ebstein's anomaly(EA).Methods The TEE characteristics of 69 patients with Ebstein's anomaly were retrospectivly analized.Results TEE could display the anatomic features of tricusipid valves(TV) clearly in all patients.Six cases were found having downward displacement of anterior leaflet before cardiopulmonary bypass,6 were found having hypoplasia of posterior leaflet, and posterior leaflets were absent in 3 cases.Ten cases were found middle regurgitation of TV by TEE after surgical correction during the operation, which had been improved satisfatorily by second time TV plasty.Conclusions TEE is useful in accurate diagnosis of the EA,and evaluation of operative effects during the operation, thus could help increase success rate of operation.

Echocardiographic diagnosis of juxtaposition of atrial appendage / 中华超声影像学杂志

Objective To study the value of echoeardiography for diagnosis of juxtaposition of atrial appendage(JAA) and to discuss its features. Methods Eehocardiographic characteristics of JAA in nine cases were compared with results of cardiac catheterization and operation. The diagnostic features of echocardiography were summarized. Results Seven cases had juxtaposition of left atrial appendage and two had juxtaposition of right atrial appendage. The nine cases were all associated with severe congenital heart disease and the most frequent malformations observed with JAA were double outlet right ventricle, transposition of great artery, single ventricle and so on. Direct visualization of the JAA in the parasternal short-axis view at the base of the heart and visualization of an unusual transverse orientation of the atrial septum were the most features of JAA. Echocardiographie characteristics of JAA cases were correspondent to the results of cardiac catheterization and operation. Conclusions There is high accuracy by echocardiography to diagnosis JAA. JAA should be alerted in severe congenital heart disease.

Detection of the anterior descending artery originating from the right coronary artery in tetralogy of Fallot by echoeardiography / 中华超声影像学杂志

malities should be alerted in TOF.