[Visualization of right atrial flow patterns and quantification of pulmonary to systemic flow ratio in patients with atrial septal defect by vector flow mapping].

OBJECTIVE: To evaluate the ability of vector flow mapping (VFM) in visualizing right atrial flow and quantifying pulmonary to systemic flow ratio in patients with atrial septal defect (ASD). METHODS: VFM was performed on 30 patients with ASD and 50 healthy volunteers. The pulmonary to systemic flow ratio (Qp/Qs) was calculated using VFM and spectral doppler compared with that obtained through oximetric data derived from cardiac catheterization. RESULTS: Blood streams from superior and inferior caval veins did not collide but turned forward, contributing to a forward clockwise vortex during systole on the subcostal bi-atrial plane in the healthy volunteers. The vortex was disrupted continuously by a left to right shunt in the patients with ASD during the hole cardiac cycle. The Qp/Qs measured by VFM was less angle-dependent in all the cases than the other methods. The mean value of Qp/Qs of the healthy volunteers calculated by apical three-chamber view and apical five-chamber view ranged from 0.84:1 to 1.15:1, which is consistent with the theoretical value 1 of no left to right shunts. The values of Qp/Qs of patients with ASD measured by VFM and spectral doppler showed no significant differences with those obtained through oximetric data [(2.18 +/- 0.48) vs. (2.29 +/- 0.76), P = 0.29; (2.30 +/- 0.91) vs. (2.29 +/- 0.76), P = 0.86]. However, the Qp/Qs value measured by VFM had a better correlation with the oximetric data than that measured by spectral doppler (r = 0.71, P < 0.001 vs. r = 0.38, P < 0.05). The inter-observer and intraobserver variability of Qp/Qs measured by VFM was 9.84% and 9.86% respectively. CONCLUSION: VFM can visualize right atrial flow field in patients with ASD and quantify Qp/Qs in a more accurate way than spectral dopler.

[Evaluation of papillary muscle function of patients with chronic ischemic mitral regurgitation using two-dimensional speckle tracking imaging].

OBJECTIVE: To evaluate the papillary muscle function of patients with chronic ischemic mitral regurgitation (IMR) using two-dimensional speckle tracking imaging. METHODS: 119 patients with chronic IMR and 94 normal controls were enrolled in this study. The peak systolic strain (PSS) and peak systolic strain rate (PSSR) of the papillary muscle were assessed with two-dimensional strain software. The PSS and PSSR were compared between the patients with anterior myocardial infarct (AMI) and those with inferior myocardial infarct (IMI). The correlation between the degree of IMR and the position of MI was analysed. RESULTS: The patients with chronic IMR had significantly lower PSS and PSSR than the normal controls. The IMI patients had significantly lower PSS and PSSR than the AMI patients. The IMI patients had significantly higher degree of MR than the AMI patients. CONCLUSION: Two-dimensional speckle tracking imaging is a reliable method for assessing papillary muscle function.

The diagnosis of anomalous origin of the left coronary artery from the pulmonary artery by echocardiography: Case report.

The anomalous origin of the left coronary artery from the pulmonary artery is a rare congenital heart disease that affects 1 of 300,000 live births. We present the case of an 18-year-old female presenting with chest pain and dyspnea after vigorous exercise, and whose two-dimensional echocardiogram initially displayed a "normal connection" between the left coronary artery with the aortic sinus of Valsalva. Using a systematic diagnostic echocardiography approach, we rightfully diagnosed it as anomalous origin of the left coronary artery from the pulmonary artery.

[Study on Meta analysis regarding the acceptability of medical abortion compared with surgical abortion].

OBJECTIVE: To analyze and evaluate the acceptability of mifepristone compatible with misoprostone versus conventional surgical abortion among women under unwanted early pregnancy, so as to help the unexpected pregnant women to choose the satisfactory abortion, and to provide the evidence for clinicians to make a proper clinical decision. METHODS: Six medical databases were searched, including MEDLINE, EMBASE, Cochrane library, CBMdisc, CNKI and VIP, together with twelve journals hand-searched, and references of included studies additionally searched. Two qualified reviewers reviewed the original articles, evaluating qualities of articles, and extracting data independently. After heterogeneity test, the data was pooled using Revman software if capable, or descriptive analysis was applied. RESULTS: In total, nine original clinical controlled trials were included, containing 3565 cases. Before abortion, more unwanted pregnant women chose the medical abortion because they believed medical abortion was less painful than surgical abortion (OR = 466.51, 95% CI: 91.37 - 2381.88), but medical abortion was less time-consuming than surgical abortion (OR = 0.02, 95% CI: 0.01 - 0.06). After abortion, satisfaction with medical abortion was similar to that with surgical abortion, with insignificant difference (P = 0.89). However, second choice and recommendation rates of medical abortion were much higher than those of surgical abortion with OR and 95% CI as 2.72, 2.13 - 3.47 and 4.19, 2.16 - 11.16, respectively. CONCLUSIONS: Medical abortion was less painful than surgical abortion and the rate of second choice and recommendation to others were all also higher than those of surgical abortion. However, the process of medical abortion was not as quick as surgical abortion but the satifacation of both methods seemed similar. Therefore, the two artificial abortion methods were not recommended to replace each other at the present time.