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Objective:To evaluate left atrial(LA) function and its value in predicting left ventricular(LV) remodeling in patients with coronary heart disease (CHD) by four dimensional automatic left atrial quantitation (4D Auto LAQ).Methods:A total of 176 patients with CHD were prospectively enrolled in Fuwai Central China Cardiovascular Hospital from October 2021 to September 2022. They were divided into two groups according to left ventricular mass index: LV remodeling group (female>95 g/m 2, male>115 g/m 2, n=88) and Non-LV remodeling group (female≤95 g/m 2, male≤115 g/m 2, n=88). The 3D dynamic image of LA was analyzed by 4D Auto LAQ on machine to obtain the LA parameters, including the minimum, maximum, pre-systolic and emptying volumes of LA (LAVmin, LAVmax, LAVpreA, LAEV), LA ejection fraction (LAEF), LA reservoir longitudinal and circumferential strains (LASr, LASr-c), LA conduit longitudinal and circumferential strains (LAScd, LAScd-c) and LA contraction longitudinal and circumferential strains (LASct, LASct-c). Logistic regression models were used to analyze the value of LA parameters in predicting LV remodeling in patients with CHD. ROC curve was used to evaluate LA parameters and left atrial volume index (LAVI) to predict the diagnostic efficiency of LV remodeling. Results:Compared with the Non-LV remodeling group, LAVmin, LAVmax, LAVpreA were significantly increased and LAEF, LASr, LAScd, LASct, LASr-c, LAScd-c, LASct-c were significantly decreased in the LV remodeling group ( P<0.05). Logistic regression model showed that LASct-c was an independent risk factor for LV remodeling in patients with CHD after adjustment( OR=2.018, 95% CI=1.214-3.355). ROC curve analysis showed that the area under the curve of LASct-c for predicting LV remodeling in CHD patients was 0.844, the sensitivity was 0.784, and the specificity was 0.761. Conclusions:4D Auto LAQ can effectively evaluate LA function in patients with CHD.LASct-c can be used as a reference index to predict LV remodeling in patients with CHD, which provides a new evaluation method in prognosis evaluation of CHD patients.
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Objective:To evaluate the right ventricular function in patients with dilated cardiomyopathy (DCM) by four-dimensional automatic right ventricular quantitative analysis (4D Auto RVQ), and compare with the right ventricular ejection fraction measured by cardiac magnetic resonance (CMR-RVEF), and to explore the clinical application value of 4D Auto RVQ technique in evaluating the right ventricular function of patients with DCM.Methods:A prospective study was conducted to select 52 patients with DCM who were treated in Fuwai Central China Cardiovascular Hospital of Zhengzhou University from March to October 2022 as DCM group, and 52 healthy volunteers were selected as the control group during the same period. The four-dimensional right ventricular ejection fraction (4D-RVEF), right ventricular stroke volume index (RVSVI), right ventricular end-diastolic volume index (RVEDVI), right ventricular end-systolic volume index (RVESVI), four-dimensional right ventricular basal diameter (4D-RVDd-base), four-dimensional right ventricular middle diameter (4D-RVDd-mid), four-dimensional right ventricular long axis diameter (4D-RVLd), four-dimensional tricuspid annular plane systolic excursion (4D-TAPSE) and four-dimensional right ventricular fractional area change (4D-RVFAC) were obtained by 4D Auto RVQ technique. The differences of the above parameters between DCM group and control group were compared.Pearson linear correlation analysis was used to evaluate the correlation between echocardiographic parameters and CMR-RVEF. The ROC curve was used to find the most sensitive parameters for evaluating right ventricular function, and the area under the ROC curve ( AUC ) was calculated and compared.Results:Compared with the control group, RVEDVI, RVESVI, 4D-RVDd-base and 4D-RVDd-mid in the DCM group were increased, and the absolute values of 4D-RVEF, 4D-TAPSE, 4D-RVFAC, right ventricular global longitudinal strain(RVGLS) and right ventricular free wall longitudinal strain(RVFWLS) were decreased (all P<0.05). Correlation analysis showed that 4D-RVEF was positively correlated with CMR-RVEF ( r=0.711, P<0.05). ROC curve analysis showed that 4D-RVEF was superior to other parameters in evaluating right ventricular function in DCM patients (AUC: 0.916). Conclusions:4D Auto RVQ technique can quantitatively evaluate right ventricular function in DCM patients. 4D-RVEF has a significant correlation with CMR-RVEF, and 4D-RVEF has the best efficacy in evaluating right ventricular function in DCM patients.
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Objective:To evaluate the distribution of diastolic left ventricular pressure in patients with type 2 diabetes mellitus (T2DM) by relative pressure imaging (RPI) based on vector flow mapping (VFM), and to explore the clinical risk factors for the diastolic left ventricular pressure distribution.Methods:Thirty patients with T2DM and thirty normal controls were included from August 2020 to July 2021 in Fuwai Central China Cardiovascular Hospital. All selected subjects underwent conventional echocardiography.Left intraventricular pressure difference (IVPD) and left intraventricular pressure gradient (IVPG) were measured using RPI of VFM in isovolumic relaxation (IR), rapid filling (RF), atrial contraction (AC), isovolumic contraction (IC) and rapid ejection (RE) phases. The relationships between IVPD with other parameters were analyzed.Results:①Compared with the control group, E/A, e′, IVPD-IR, IVPG-IR, IVPD-RF, IVPG-RF, IVPD-AC, and IVPG-AC were significantly lower and E/e′ was significantly greater in the T2DM group ( P<0.05). ②IVPD-IR, IVPD-RF, and IVPD-AC were positively correlated with E/A ( r=0.309, P<0.05; r=0.274, P<0.05; r=0.273, P<0.05). IVPD-IR, IVPD-RF, and IVPD-AC were negatively correlated with E/e′ ( r=-0.587, P<0.05; r=-0.273, P<0.05; r=-0.415, P<0.05). IVPD-IR and IVPD-AC were positively correlated with e′ ( r=0.451, P<0.05; r=0.431, P<0.05). ③Multivariable linear regression analysis showed that hemoglobin A 1c (HbA 1c) was an independent risk factor affecting IVPD-IR, IVPD-RF, and IVPD-AC (β=-0.417, P<0.05; β=-0.451, P<0.05; β=-0.460, P<0.05). Conclusions:RPI of VFM can quantitatively evaluate diastolic left ventricular pressure distribution in patients with T2DM. HbA 1c is an independent risk factor affecting IVPD-IR, IVPD-RF, and IVPD-AC.
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Objective:To study the neuroprotective effect of nobiletin on the symptoms of postoperative cognitive impairment (POCD) induced by sevoflurane inhalation.Methods:Twenty-four aged SD rats (12 female mice and 12 male mice) were divided into three groups randomly: control group ( n=8), surgery group ( n=8) and surgery + nobiletin group ( n=8), with 4 females and 4 males in each group.The rats in surgery group and surgery+ nobiletin group were given normal saline(0.1 ml/10 g, once a day) and nobiletin(100 mg/kg, once a day) intragastrically for 6 weeks.Then the rats were anesthetized by sevoflurane and treated by abdominal exploration surgery, and then continued gavage for 1 week.The rats in control group were given normal saline(0.1 ml/10 g, once a day) intragastrically for 7 weeks without anesthesia or surgery.Sevoflurane inhalation anesthesia and abbreviated laparotomy were not done for control group.Morris water maze and open field experiment were used to measure the memory and cognitive ability and the independent exploration ability respectively.The changes of α-band electroencephalogram (EEG) were recorded by multi-channel physiological signal acquisition and processing system.The concentration of S100β, a marker of neurological impairment was detected by ELISA.Western blot was used to detect the expression level of IBA-1 in microglia.SPSS 20.0 software was used to analyze the data. Results:There were no significant differences in Morris water maze, positioning cruise test and open field test among the groups before operation (all P>0.05). The differences were statistically significant among the groups 7 days after operation (all P<0.05). Compared with the control group (the escape latency, path length and cross platform times were ((20.37±1.11)s, (552.37±14.19)cm, (6.75±0.43)times respectively), the escape latency ((40.87±2.03)s) and path length ((1 258.62±19.53)cm) of rats in surgery group were significantly longer (both P<0.01), and the cross platform times ((2.12±0.33)times) significantly reduced ( P<0.01). The differences between surgery + nobiletin group ((22.37±1.11)s, (584.50±10.90)cm, (6.62±0.48)times) and control group were not significant (all P>0.05). The open field experiment showed that the movement distance, the crossed square number, and activity times in surgery group ((1.78±0.55) m, (4.75±0.50), (14.87±0.33) times) decreased significantly compared with those in control group ((3.73±0.07) m, (11.10±0.78), (51.12±0.78) times, all P<0.01). No significant difference was found between surgery + nobiletin group ((3.76±0.07)m, (10.75±0.66), (50.75±0.43)times) and control group(all P>0.05). Before anesthesia, there was no significant difference in the power ratio of α-band among the three groups ( P>0.05), but the differences during anesthesia and operation were significant ( F=72.58, 101.50, P<0.01). During anesthesia and operation, the power ratio of α-band in anesthesia and in surgery group (2.51±0.04, 2.14±0.03) were significantly lower (both P<0.01) than those in control group (3.49±0.03, 3.49±0.03), while there was no obvious changes (both P>0.05) in the surgery + nobiletin group (3.50±0.04, 3.51±0.04). There were significant differences in Bcl-2 protein expression and caspase 3/7 protein activity among the three groups ( F=5.21, 7.84, P<0.01). Compared with control group (1.00±0.02, 1 557.46±3.63), Bcl-2 of rats in the surgery group(0.40±0.05) were significantly lower and Caspase3/7 expression of surgery group (3 689.58±10.46) was significantly higher (both P<0.01), while the rats in the surgery + nobiletin group had no significant difference in both Bcl-2 level (1.03±0.06) and caspase 3/7 activities (1 805.28±6.17, both P>0.05). The difference of S100 β protein expression was significant among the three groups ( F=490.80, P<0.01). Compared with the control group ((0.18±0.01)μg/L), the concentration of S100β protein in the surgery group ((2.13±0.02)μg/L) decreased ( P<0.01), while there was no significant difference in the surgery + nobiletin group ((0.16±0.01) μg/L, P>0.05). The expression levels of IBA-1 protein ( F=10.83) and TNF-α, IL-1, IL-1β and IL-6 ( F=996.20, 221.40, 73.02, 174.13) were significantly different among the three groups (all P<0.01). The expression level of the neuroglial marker IBA-1 in the surgery group(1.36±0.02) was significantly higher than that in the control group (1.00±0.01, P<0.01), while the surgery + nobiletin group (1.03±0.01) had no significant different compared with control group ( P>0.05). The levels of inflammatory factors, including TNF-α, IL-1, IL-1β and IL-6, in the brain of rats treated with nobiletin ((49.06±3.63)pg/mg, (2.09±0.43)pg/mg, (16.27±0.80)pg/mg, (2.11±0.19)pg/mg) were significantly lower than those in the surgery group((145.10±6.46)pg/mg, (5.67±0.43)pg/mg, (27.88±3.43)pg/mg, (4.74±0.32)pg/mg, all P<0.01). Conclusion:Nobiletin can obviously alleviate POCD symptoms caused by sevoflurane inhalation anesthesia.
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Objective:To quantitatively evaluate the global myocardial work of left ventricle in patients with chronic kidney disease (CKD) by left ventricular pressure-strain loops (PSL).Methods:Forty patients with chronic kidney disease (CKD) in Henan Provincial People′s Hospital from February 2019 to October 2019 were chosen as case group.According to the decreased level of the glomerular filtration rate (GFR), CKD patients were divided into CKD 2-3 stage group( n=20) and CKD 4-5 stage group( n=20), and 20 healthy volunteers were selected as control group.The working parameters of the global left ventricular myocardium including the global work index (GWI), the global constructive work (GCW), the global wasted work (GWW), the global work efficiency (GWE) were measured by the left ventricular PSL, and the differences of the parameters among the three groups were compared. Results:Compared with the control group, the GWI, GCW, GWW in the CKD 2-3 stage group and CKD 4-5 group were significantly higher and the GWE was lower than those in the control group differences were all (all P<0.05). Compared with the CKD 2-3 stage group, the GWI and GCW of the CKD 4-5 stage group were increased (all P<0.05), but there were no significant differences in GWW and GWE ( P>0.05). Conclusions:Left ventricular PSL provides a new method for evaluating the changes of left ventricular systolic function in patients with CKD.
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Objective:To explore the application value of pressure-strain loop (PSL) in evaluating left ventricular myocardial work (MW) in patients with chronic heart failure (CHF).Methods:Seventy patients with CHF were selected as case group(CHF group) and were divided into 2 groups according to the left ventricular ejection fraction (LVEF) in ultrasonic cardiogram: LVEF preserve group (HFpEF group, LVEF≥50%, n=35) and LVEF reduced group (HFrEF group, LVEF<50%, n=35). Thirty-three healthy volunteers were selected as control group at the same period. Two-dimensional dynamic images in apical two chamber, three chamber and four chamber views were collected by two-dimensional speckle-tracking. Using the off-line EchoPAC software, a tracing analysis was conducted and the blood pressure was entered to obtain left ventricular global longitudinal strain (GLS), global MW index (GWI), global constructive work (GCW), global wasted work (GWW) and MW efficiency (GWE). The differences of GLS and MW parameters (GWI, GCW, GWW, GWE) were compared between each groups, and Pearson correlation was used to analyze the correlation between MW parameters and LVEF. Results:Compared with the control group and HFpEF group, the left atrial dimension(LAD), left ventricular end-diastolic dimension(LVDd), left ventricular end-diastolic volume(LVEDV), left ventricular end-systolic volume(LVESV) in HFrEF group increased, while LVEF decreased significantly( P<0.05). Compared with the control group, LAD in HFpEF group increased, the vaules of GLS, GWI, GCW were obviously lower in HFpEF group and HFrEF group(all P<0.05), GWW was higher and GWE was lower in HFrEF group(all P<0.05). GLS, GWI, GCW, GWE decreased and GWW increased in HFrEF group than those in HFpEF group, and all the differences were statistically significant(all P<0.05). In CHF group, GWW was negatively correlated with LVEF ( r=-0.521, P<0.001) while positive correlations between GWI, GCW, GWE and LVEF were discovered ( r=0.846, 0.807, 0.788; all P<0.001). Conclusions:PSL can effectively evaluate the left ventricular MW in CHF patients. It has a certain correlation with LVEF and can reflect left ventricular systolic function. It provides a new reference index for the clinical diagnosis and evaluation of prognosis in CHF patients.
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Objective@#To explore the application value of pressure-strain loop (PSL) in evaluating left ventricular myocardial work (MW) in patients with chronic heart failure (CHF).@*Methods@#Seventy patients with CHF were selected as case group(CHF group) and were divided into 2 groups according to the left ventricular ejection fraction (LVEF) in ultrasonic cardiogram: LVEF preserve group (HFpEF group, LVEF≥50%, n=35) and LVEF reduced group (HFrEF group, LVEF<50%, n=35). Thirty-three healthy volunteers were selected as control group at the same period. Two-dimensional dynamic images in apical two chamber, three chamber and four chamber views were collected by two-dimensional speckle-tracking. Using the off-line EchoPAC software, a tracing analysis was conducted and the blood pressure was entered to obtain left ventricular global longitudinal strain (GLS), global MW index (GWI), global constructive work (GCW), global wasted work (GWW) and MW efficiency (GWE). The differences of GLS and MW parameters (GWI, GCW, GWW, GWE) were compared between each groups, and Pearson correlation was used to analyze the correlation between MW parameters and LVEF.@*Results@#Compared with the control group and HFpEF group, the left atrial dimension(LAD), left ventricular end-diastolic dimension(LVDd), left ventricular end-diastolic volume(LVEDV), left ventricular end-systolic volume(LVESV) in HFrEF group increased, while LVEF decreased significantly(P<0.05). Compared with the control group, LAD in HFpEF group increased, the vaules of GLS, GWI, GCW were obviously lower in HFpEF group and HFrEF group(all P<0.05), GWW was higher and GWE was lower in HFrEF group(all P<0.05). GLS, GWI, GCW, GWE decreased and GWW increased in HFrEF group than those in HFpEF group, and all the differences were statistically significant(all P<0.05). In CHF group, GWW was negatively correlated with LVEF (r=-0.521, P<0.001) while positive correlations between GWI, GCW, GWE and LVEF were discovered (r=0.846, 0.807, 0.788; all P<0.001).@*Conclusions@#PSL can effectively evaluate the left ventricular MW in CHF patients. It has a certain correlation with LVEF and can reflect left ventricular systolic function. It provides a new reference index for the clinical diagnosis and evaluation of prognosis in CHF patients.
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Objective To investigate the effect of warfarin on coagulation and hemorheology in patients with atrial fibrillation.Methods 106 cases of admitted in our hospital from October 2014 to October 2016 were randomly divided into observation group(53 cases)and control group(53 cases).The control group re-ceived routine treatment,the observation group received routine and warfarin treatment.The two groups were treated for 4 weeks.The therapeutic effects were compared between the two groups.Before and after treat-ment,indicators of heart function,blood coagulation and hemorheology were observed.Results The total effi-ciency of observation group(92.45%)was higher than that of the control group(73.58%,P<0.05).After treatment,the TT and APTT of the two groups both increased(P<0.05);The TT and APTT of the observa-tion group were higher than that of the control group(P<0.05);The plasma viscosity,erythrocyte aggrega-tion index,and fibrinogen of the two groups decreased(P<0.05);The plasma viscosity,erythrocyte aggrega-tion index,fibrinogen of the observation group were lower than that of the control group(P<0.05).Conclu-sion Warfarin has obvious curative effect on patients with atrial fibrillation,and can improve the function of blood coagulation and hemorheology.