[Metalloproteinase Tolloid-like 1 gene mutation in Chinese patients with sporadic congenital heart diseases].

OBJECTIVE: To explore whether there are gene mutations of Tolloid-like 1 (TLL-1) gene in Chinese patients with sporadic congenital heart disease (CHD). METHODS: One hundred and fifteen patients with sporadic CHD were selected as CHD group. One hundred and two age and gender-matched healthy people were recruited as control group. After amplifying the exon 10 of the TLL-1 gene by polymerase chain reaction, the polymerase chain reaction products were purified, sequenced and analyzed in order to investigate the TLL-1 gene mutation. RESULTS: An insertion mutation of base A in the exon 10 of TLL-1 gene was identified in 7 out of 115 CHD patients, including 3 patients with atrial septal defect, 2 patients with ventricular septal defect, 1 patients with patent ductus arteriosus and 1 patients with complex CHD, the total mutation rate was 6.1% in CHD group and 0 in control group (P < 0.01). CONCLUSIONS: TLL-1 gene mutation with an insertion mutation of base A in exon 10 is often in Chinese patients with various CHD. The underlying pathogenesis between TLL-1 gene mutation and occurrence of congenital heart disease in Chinese people remains unclear and warrants further investigations.

Protective effects of salidroside on epirubicin-induced early left ventricular regional systolic dysfunction in patients with breast cancer.

BACKGROUND: Salidroside [2-(4-hydroxyphenyl)ethyl-ß-D-glucopyranoside], one of the most potent ingredients extracted from the plant Rhodiola rosea L., has been shown to have a cardiovascular protective effect as an antioxidant, and early treatment of epirubicin-induced cardiotoxicity has been the focus of clinical chemotherapy in patients with breast cancer. However, the cardioprotective effects of salidroside on epirubicin-induced cardiotoxicity, especially early left ventricular regional systolic dysfunction, have to date been sparsely investigated. OBJECTIVE: The aim of this study was to investigate the protective effects of salidroside in preventing early left ventricular regional systolic dysfunction induced by epirubicin. METHODS: Sixty patients with histologically confirmed breast cancer were enrolled. Eligible patients were randomized to receive salidroside (600 mg/day; n = 30) or placebo (n = 30) starting 1 week before chemotherapy. Patients were investigated by means of echocardiography and strain rate (SR) imaging. We also measured plasma concentrations of reactive oxygen species (ROS). All parameters were assessed at baseline and 7 days after each new epirubicin dose of 100 mg/m2. RESULTS: A decline of the SR peak was observed at an epirubicin dose of 200 mg/m2, with no significant differences between salidroside and placebo (1.35 ± 0.36 vs 1.42 ± 0.49/second). At growing cumulative doses of epirubicin, the SR normalized only with salidroside, showing a significant difference in comparison with placebo at epirubicin doses of 300 mg/m2 (1.67 ± 0.43 vs 1.32 ± 0.53/second, p < 0.05) and 400 mg/m2 (1.68 ± 0.29 vs 1.40 ± 0.23/second, p < 0.05). Moreover, a significant increase in plasma concentrations of ROS was found with placebo, but they remained unchanged with salidroside. CONCLUSION: Salidroside can provide a protective effect on epirubicin-induced early left ventricular regional systolic dysfunction in patients with breast cancer.

Real-time three-dimensional echocardiographic determination of right ventricular outflow tract high septal pacing sites.

OBJECTIVE: To investigate the feasibility of determination of right ventricular outflow tract (RVOT) high septal pacing site visualized by real-time three-dimensional echocardiography (RT3DE). METHODS: The forty subjects with RVOT pacing were analysed. RT3DE determination of RVOT high septal pacing sites was compared with chest X-ray (CXR). RESULTS: RVOT septal pacing sites could be obtained in all patients by RT3DE.When pacing sites were categorized as septal or non-septal, there were good agreements between echocardiography and CXR (kappa = 0.745). However, when RVOT pacing sites were categorized as high septal or non-high septal in identifying the exact anatomic location of pacing sites, there was only mild agreement between echocardiography and CXR (kappa = 0.275). Moreover, when RT3DE was used as the gold standard in identifying the exact anatomic location of RVOT, pacing at the RVOT high septal could only be achieved in 37.5% (n= 15) of patients using RT3DE, but in 65% (n= 26) using CXR, because the RVOT septal pacing lead tip found at high septal by CXR is actually found at low septal or free wall by RT3DE. CONCLUSION: It is limited to accurately locate RVOT high septal pacing site only by CXR, RT3DE allows to determinate the RVOT high septal pacing sites helpfully.

The impacts of transcatheter occlusion for congenital atrial septal defect on left ventricular systolic synchronicity: a three-dimensional echocardiography study.

OBJECTIVES: To investigate the impacts of transcatheter occlusion for congenital atrial septal defect (ASD) on left ventricular (LV) systolic synchronicity using a real time three-dimensional echocardiography (RT3DE). METHODS: Thirty patients with ASD closure were recruited for the study. Realtime three-dimensional echocardiographic data sets were acquired for the measurement of LV volumes LV ejection fractions and LV three-dimensional systolic synchronicity before and at 6 months after transcatheter occlusion for ASD. M-mode echocardiography and RT3DE were performed to characterize interventricular septal (IVS) motion. RESULTS: There were no differences in LV systolic synchronicity between before and after transcatheter closure of ASD (Tmsv-16SD%: 5.6%+/- 1.4% vs 5.8%+/- 1.8%, P > 0.05; Tmsv-12SD%: 5.2 +/- 1.1% vs 5.4 +/- 1.2%, P > 0.05). But the abnormal IVS motion was found before device closure and normalized after transcatheter occlusion for ASD using M-mode echocardiography and the excursion-time figure (bull's-eye derived from RT3DE); At the same time, LV ejection fraction (59.8 +/- 2.6 vs 66.7 +/- 5.9, P < 0.05) stroke volume (49 +/- 14 vs 63 +/- 11, P < 0.05) was improved significantly as well as normalization of IVS motion after transcatheter occlusion for ASD. The correlation between ASD diameter and change of LVEF is significant (r = 0.85, P < 0.001). CONCLUSION: Although transcatheter occlusion did not significantly impact on intrinsic LV systolic synchronicity in patients with ASD, LV systolic function can be improved through normalization of IVS abnormal motion after transcatheter ASD occlusion.

[Effect of rhodiola on serum troponin 1, cardiac integral backscatter and left ventricle ejective fraction of patients who received epirubicin-contained chemotherapy].

OBJECTIVE: To investigate the myocardial protective effect of Rhodiola on patients who received epidoxorubicin (EPI) treatment. METHODS: Forty-two patients with myocardial damage who received 3 courses of EPI-contained chemotherapy were randomly and equally assigned to two groups, the Rhodiola treated group and the control group. After 1-month treatment, the changes in serum troponin I (cTnI) level, cardiac integral backscatter (IBS), and left ventricle ejective fraction (LVEF) in patients were observed and compared between groups. RESULTS: Levels of cTnI in the treated group and control group were (0.54 +/- 0.05) mg/L and (0.98 +/- 0.03) mg/L respectively, IBS were 55.23 +/- 5.72 scores and 61.23 +/- 5.96 scores, and LVEF (%) were 68 +/- 3 and 57 +/- 2 respectively, all showed significant differences between groups (P<0.05). CONCLUSION: Rhodiola can improve cardiac function, and suppress the increase of serum cTnI level and IBS in patients who received EPI treatment.