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One novel compound, (R)-3, 6-diethoxy-4-hydroxycyclohex-3-en-1-one (1) and thirteen known compounds were isolated from the waste tobacco leaves. The structures of two compounds (1-2) were confirmed and attributed firstly by the extensive spectroscopic data, including 1D/2D NMR, IR, HR-ESI-MS, CD, and ECD spectra. Notably, seven compounds (2, 3, 9, 10, 11, 12, and 13) exhibited better tyrosinase inhibitory activity than the positive control kojic acid. The binding modes of these compounds revealed that their structure formed strong hydrogen bonds and van der Waals forces with the active sites of tyrosinase. These results indicated that waste tobacco leaves are good resources for developing tyrosinase inhibitors.
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Inhibidores Enzimáticos , Monofenol Monooxigenasa , Nicotiana , Hojas de la Planta , Monofenol Monooxigenasa/antagonistas & inhibidores , Monofenol Monooxigenasa/metabolismo , Hojas de la Planta/química , Nicotiana/química , Inhibidores Enzimáticos/química , Inhibidores Enzimáticos/farmacología , Inhibidores Enzimáticos/aislamiento & purificación , Estructura Molecular , Relación Estructura-Actividad , Simulación del Acoplamiento MolecularRESUMEN
Hemorrhagic foci surrounding the lacune in the long-term evolution of recent single subcortical infarcts (RSSIs) remains largely unexplored. We aimed to determine the prevalence, characteristics, and predictors of hemorrhagic foci in patients with RSSI. From a prospective, longitudinal study of RSSIs, we recruited patients who underwent multimodal MRI assessments both at baseline and approximately one year after the stroke onset. Hemorrhagic foci were identified using susceptibility-weighted imaging (SWI). Among 101 patients with RSSI, nearly half (n = 45, 44.6%) had hemorrhagic foci within the index RSSI lesions on follow-up SWI. RSSIs with hemorrhagic foci formation were associated with a longer time to follow-up imaging (median 449 versus 401 days, P = 0.005) and higher likelihood of being located in the anterior circulation compared to those without hemorrhagic foci (88.9% versus 64.3%, P = 0.003). Hemorrhagic foci were also associated with larger lesion size (P < 0.001), a higher proportion of cavitation formation (P = 0.003), higher baseline NIHSS scores (P = 0.004), and poorer functional outcomes (P = 0.001). In the subset of RSSIs in the lenticulostriate artery (LSA) territory, after adjustment for covariates, larger initial lesion volume (OR 1.80, 95% CI 1.13-2.87; P = 0.014) and greater decreases in LSA total length (OR 0.59, 95% CI 0.36-0.96; P = 0.035) were independently associated with hemorrhagic foci formation. The extent of ischemia in the initial infarct is predictive of the presence of hemorrhagic residues. Our findings contribute to the current understanding of the mechanisms underlying the evolution of RSSIs.
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@#Abstract: Objective To evaluate the potential transmission risk of schistosomiasis in Yunnan Province, and to provide strategic basis for the prevention and control. Methods Based on the prevalence of schistosomiasis, the social and environmental factors that may lead to the epidemic, 1-3 villages from 3 provincial-level and 15 county-level counties (cities and districts) were selected as the evaluated villages in 2021. The risk of schistosomiasis spread was analyzed comprehensively by consulting, reviewing and collecting routine surveillance data of schistosomiasis in the villages, combined with snail and wild feces survey. The risk level was evaluated for the positive snails, positive wild feces, resident infection, average density of live snails and snail frame occurrence rate. Results Totally 7 snail counties schistosomiasis transmission was blocked of 18 epidemic counties and the rest were eliminated counties. A total of 152 447 snail frames were investigated and 3 043 frames with snails, 15 895 snails were captured and included 15 727 live snails in the 32 evaluated villages. The total area of snail was 58.87 hm2 and the area of reoccurrence was 34.19 hm2 with snail frame occurrence rate of 2.00% and average density of live snails 0.103 2/0.11 m2, and no positive snails were found by loop-mediated isothermal amplification (LAMP) assay. A total of 1 374 wild feces were collected in 27 evaluated villages of 14 epidemic counties, mainly from cattle, dogs, sheep, equine animals, pigs and so on, all of which were negative. According to the risk assessment of epidemic spread, Yongle Village and Yongsheng Village in Eryuan County, Zhiming Village in Chuxiong City were Ⅱ risk, and the rest were Ⅲ risk. Conclusions Although the risk of transmission is low in Yunnan Province, the risk of transmission and spread still exists. It is necessary to strengthen the risk monitoring, control of snail and effective management of livestock to prevent the rebound of the epidemic.
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Objective: To explore the feasibility of single-breath-hold compressed sensing real-time cine imaging (CS-cine) in the assessment of ventricular function and left ventricular (LV) strain. Methods: A total of 70 subjects were enrolled prospectively, and all subjects underwent cardiac magnetic resonance imaging (cardiac MRI) using both the standard steady-state free procession cine (sta-cine) acquisition and a prototype CS-cine sequence. For both CS-cine and sta-cine imaging, continuous short-axis cine images were acquired from the base to the apex to cover the entire left ventricle, and long-axis cine images including two-, three-, and four-chamber views were also acquired. The scanning range, number of slices, slice thickness and intervals were kept identical for the two cine images of the same participant. Subjective evaluation of the image quality was performed on all cine images. For both sequences, the conventional function parameters of the left and the right ventricles and LV strain values were assessed with post-processing software analysis. The cine image quality, conventional ventricular function parameters, and LV strain values were compared between the two cine groups and the differences were examined. Inter- and intraobserver agreements for CS-cine images were measured using intraclass correlation coefficient ( ICC). Bland-Altman analysis was performed to assess reproducibility between the two cine methods. Results: The median scanning time of CS-cine was 21 s versus 272 s for sta-cine ( P<0.001). The median image quality scores of two groups were significantly different, 4 points for sta-cine and 2 points for CS-cine ( P<0.001). Bi-ventricular end-diastolic volumes (EDV), stroke volume (SV) and ejection fraction (EF) were significantly smaller in CS-cine ( P<0.001). Nevertheless, no significant differences between the two groups in bi-ventricular ESV or LV mass were observed ( P>0.05). LV strain parameters, including the peak radial strain, peak circumferential strain and peak longitudinal strain derived from LV mid-ventricular slice, were significantly different in the two sequences ( P<0.001). Moreover, CS-cine-derived functional parameters and strain measurements have a good correlation with those of sta-cine (for RV function parameters, and left ventricular PLS, PCS values, more than 95% points fell within the limits of agreement [ LoA]; meanwhile, more than 91% points fell within the LoA for other parameters) and inter- and intraobserver agreements were strong ( ICC=0.88 to 0.99) for CS-cine. Conclusion: CS-cine can well realize the rapid acquisition of cine images for quantitative analysis of cardiac function, and the conventional ventricular function parameters and LV globalized strain values obtained from CS-cine imaging have good reproducibility.
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Ventrículos Cardíacos , Imagen por Resonancia Cinemagnética , Estudios de Factibilidad , Ventrículos Cardíacos/diagnóstico por imagen , Humanos , Imagen por Resonancia Magnética , Imagen por Resonancia Cinemagnética/métodos , Espectroscopía de Resonancia Magnética , Reproducibilidad de los Resultados , Función Ventricular IzquierdaRESUMEN
BACKGROUND: Single subcortical infarction (SSI) is caused by two main etiological subtypes, which are branch atheromatous disease (BAD) and cerebral small vessel disease (CSVD)-related SSI. We applied the Beijing version of the Montreal Cognitive Assessment (MoCA-BJ), the Shape Trail Test (STT), and the Stroop Color and Word Test (SCWT) to investigate the differences in cognitive performance between these two subtypes of SSI. METHODS: Patients with acute SSIs were prospectively enrolled. The differences of MoCA-BJ, STT, and SCWT between the BAD group and CSVD-related SSI group were analyzed. A generalized linear model was used to analyze the associations between SSI patients with different etiological mechanisms and cognitive function. We investigated the correlations between MoCA-BJ, STT, and SCWT using Spearman's correlation analysis and established cut-off scores for Shape Trail Test A (STT-A) and STT-B to identify cognitive impairment in patients with SSI. RESULTS: This study enrolled a total of 106 patients, including 49 and 57 patients with BAD and CSVD-related SSI, respectively. The BAD group performances were worse than those of the CSVD-related SSI group for STT-A (83 [60.5-120.0] vs. 68 [49.0-86.5], Pâ=â0.01), STT-B (204 [151.5-294.5] vs. 153 [126.5-212.5], Pâ=â0.015), and the number of correct answers on Stroop-C (46 [41-49] vs. 49 [45-50], Pâ=â0.035). After adjusting for age, years of education, National Institutes of Health Stroke Scale and lesion location, the performance of SSI patients with different etiological mechanisms still differed significantly for STT-A and STT-B. CONCLUSIONS: BAD patients were more likely to perform worse than CSVD-related SSI patients in the domains of language, attention, executive function, and memory. The mechanism of cognitive impairment after BAD remains unclear.
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Enfermedades de los Pequeños Vasos Cerebrales , Disfunción Cognitiva , Infarto Cerebral , Disfunción Cognitiva/etiología , Función Ejecutiva , Humanos , Pruebas de Estado Mental y DemenciaRESUMEN
An amendment to this paper has been published and can be accessed via a link at the top of the paper.
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A 53-year-old woman was found "an occupant in the left ciliary body" two years ago and underwent the surgery of "left eye ball removal". Pathological results confirmed the diagnosis of malignant melanoma. The patient was admitted to our hospital again due to newly found heart murmur. With the combination of cardiac magnetic resonance (CMR) imaging characteristics, including high signals on T1-weighted and fat-suppressed T1-weighted images, the high signal on T2-weighted images, uneven first-pass perfusion and late gadolinium enhancement (LGE), as well as PET signal characteristics, the diagnosis of malignant melanoma cardiac metastasis was made. This case suggests that multimodality CMR, including T1-weighted, T2-weighted, first-pass perfusion, late gadolinium enhancement, and cine imaging, can be used to monitor and detect cardiac metastasis of melanoma in a relatively early stage. Therefore, we recommend a routine echocardiography screening for patients diagnosed with melanoma. In addition, CMR examinations and PET/CT may help early detection and timely intervention of melanoma cardiac metastasis, as for their good specificity in detecting, this disease in clinical practice.
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Neoplasias del Ojo , Neoplasias Cardíacas , Melanoma , Medios de Contraste , Neoplasias del Ojo/diagnóstico por imagen , Neoplasias del Ojo/patología , Neoplasias del Ojo/cirugía , Femenino , Gadolinio , Neoplasias Cardíacas/diagnóstico por imagen , Neoplasias Cardíacas/secundario , Humanos , Melanoma/diagnóstico por imagen , Melanoma/secundario , Persona de Mediana Edad , Miocardio , Tomografía Computarizada por Tomografía de Emisión de Positrones , Valor Predictivo de las PruebasRESUMEN
BACKGROUND: Peripartum cardiomyopathy (PPCM) is rare and potentially life-threatening; its etiology remains unclear. Imaging characteristics on cardiovascular magnetic resonance (CMR) and their prognostic significance have rarely been studied. We sought to determine CMR's prognostic value in PPCM by using T1 and T2 mapping techniques. METHODS: Data from 21 PPCM patients from our CMR registry database were analyzed. The control group comprised 20 healthy age-matched females. All subjects underwent comprehensive contrast-enhanced CMR. T1 and T2 mapping using modified Look-Locker inversion recovery and T2 prep balanced steady-state free precession sequences, respectively. Ventricular size and function, late gadolinium enhancement (LGE), myocardial T1 value, extracellular volume (ECV), and T2 value were analyzed. Transthoracic echocardiography was performed at baseline and during follow-up. The recovered left ventricular ejection fraction (LVEF) was defined as LVEF ≥50% on echocardiography follow-up after at least 6 months of the diagnosis. RESULTS: CMR imaging showed that the PPCM patients had severely impaired LVEF and right ventricular ejection fraction (LVEF: 26.8 ± 10.6%; RVEF: 33.9 ± 14.6%). LGE was seen in eight (38.1%) cases. PPCM patients had significantly higher native T1 and ECV (1345 ± 79 vs. 1212 ± 32 ms, P < 0.001; 33.9 ± 5.2% vs. 27.1 ± 3.1%, P < 0.001; respectively) and higher myocardial T2 value (42.3 ± 3.7 vs. 36.8 ± 2.3 ms, P < 0.001) than did the normal controls. After a median 2.5-year follow-up (range: 8 months-5 years), six patients required readmission for heart failure, two died, and 10 showed left ventricular function recovery. The LVEF-recovered group showed significantly lower ECV (30.7 ± 2.1% vs. 36.8 ± 5.6%, P = 0.005) and T2 (40.6 ± 3.0 vs. 43.9 ± 3.7 ms, P = 0.040) than the unrecovered group. Multivariable logistic regression analysis showed ECV (OR = 0.58 for per 1% increase, P = 0.032) was independently associated with left ventricular recovery in PPCM. CONCLUSIONS: Compared to normal controls, PPCM patients showed significantly higher native T1, ECV, and T2. Native T1, ECV, and T2 were associated with LVEF recovery in PPCM. Furthermore, ECV could independently predict left ventricular function recovery in PPCM.
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Cardiomiopatías/diagnóstico por imagen , Imagen por Resonancia Cinemagnética , Complicaciones Cardiovasculares del Embarazo/diagnóstico por imagen , Volumen Sistólico , Disfunción Ventricular Izquierda/diagnóstico por imagen , Función Ventricular Izquierda , Adulto , Cardiomiopatías/etiología , Cardiomiopatías/fisiopatología , Estudios de Casos y Controles , Bases de Datos Factuales , Femenino , Humanos , Variaciones Dependientes del Observador , Periodo Periparto , Valor Predictivo de las Pruebas , Embarazo , Complicaciones Cardiovasculares del Embarazo/etiología , Complicaciones Cardiovasculares del Embarazo/fisiopatología , Recuperación de la Función , Reproducibilidad de los Resultados , Factores de Riesgo , Factores de Tiempo , Disfunción Ventricular Izquierda/etiología , Disfunción Ventricular Izquierda/fisiopatología , Adulto JovenRESUMEN
OBJECTIVE: To assess biventricular, especially right ventricular, function and deformationin rhesus monkeys with spontaneous type 2 diabetes mellitus (T2DM) using cardiac magnetic resonance (CMR). METHODS: Twelve male spontaneous T2DM rhesus monkeys and age, sex, body mass matched 9 healthy rhesus monkeys without hypertension and myocardial infarction were included in this study. Fasting blood glucose (FPG), glycated hemoglobin (HbA1c) and blood liquid levels were measured. Biventricular function and myocardial deformations were evaluated by CMR cine and tissue-tracking. RESULTS: Compared with control, the FPG and HbA1c levers were significantly increased in T2DM group, but there was no significant difference in body mass and age between the two groups. CMR result showed that there was no significant decrease in right ventricle and left ventricle ejection fraction in T2DM (P < 0.05). However, the absolute value of radial and circumferential global peak systolic strain, systolic strain rate and three directions global peak diastolic strain rate of the right ventricle free wall were lower in the T2DM group (P < 0.05). Also, only radial and circumferential peak systolic strain and radial diastolic strain rate of left ventricle were higher (P < 0.05). CONCLUSIONS: Right ventricle showed systolic and diastolic dysfunction which were consistent with left ventricle in T2DM by CMR-tissue tracking.
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Diabetes Mellitus Tipo 2/complicaciones , Ventrículos Cardíacos/diagnóstico por imagen , Disfunción Ventricular Derecha , Animales , Macaca mulatta , Imagen por Resonancia Magnética , Masculino , Reproducibilidad de los Resultados , Volumen SistólicoRESUMEN
OBJECTIVE: To detect cardiac amyloidosis (CA) using cardiac magnetic resonance feature tracking(CMR-FT). METHODS: Forty-three CA patients and 24 healthy volunteers underwent steady-state free precession cine sequence on 3.0T MRI after injection of Magnevist. Software cvi 42 was used for analyzing the left ventricular function including left ventricular mass (diastole) (LVMD), left ventricular mass (systole) (LVMS), left ventricle end-diastolic volume (LVEDV), left ventricle end-systolic volume (LVESV), left ventricle stroke volume (LVSV), and left ventricular ejection fraction (LVEF), as well as myocardial strains including 3D global longitudinal strain (GLS), global circumferential strain (GCS), and global radial strain (GRS), and 2D endocardial and epicardial longitudinal strain, circumferential strain, and radial strain (ENDO-LS, EPI-LS, ENDO-CS, EPI-CS, ENDO-RS, and EPI-RS). The global and layer-specific strains were compared between the CA patients with LVEF >50%, the CA patients with LVEF ≤50%, and the healthy controls. RESULTS: For the left ventricular function, the CA patients had greater myocardial mass than the healthy controls (P < 0.05); the CA patients with LVEF ≤50% had greater LVESV and lower LVSV than those with LVEF >50% (P < 0.05). For the global strains, significant differences also appeared in GLS and GCS among the three groups (all P < 0.05). The CA patients had lower GRS than the healthy controls (P < 0.05), while no significant difference was found in GRS between the CA patients with LVEF >50% and those with LVEF ≤50% (P>0.05). For the layer-specific strains, significant differences in ENDO-LS, EPI-LS, ENDO-CS, EPI-CS, ENDO-RS, and EPI-RS were found among the three groups (all P < 0.05). There were significant correlations between GLS and LVEF (r=-0.404, P=0.016), and between GCS and LVEF (r=-0.602, P < 0.001) in the CA patients. CONCLUSION: CMR-FT can assess not only global strains but also layer-specific strains for the myocardial function of CA patients.
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Amiloidosis/diagnóstico por imagen , Cardiopatías/diagnóstico por imagen , Imagen por Resonancia Magnética , Función Ventricular Izquierda , Estudios de Casos y Controles , Humanos , Reproducibilidad de los Resultados , Volumen Sistólico , SístoleRESUMEN
OBJECTIVE: To determine the potential value of the two-dimensional (2D) cardiac magnetic resonance imaging (CMR) tissue tracking (CMR-TT) method in assessing the cardiac function of tree shrew at 7T. METHODS: Healthy adult tree shrews (male, n=8) and spraguedawley rats(male, n=8) were selected for this study. CMR was performed to acquire the short-axis images of left ventricle at 7T using the same appropriative coil and cine sequence for all experimental animals. The CMR images were processed using the professional cardiac analysis software, calculating ejection fraction (EF), radial peak sysolic strain (Err), circumferential peak sysolic strain (Ecc), radial peak sysolic displacement (DR), and LVM/BM ãthe ratio of left ventricular mass (LVM) to body mass (BM)ã. RESULTS: Cine imaging for the tree shrews was 100% successful following the CMR protocol for the rats, with clearly visible main segments of cardiac. Significant differences in EF, Err, Ecc and DR were found between the two groups of animals (P < 0.01). The tree shrews has lower EF, Err and Ecc than the rats. Err and Ecc appeared in the fifteenth phase in left ventriclar systole in the tree shrews, compared with the tenth phase in the rats.The tree shrews also had higher LVM/BM than the rats. CONCLUSION: The cardiac function of tree shrew can be assessed using the 2D CMR-TT method despite significant differences across species.
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Corazón/diagnóstico por imagen , Imagen por Resonancia Cinemagnética , Tupaiidae , Función Ventricular Izquierda , Animales , Imagen por Resonancia Magnética , Masculino , Ratas , Ratas Sprague-Dawley , Reproducibilidad de los Resultados , Volumen Sistólico , SístoleRESUMEN
OBJECTIVE: To study the application value of motion-correction phase sensitive inversion recovery (MOCO-PSIR) to evaluate myocardial fibrosis in the patients with heart failure caused by dilated cardiomyopathy (DCM). METHODS: A prospective study included 60 patients who underwent cardiac MRI enhanced scan from June 2017 to November 2018, including 38 patients who were clinically diagnosed with DCM and 22 patients in the normal control group. All patients were scanned with three late gadolinium enhancement (LGE) sequences: segmented-PSIR, single-shot-PSIR, MOCO-PSIR at the same time. The subjective quality score (level 4) and image signal-to-noise ratio (objective evaluation) of normal and abnormal myocardium were analyzed and compared in three scanning technique groups. The detection rate of myocardial fibrosis and image acquisition time of the three scanning techniques were recorded. RESULTS: In the normal control group (sinus rhythm), subjective score showed no statistical significance. Subjective scoring results in the patients with DCM: MOCO-PSIR>single-shot-PSIR> segmented-PSIR (P < 0.05). SNR results PSIR-LGE images in DCM patients as well as control group: segmented-PSIR>MOCO-PSIR> single-shot-PSIR (P < 0.05). In the whole 646 segments analysis of DCM patients, the ratio unable to judge in segmented-PSIR was up to 25.5%, but only 1.4% in MOCO-PSIR. Significant difference was found in the three groups. While in the 374 segments of control group, no statistical difference was found in comparison of incapability to judge. Acquisition time covered left ventricular: (5.6±1.7) min in segmented-PSIR, (0.4±0.2) min in single-shot-PSIR and (4.5±1.1) min in MOCO-PSIR. Pairwise comparison of acquisition time among three scanning techniques was statistically significant (P < 0.001). CONCLUSION: MOCO-PSIR-LGE has better clinical significance than conventional delayed enhanced scan sequences in the diagnosis of myocardial fibrosis in the patients with heart failure caused by dilated cardiomyopathy.
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Cardiomiopatía Dilatada/diagnóstico por imagen , Insuficiencia Cardíaca/diagnóstico por imagen , Imagen por Resonancia Magnética , Miocardio/patología , Estudios de Casos y Controles , Medios de Contraste , Fibrosis , Gadolinio , Humanos , Aumento de la Imagen , Estudios ProspectivosRESUMEN
OBJECTIVE: To determine the myocardial texture features of cardiac magnetic resonance (CMR) in healthy adult Han populations. METHODS: 59 healthy Han volunteers were recruited for this study from May 2016 to November 2017. CMR examinations were performed on the participants with a 3.0T scanner (Tim Trio, Siemens Medical Solution) to estimate the functional parameters, Native T1 value and ECV. Texture analysis (TA) was performed on the region of interest (ROI) in the left ventricle myocardium on T1 mapping images, with 40 myocardial texture features being extracted. Differences in the myocardial texture features across gender and age groups were analyzed through Student's t-tests or Wilcoxon signed-rank tests. Spearman correlations were analyzed between the myocardial texture features and age, native T1 value and extracellular volume (ECV). RESULTS: Of the 59 participants, 28 were women and 29 were in the younger age group (< 45 years old). The male participants had higher left ventricular mass index (Lvmassi) and lower native T1 than their female counterparts (P < 0.01). No gender differences in blood pressure, heart rate, left ventricular ejection fraction (LVEF) and ECV values were found. Ten of the forty myocardial texture features showed gender differences, including two first order features and eight Grey-level co-occurrence matrix (GLCM) features. Gender differences appeared in five first order features and eight GLCM features in the younger group (< 45 years old), but not in the older group (≥45 years old). Eight myocardial texture features were correlated with age, including five first order features and three GLCM features (all P < 0.01). Six first-order texture features were correlated with Native T1 values of the left ventricle middle myocardium. Three first-order texture features were correlated with ECV. CONCLUSION: Myocardial texture features in T1 mapping images vary by gender and age in healthy Han populations.
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Corazón/diagnóstico por imagen , Miocardio , Función Ventricular Izquierda , Adulto , Factores de Edad , Medios de Contraste , Femenino , Voluntarios Sanos , Humanos , Espectroscopía de Resonancia Magnética , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Factores SexualesRESUMEN
BACKGROUND: Myocardial fibrosis is a common pathophysiological process that is related to ventricular remodeling in congenital heart disease. However, the presence, characteristics, and clinical significance of myocardial fibrosis in Ebstein's anomaly have not been fully investigated. This study aimed to evaluate myocardial fibrosis using cardiovascular magnetic resonance (CMR) late gadolinium enhancement (LGE) and T1 mapping techniques, and to explore the significance of myocardial fibrosis in adolescent and adult patients with Ebstein's anomaly. METHODS: Forty-four consecutive patients with unrepaired Ebstein's anomaly (34.0 ± 16.2 years; 18 males), and an equal number of age- and gender-matched controls, were included. A comprehensive CMR protocol consisted of cine, LGE, and T1 mapping by modified Look-Locker inversion recovery (MOLLI) sequences were performed. Ventricular functional parameters, native T1, extracellular volume (ECV), and LGE were analyzed. Associations between myocardial fibrosis and disease severity, ventricular function, and NYHA classification were analyzed. RESULTS: LGE was found in 10 (22.7%) patients. Typical LGE in Ebstein's anomaly was located in the endocardium of the septum within the right ventricle (RV). The LV ECV of Ebstein's anomaly were significantly higher than those of the controls (30.0 ± 3.8% vs. 25.3 ± 2.3%, P < 0.001). An increased ECV was found to be independent of the existence of LGE. Positive LGE or higher ECV (≥30%) was associated with larger fRV volume, aRV volume, increased disease severity, and worse NYHA functional class. In addition, ECV was significantly correlated with the LV ejection fraction (P < 0.001). CONCLUSIONS: Both focal and diffuse myocardial fibrosis were observed in adolescent and adult patients with Ebstein's anomaly. Increased diffuse fibrosis is associated with worse LV function, increased Ebstein's severity, and worse clinical status.
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Anomalía de Ebstein/diagnóstico por imagen , Imagen por Resonancia Cinemagnética , Miocardio/patología , Disfunción Ventricular Izquierda/diagnóstico por imagen , Función Ventricular Izquierda , Remodelación Ventricular , Adolescente , Adulto , Factores de Edad , Estudios de Casos y Controles , Niño , China/epidemiología , Medios de Contraste/administración & dosificación , Estudios Transversales , Progresión de la Enfermedad , Anomalía de Ebstein/epidemiología , Anomalía de Ebstein/patología , Anomalía de Ebstein/fisiopatología , Femenino , Fibrosis , Gadolinio DTPA/administración & dosificación , Humanos , Masculino , Valor Predictivo de las Pruebas , Prevalencia , Pronóstico , Sistema de Registros , Factores de Riesgo , Índice de Severidad de la Enfermedad , Volumen Sistólico , Disfunción Ventricular Izquierda/epidemiología , Disfunción Ventricular Izquierda/patología , Disfunción Ventricular Izquierda/fisiopatología , Adulto JovenRESUMEN
The cine magnetic resonance imaging based technique feature tracking-cardiac magnetic resonance (FT-CMR) is emerging as a novel, simple and robust method to evaluate myocardial strain. We investigated the distribution characteristics of left-ventricular myocardial strain using a novel cine MRI based deformation registration algorithm (DRA) in a cohort of healthy Chinese subjects. A total of 130 healthy Chinese subjects were enrolled. Three components of orthogonal strain (radial, circumferential, longitudinal) of the left ventricle were analyzed using DRA on steady-state free precession cine sequence images. A distinct transmural circumferential strain gradient was observed in the left ventricle that showed universal increment from the epicardial to endocardial myocardial wall (epiwall: -15.4 ± 1.9%; midwall: -18.8 ± 2.0%; endowall: -22.3 ± 2.3%, P < 0.001). Longitudinal strain showed a similar trend from epicardial to endocardial layers (epiwall: -16.0 ± 2.9%; midwall: -15.6 ± 2.7%; endowall: -14.8 ± 2.4%, P < 0.001), but radial strain had a very heterogeneous distribution and variation. In the longitudinal direction from the base to the apex of the left ventricle, there was a trend of decreasing peak systolic longitudinal strain (basal: -23.3 ± 4.6%; mid: -13.7 ± 7.3%; apical: -13.2 ± 5.5%; P < 0.001). In conclusion, there are distinct distribution patterns of circumferential and longitudinal strain within the left ventricle in healthy Chinese subjects. These distribution patterns of strain may provide unique profiles for further study in different types of myocardial disease.
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Algoritmos , Ventrículos Cardíacos/diagnóstico por imagen , Imagen por Resonancia Cinemagnética , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , China , Femenino , Voluntarios Sanos , Ventrículos Cardíacos/fisiopatología , Humanos , Procesamiento de Imagen Asistido por Computador , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Programas Informáticos , Adulto JovenRESUMEN
BACKGROUND: Cone reconstruction is a novel surgical procedure for tricuspid valve repair in Ebstein anomaly. This study examined the effect of cone reconstruction on right ventricle (RV) geometry, function, and synchronization. METHODS: Twenty-one patients (4-49 year-old) underwent cone reconstruction were enrolled, and matched with healthy individuals. Pre-operative and follow-up echocardiography was performed along with cardiac magnetic resonance (CMR) imaging in 18 patients. A new parameter, tricuspid annular movement synchronicity index (TAMSI), was used to describe global synchronization of RV in the annular plane. TAMSI was defined as standard deviation of the systolic excursion of the hinge points of the three leaflets divided by their average value. RESULTS: After 9.1 (range 1-12) months follow-up, there were no deaths; tricuspid regurgitation was reduced from moderate/severe to mild or less in 95.2% of patients. In 18 patients with both pre and post CMR data, functional RV volume decreased after repair (134.3 ± 58.3 ml/m(2) to 96.6 ± 29.6 ml/m(2); P=0.001), while ejection fraction was not significantly altered (38.2 ± 9.2% to 36.5 ± 8.5%; P=0.357). TAMSI was significantly reduced after surgery, from 0.613 ± 0.220 to 0.169 ± 0.088 (P<0.001). A value similar to the normal control (0.181 ± 0.081) indicated more synchronized RV movement pattern. CONCLUSIONS: Cone reconstruction yielded good short-term survival in Ebstein anomaly. It reduced functional RV volume, improved RV global synchronization, and restored RV geometry. As such, it may improve RV performance and long-term prognosis. In addition, our described TAMSI proved to be a useful adjunct to postoperative assessments.
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Anomalía de Ebstein/cirugía , Válvula Tricúspide/cirugía , Adolescente , Adulto , Procedimientos Quirúrgicos Cardíacos/métodos , Niño , Preescolar , Anomalía de Ebstein/diagnóstico por imagen , Anomalía de Ebstein/patología , Anomalía de Ebstein/fisiopatología , Femenino , Corazón/anatomía & histología , Corazón/fisiopatología , Ventrículos Cardíacos/anatomía & histología , Humanos , Espectroscopía de Resonancia Magnética , Masculino , Persona de Mediana Edad , Resultado del Tratamiento , Válvula Tricúspide/diagnóstico por imagen , Válvula Tricúspide/patología , Válvula Tricúspide/fisiopatología , Función Ventricular Derecha , Adulto JovenRESUMEN
OBJECTIVES: To review clinical application of cardiac magnetic resonace (CMR) imaging in a tertiary hospital. METHODS: A total of 344 medical records were reviewed in relation to the use of CMR imaging over one year period in a tertiary hospital in China. Data regarding indications for CMR imaging, cardiac structure and function, late gadolinium enhancement (LGE), and diagnoses made from CMR imaging were extracted and examined. RESULTS: Detection of heart failure and cardiomyopathies was the most common reason for CMR imaging requests [164 (47.7%) of requests], which was followed by diagnoses of coronary artery disease [79 (23.0%) of requests] and ventricular arrhythmia [65 (18.9%) of requests]. Quantitative analyses were made in 319 (92.7%) cases, with 208 (65.2%) patients being identified with ventricular dilatation and 46 (14.4%) patients being identified with right ventricular dilatation. Apart from 74 (21.5%) cases for which a confirmed diagnosis could not be obtained, CMR imaging assessment corrected 21.2% (73 patients) and confirmed 57.3% (197 patients) of initial referral diagnoses. CONCLUSIONS: CMR imaging is mainly used for structural and functional assessments of hearts, which can help identify abnormalities that are not detected by other imaging modalities. It can provide incremental diagnostic, therapeutic, and prognostic information.
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Corazón/diagnóstico por imagen , Imagen por Resonancia Magnética , China , Medios de Contraste , Humanos , Valor Predictivo de las Pruebas , Pronóstico , Centros de Atención TerciariaRESUMEN
OBJECTIVES: To establish reference values for left ventricular (LV) myocardial strains in a cohort of healthy Chinese volunteers with feature tracking cardiac magnetic resonance imaging. METHODS: A total of 60 healthy volunteers were recruited, receiving a cardiac magnetic resonance imaging (CMR) examination at 3.0T scanner (Tim Trio, Magnetum, Siemens, Germany). A new feature tracking CMR software (Trufisp-strain, Siemens) was used to analyze left ventricular myocardial strain parameters, including radial, circumferential, longitudinal strain, systolic strain rate, and early diastolic strain rate. RESULTS: The image quality was sufficient to perform strain analysis.The reference values of global strain, global strain rate and segmental strains were obtained. A good inter- and intra-observer agreement was achieved in global strain analysis (except circumferential straininter-observer in apical level), with (37.7±9.6)% for LV global mean radial strain, (-18.4±3.3)% for circumferential strain and (-15.2±2.3%) for longitudinal strain, respectively.Age was positively correlated with global mean radial strain ( r=0.416, P<0.001) and negatively correlated with early diastolic strain rate (circumferential or longitudinal) and circumferential strain( r=-0.436, P<0.001; r=-0.326, P=0.011; r=-0.273, P=0.035, respectively). Women showed higher circumferential and longituinal strain values and lower systolic circumferential strain rate than men. The strain parameters were correlated with left ventricular ejection fraction (LVEF) ( P<0.05). CONCLUSIONS: FT-CMR (Trufisp-strain software) is a fast, convenient and highly reproducible method for analyzing left ventricular myocardial strains, which can sensitively detect gender and age differences. The reference values of LV myocardial strains can support further studies in the future.
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Corazón/diagnóstico por imagen , Imagen por Resonancia Cinemagnética , Función Ventricular Izquierda , Factores de Edad , Pueblo Asiatico , China , Femenino , Corazón/fisiopatología , Humanos , Imagen por Resonancia Magnética , Masculino , Miocardio , Variaciones Dependientes del Observador , Valores de Referencia , Reproducibilidad de los Resultados , Factores Sexuales , Volumen SistólicoRESUMEN
OBJECTIVES: To evaluate the effect of comprehensive schistosomiasis control project in Yunnan Province after its implementation for ten years, so as to provide the evidence for formulating the future prevention and control strategy. METHODS: The data of the schistosomiasis comprehensive control project and the endemic situation were collected and analyzed to evaluate the control effect of the project in Yunnan Province from 2004 to 2013. RESULTS: After the comprehensive control project implementation for ten years, the Oncomelania hupensis snail area in Yunnan Province decreased from 4,364.79 hm2 in 2004 to 1,528.50 hm2 in 2013, with a reduction rate of 64.98%, and the occurrence rate of frames with snails and the density of living snails decreased from 4.71% and 0.26 snails/0.1 m2 in 2004 to 1.35% and 0.04 snails/0.1 m2 in 2013, with the reduction rates of 71.34% and 84.62%, respectively. The schistosome infected snails were found only in 2011 and 2013 since 2008. In 2013, the infection rates of human (0.0021%) and cattle (0.0209%) decreased by 99.84% and 99.44%, respectively, compared to those in 2004, and no acute schistosome infection cases were found since 2008. The 212 villages with relatively serious endemic situation (Type One, Type Two and Type Three) all declined to the slight endemic villages (Type Four and Type Five), therefore, they reached the criteria of schistosomiasis transmission controlled or interrupted. The awareness rates of schistosomiasis control among villagers and students in endemic areas were above 90% and 98%, respectively. CONCLUSION: The effect of the comprehensive schistosomiasis control project is significant in Yunnan Province, but the task to consolidate and enlarge the control results still remains a challenge.
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Esquistosomiasis/prevención & control , China/epidemiología , Educación en Salud , Humanos , Factores de TiempoRESUMEN
OBJECTIVE: To evaluate the molluscicidal effect of 5% powder of niclosamide ethanolamine salt granules (NEG) in the field of mountainous areas in Yunnan Province. METHODS: The grasslands with Oncomelania hupensis snail habitats were chosen in Beideng Village, Heqing County, Yunnan Province, and were divided into 7 groups (groups of NEG 30 g/m2, NEG 40 g/m2, NEG 50 g/m2, NEG 40 g/m2 plus obstacle clearing, 50% niclosamide ethanolamine salt wettable powder (WPN) 6 g/m2, WPN 6 g/m2 plus obstacle clearing, and fresh water). The snail death rates and the densities of living snails were investigated and the results were compared in the different groups 7 d, 15 d, and 30 d after the implementation. RESULTS: Seven d, 15 d, and 30 d after the implementation, the snail death rates of the groups of NEG 30 g/m2, 40 g/m2, and 50 g/m2 were from 72.75 % to 95.83%, and the average descent rates of living snail densities were from 72.26% to 95.54%. Seven d, 15 d, and 30 d after the implementation, in the NEG 40 g/m2 group, the snail death rates were from 81.69% to 87.19%, and the average descent rates of living snail densities were from 81.42% to 87.91% ; in the NEG 40 g/m2 plus obstacle clearing group, the snail death rates were from 84.89% to 88.24% and the average descent rates of living snail densities were from 85.63% ~ 88.22%; in the WPN 6 g/m2 group, the snail death rates were from 85.23% to 86.17% and the average descent rates of living snail densities were from 85.76% to 86.05%; in the WPN 6 g/m2 plus obstacle clearing group, the snail death rates were from 88.89% to 92.10% and the average descent rates of living snail densities were from 86.71% to 92.20%. The obstacle clearing improved the molluscicidal effect. CONCLUSION: NEG has a good molluscicidal effect in the field of mountainous areas in Yunnan Province.