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Objective : To study diagnostic value of ultrasonic cardiography (UCG) for right heart occupying lesions (RHOL).Methods :A total of 48 RHOL patients ,who were diagnosed in our hospital from Jan 2014 to Jun 2017 , were selected .All patients received UCG and pathological examination to determine lesion location and type .With pathological examination as gold standard ,diagnostic coincidence rate of UCG for RHOL type was analyzed .Re‐sults :RHOL distribution :compared with superior&inferior vena cava ,there were significant rise in percentages of RHOL located at right atrium ,right ventricle and pulmonary artery (6.25% vs.31.25%, 29. 17%, 33. 33%) , P＜0.01 all.RHOL type :percentage of malignant occupation was significantly higher than those of thrombus and myxoma (54.17% vs.20. 83%, 25.00%) , P＜0. 01 both .With pathological examination as gold standard ,diag‐nostic coincidence rates of UCG for thrombus ,malignant occupation and myxoma were 80.00%, 92. 86% and 100% respectively ,there was no significant difference among them , P＝0. 220 .A total of 18 cases (37.50%) with peri‐cardial effusion were found by UCG ,including two cases (4. 16%) who were diagnosed as benign thrombotic lesion by pathological examination ,and the other 16 cases (33.33%) were caused by malignant RHOL invading right heart system ,which included two cases (4.16%) of essential RHOL and 14 cases (29. 17%) with malignant lesion heart metastasis from other sites .Conclusion :RHOL type mainly includes thrombus ,malignant occupation and myxoma , and malignant occupation possesses relatively high incidence rate ,and it usually comes from malignant tumor metas‐tasis from other sites .Accuracy of UCG is high in diagnosing RHOL ,which is worth extending .
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Objective :To explore therapeutic effect of ramipril tablet and nifedipine controlled release tablet on aged patients with hypertensive heart disease and its influence on cardiac function and inflammatory factor level .Methods :A total of 186 aged patients with hypertensive heart disease were randomly equally divided into ramipril group ,nifedipine group and com‐bined treatment group (received ramipril + nifedipine).After eight weeks ,the therapeutic effect were observed and com‐pared among all groups.Results :Compared with before treatment , there were significant rise in LVEF ,cardiac index (CI) ,left ventricular early diastolic／late diastolic peak flow velocity (E／A) and 6min walking distance (6MWD) ,and sig‐nificant reductions in plasma levels of BNP ,CRP ,interleukin (IL)‐1 and IL‐6 after treatment in three groups , P＜0.01 all.Compared with ramipril group and nifedipine group after treatment ,there were significant rise in LVEF [ (43.44 ± 5.75)%,(43.41 ± 5.73)% vs.(49.89 ± 5.84)%] ,CI [(2.23 ± 0.64) L·min－1 ·m－2 ,(2.28 ± 0.69) L·min－1 ·m－2 vs.(2.87 ± 0.71) L·min－1 ·m－2 ] ,E／A [(0.87 ± 0.31) ,(0.90 ± 0.32) vs.(1.21 ± 0.39)] ,6MWD [(233.44 ± 38.95) m ,(236.45 ± 39.13) m vs.(299.77 ± 45.77) m] ,and significant reductions in plasma levels of BNP [ (199.67 ± 27.86) ng／L ,(194.55 ± 25.46) ng／L vs.(124.67 ± 29.45) ng／L] ,CRP [ (10.32 ± 3.18) mg／L ,(10.21 ± 2.89) mg／L vs. (8.35 ± 2.12) mg／L] , tumor necrosis factor (TNF)‐α [ (45.52 ± 14.56) pg／ml ,(45.45 ± 13.78) pg／ml vs.(37.86 ± 10.35) pg／ml] ,IL‐1 [ (6.34 ± 2.54) pg／ml ,(6.31 ± 2.31) pg／ml vs.(3.42 ± 1.89) pg／ml] and IL‐6 [ (6.71 ± 2.23) pg／ml ,(6.68 ± 2.11) pg／ml vs.(4.11 ± 1.75) pg／ml] , P＝0.001 all.Over all therapeutic effect of combined treatment was significantly higher than that of ramipril group ( Z＝ 3.747 , P＝ 0.001 ) and nifedipine group ( Z＝ 3.838 , P＝0.001).Conclusion :Ramipril combined nifedipine can improve therapeutic effect and cardiac function ,and reduce plasma levels of inflammatory factors in aged patients with hypertensive heart disease .
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Objective To study the association of metabolic syndrome (MS)with cardiovascular disease (CVD).Methods According to the diagnostiv criteria for MS,1457 MS patients as the research objects,who were screened out of the tangshian harbor economic development zone hospital.All patients were detected with waist circ-umference,seat systolic blood pressure(SBP),diastolic boold pressure(DBP),fasting Plasma glucose(FPG),total cholesterol(TC),low -density lipoprotein cholesterol(LDL -C),high density lipoprotein cholesterol(HDL -C),tri-glyceride(TG).By 3 years follow -up and the carotid ultrasound detection of carotid intima -media thickness(IMT), all the patients were divided into three groups according to the diagnosis:event group (Coronary heart disease +Hypertensive heart disease,stroke,Coronary heart disease +Hypertensive heart disease +stroke)and control group. Results The patients′SBP[(145.5 ±15.7)mmHg,(149.9 ±13.8)mmHg,(156.3 ±14.6)mmHg],DBP [(92.5 ±8.7)mmHg,(97.9 ±9.0)mmHg,(101.0 ±10.0)mmHg],FPG[(6.3 ±2.6)mmol/L,(6.0 ± 2.5)mmol/L,(6.9 ±2.6)mmol/L],TC[(5.46 ±1.28)mmol/L,(5.10 ±1.15)mmol/L,(5.37 ±1.21)mmol/L], LDL -C[(3.40 ±0.75)mmol/L,(3.08 ±0.65)mmol/L,(3.24 ±0.72)mmol/L],TG[(3.44 ±1.60)mmol/L, (3.31 ±1.52)mmol/L,(3.38 ±1.58)mmol/L]of the event group were significantly higher than the control group [(139.2 ±17.4)mmHg,(85.6 ±9.1 )mmHg,(5.5 ±2.1 )mmol/L,(1.4 ±0.4 )mmol/L,(2.59 ± 0.64)mmol/L,(2.61 ±1.28)mmol/L]and HDL -C[(1.13 ±0.38)mmol/L,(1.2 ±0.4)mmol/L,(0.9 ± 0.23)mmol/L]was significantly lower than the control group[(1.4 ±0.4)mmol/L](P <0.05).Detection rates of all the event groups were significantly higher in age[(53.4 ±6.4)years,(54.6 ±6.6)years,56.3 ±6.8)years], hypertensive heart disease(67.8%,74.8%,88.0%),high blood sugar(46.7%,42.9%,49.7%),and carotid atherosvletosis (19.9%,18.9%,29.3%)than the control group[(47.2 ±6.5)years,47.2%,24.3%,5%)](P <0.05).Conclusion There was a correlation between Mdtabolic syndrome and Cardiovascular disease.
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Objective To investigate the diagnostic value of preoperative real-time three-dimensional color Doppler transthoracic echocardiography on assessment of patients with structural heart disease (SHD). Methods A total of 111 pa?tients were assessed preoperatively using real-time three-dimensional color Doppler transthoracic echocardiography (RT-3D-CDTTE), which include 31 SHD patients and 80 patients without SHD that were designed as negative control. Conven?tional two-dimensional color Doppler transthoracic echocardiography (2D-CDTTE) were used to compared with RT-3D-CDTTE while cardiovascular angiography and intraoperative findings were used as“Golden Standard”simultaneously. First of all, preoperative echocardiographic examination were performed and diagnosis was given. Angiography and intraoperative findings were hired to verify the accuracy of echocardiographic diagnosis before operation. Results (1) The preoperative RT-3D-CDTTE displayed three-dimensional structure and hemodynamic status of SHD cardiac lesions clearly, which were consistent with cardiovascular angiography and intraoperative findings. (2) P value of McNemar test between 2D-CDTTE and“Golden Standard”was greater than 0.05, Kappa=0.654 (P<0.001). P value of McNemar test between RT-3D-CDTTE and“Golden Standard”was greater than 0.05, Kappa=0.932 (P<0.001). Conclusion RT-3D-CDTTE can provides essen?tial information for preoperative evaluation which is important for decision of SHD management.
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Objective To investigate the clinical application of retrograde autologous priming (RAP)in congenital heart disease surgery by cardiopulmonary bypass.Methods Twenty congenital heart disease patients undergoing heart operation by cardiopulmonary bypass were randomly divided into two groups,group control (n=10)and group RAP (n=10).Group control was received the regular priming method,whereas group RAP with RAP technique.The hematologic parameters were measured before CPB,15 minutes following CPB,1 h and 24 h after CPB.The priming volume, transfusion requirements,ventilator time and ICU stay time were recorded.Results All patients were healed completely without death and transfusing complications.The priming volume in group RAP was significantly lower than that in group control (P<0.01).The levels of hemoglobin and hemato-crit in group RAP at 15 min following CPB and 1 h after CPB were significantly higher compared to group control (P<0.05).Lactate in group RAP at 1 h and 24 h after CPB were significantly lower than those in group control (P<0.05).The transfusion requirements in group RAP were significantly decreased than group control (P<0.05).Conclusion In congenital heart disease surgery by cardiop-ulmonary bypass,RAP technique can effectively decrease priming volume,hemodilution and transfu-sion requirements,improve tissue perfusion and pulmonary function.