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Objective To explore the value of echocardiography in patients with aortic stenosis who underwent transapical aortic valve implantation (TAAVI).Methods Fifteen high-risk patients with severe aortic stenosis were chosen in the present study,all of which received TAAVI in Fuwai Hospital Chinese Academy of Medical Sciences from June 2014 to March 2015.The left ventricular end-diastolic diameter (LVEDD),left atrial diameter (LAD),left ventricular ejection fraction (LVEF),effective orifice area (EOA),mean aortic pressure gradient (MPG),as well as artificial valve function of patients were measured at different time points (before operation,discharge,1 month and 3-6 months after operation) by echocardiography.The data were analyzed using one-way ANOVA analysis with SPSS software,and multiple comparisons were done using LSD student t test.Results The data from preoperative echocardiography indicated severe aortic stenosis in the 15 patients,with the average level of EOA as (0.55± 0.28) cm2 and MPG as (58.93± 14.96) mmHg (1 mmHg=0.133 kPa).Moderate paravalvular aortic regurgitation was observed in one patients,who was then received a second implantation.There was no significant difference between LVEDD,LAD,and LVEF when the patients were at discharge,1 month and 3-6 months after operation.The prosthetic valves were stable and conformed by echocardiography,while paravalvular leak regurgitation (1-2 mm) was observed in 7 patients.One patient died of other reasons.Compared with preoperative data,the EOA increased while MPG decreased when the patients were at discharge,1 month and 3-6 month after operation (t=6.619,7.357,6.401,all P ＜ 0.001;t=9.523,9.687,5.932,all P ＜ 0.001).Conclusion With careful patient screening and selection,TAAVI can be an effective treatment for high-risk severe aortic stenosis patients,in which echocardiography plays an important role during the surgery and follow up.
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Objective:To evaluate the changes of the left atrial systolic function in patients with acute myocardial infarction(AMI)using quantitative tissue velocity imaging(QTVI).Methods:The systolic velocities of the middle of left atrial lateral wall,anterior wall,inferior wall and atrial septum were measured with QTV1 in 45 patients with AMI.The left atrial volume and active atrial emptying fraction(AA-EF)were measured using single-plane Simpson method.Results:(1)Compared with the control group(30 normal subjects),the diameter and volume of the left atrium,as well as AA-EF,increased obviously in patients with AMI(P ＜ 0.01).(2)Compared with the control group,the systolic velocities of the middle of left atrial lateral wall,anterior wall,inferior wall and atrial septum,as well as the average value,increased significantly in patients with AMI (P ＜ 0.05 or P ＜ 0.01).In addition,the average value of left atrial systolic velocity was closely correlated with AA-EF(r=-0.906,tr=14.001,P ＜ 0.01).Conclusion:QTVI could be used to evaluate the left atrial systolic function accurately in patients with AMI.
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DynaPulse, a newly developed noninvasive apparatus, is valuable in assessing blood pressure, cardiac output and vascular compliance. The purpose of the present study was to evaluate the validity of cardiac output measurement using DynaPulse in patients, compared with echocardiography and Fick method. Forty five inpatients underwent cardiac output measurement using DynaPulse (CO DP ) and Doppler echocardiography (CO DE ), cardiac output was measured with DynaPulse (CO DP ) and Fick method (CO FM ) in additional 26 patients. A good correlation was found between CO DP and CO DE ( r =0 76). There was an acceptable correlation between CO DP and CO FM ( r =0 61). DynaPulse can provide a noninvasive, clinically useful estimation of cardiac output.