The role of ultrasonic cardiogram in the diagnosis of hypertension complicated with type 2 diabetes mellitus.

Hypertension diabetes mellitus is one of the serious complications of hypertension. In this study, ambulatory blood pressure monitoring (ABPM) and ultrasonic cardiogram (UCG) were used to investigate the cardiac changes and its influencing factors in hypertensive patients with type 2 diabetes mellitus. The ABPM, UCG, Hemoglobin A1c (HbA1c) and body mass index (BMI) of patients were examined. The comparison of HbA1c, BMI, gender, age, daytime and nighttime blood pressure, left ventricular mass index (LVMI), left ventricular hypertrophy (LVH), isovolumic relaxation time (IVRT) and E/A ratio were made between the two groups. The cardiac function of control group was better than that of group B, while that of group B was better than group A. The cardiac index level in group B was better than that in group A, but lower than that in control group. The LVMI in group A was clearly higher than group B and control group, and the incidence of LVH increased. In group A, the nocturnal systolic blood pressure was higher than control group and group B. Nocturnal diastolic blood pressure, daytime diastolic blood pressure and systolic blood pressure in groups A and B were higher than those the control group. The findings indicated that hypertension complicated with type 2 diabetes mellitus can cause degeneration of the heart, and complicated with type 2 diabetes mellitus can accelerate ventricular remodeling and functional deterioration. Hypertension with type 2 diabetes mellitus are more prone to left ventricular damage.

Changes of serum uric acid and its clinical correlation in children with dilated cardiomyopathy.

BACKGROUND: Dilated cardiomyopathy (DCM) is the most common type of childhood cardiomyopathy and uric acid (UA) is considered closely associated with cardiovascular disease. There are few reports about the relationship between serum UA level and DCM in children, and the present study aimed to analyze the changes and clinical correlation of the two. METHODS: The clinical data of 49 children under 16 years old and who were hospitalized with DCM, and 44 healthy children who underwent physical examination in the same period at Tianjin Children's Hospital from June 2015 to November 2019 were analyzed retrospectively. RESULTS: The 49 children in the case group included 17 males and 32 females, aged from 2 to 172 months. The case group were divided into New York Heart Association (NYHA) functional class I (n=2), class II (n=17), class III (n=11), and class IV (n=19). The 44 healthy children selected as the control group included 20 males and 24 females aged from 2 to 161 months. The serum UA level was detected, and an ultrasonic cardiogram was conducted in each child. The serum UA level, left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), and left atrial diameter (LAD) of the case group were higher than that of the control group, while the left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) were lower than that of the control group, and significant statistical differences were seen between the two groups (P<0.01). The serum UA level, LVEDD, LVESD, and LAD of NYHAIII-IV class patients were higher than that of the NYHAI-II class, but LVEF and LVFS were lower than that of the NYHA I-II class, and there were significant statistical differences between the two groups (P<0.01). Statistical correlations were seen between the serum UA level and NYHA functional class, LVEDD, LVESD, LAD, LVEF, and LVFS (rs=0.599, 0.567, 0.579, 0.475, -0.333, -0.341, respectively, P<0.05). CONCLUSIONS: Elevated serum UA levels exist in children with DCM and correlate with NYHA functional class and ultrasonic values. Change in serum UA levels may be used as a biomarker reflecting the severity of DCM in children.

[Electroacupuncture at "Neiguan"(PC6) decreased cardiac sympathetic hyperactivity and improved cardiac function in chronic myocardial ischemia model rats].

OBJECTIVE: To investigate the autonomic nervous mechanism of acupuncture therapy in the treatment of ischemic cardiomyopathy by observing the influence of electroacupuncture (EA) at "Neiguan"(PC6) on the superior cervical cardiac nerve activity and cardiac function in chronic myocardial ischemia (CMI) rats. METHODS: Male SD rats were randomly divided into control, model and EA groups (n＝8 in each group). The CMI model was established by ligating the anterior descending branch of the left coronary artery. EA (15 Hz, 1.5 mA) was applied to bilateral PC6 for 20 min, once a day for 28 consecutive days. Cardiac sympathetic nerve electrical activities (CSNEA), electrocardiogram (ECG) of the standard limb lead Ⅱ and ultrasonic cardiogram (UCG) were recorded for observing changes of ST segment height, left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS)．. RESULTS: The CSNEA was significantly increased(P<0.001), and the hight of ECG-STⅡ， LVEF and LVFS were considerably decreased in the model group relevant to the control group (P<0.01, P<0.001), while after the intervention, modeling induced increase of CSNEA and decrease of ECG-STⅡ， LVEF and LVFS were obviously suppressed in the EA group in comparison with the model group (P<0.01, P<0.05, P<0.001). CONCLUSION: EA of PC6 can improve cardiac function and myocardial ischemia in CMI rats, which is possibly related to its effect in decreasing cardiac sympathetic hyperactivity.

Electroacupuncture at "Neiguan"(PC6) decreased cardiac sympathetic hyperactivity and improved cardiac function in chronic myocardial ischemia model rats / 针刺研究

OBJECTIVE: To investigate the autonomic nervous mechanism of acupuncture therapy in the treatment of ischemic cardiomyopathy by observing the influence of electroacupuncture (EA) at "Neiguan"(PC6) on the superior cervical cardiac nerve activity and cardiac function in chronic myocardial ischemia (CMI) rats. METHODS: Male SD rats were randomly divided into control, model and EA groups (n＝8 in each group). The CMI model was established by ligating the anterior descending branch of the left coronary artery. EA (15 Hz, 1.5 mA) was applied to bilateral PC6 for 20 min, once a day for 28 consecutive days. Cardiac sympathetic nerve electrical activities (CSNEA), electrocardiogram (ECG) of the standard limb lead Ⅱ and ultrasonic cardiogram (UCG) were recorded for observing changes of ST segment height, left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS)．. RESULTS: The CSNEA was significantly increased(P<0.001), and the hight of ECG-STⅡ， LVEF and LVFS were considerably decreased in the model group relevant to the control group (P<0.01, P<0.001), while after the intervention, modeling induced increase of CSNEA and decrease of ECG-STⅡ， LVEF and LVFS were obviously suppressed in the EA group in comparison with the model group (P<0.01, P<0.05, P<0.001). CONCLUSION: EA of PC6 can improve cardiac function and myocardial ischemia in CMI rats, which is possibly related to its effect in decreasing cardiac sympathetic hyperactivity.

Effects of metoprolol combined with trimetazidine on cardiac function and matrix metalloproteinase－9 levels in patients with coronary heart disease complicated with chronic heart failure / 中国基层医药

Objective To observe the effect of metoprolol combined with trimetazidine on coronary heart disease with chronic congestive heart failure ,and its effects on myocardial structure ,plasma brain natriuretic peptide (BNP) and matrix metalloproteinase－9 (MMP－9).Methods From January 2016 to November 2017,160 coronary heart disease patients with chronic congestive heart failure in the First Peopleˊs Hospital of Wenling were randomly divided into treatment group (78 cases)and control group (77 cases)through random number table method.The control group was given conventional anti－heart failure treatment.The treatment group was treated with metoprolol and trimetazidine. After 3 months of treatment,left ventricular end－diastolic volume (LVEDV), left ventricular end －systolic volume (LVESV),LVEF,BNP and changes in MMP －9 were compared.Results The total effective rate of the treatment group was 90.36%,which was significantly higher than 77.92%of the control group (χ2 ＝5.024,P＜0.05).There were no statistically significant differences in LVESV and LVEDV between the two groups before and after treatment (t＝0.07,P＝0.47;t＝0.75,P＝0.22;t＝0.90,P＝0.18;t＝1.24,P＝0.10).Compared with before treatment ,the LVEF change in the control group had no statistically significant difference ( P＞0.05),the LVEF of the treatment group was increased [(41.38 ±9.26)% vs.(46.31 ±10.8)%] ( t ＝－3.15,P＝0.001).After treatment,the LVESV between the treatment group and control group had statistically significant difference [(124.54 ±16.57) mL vs.(106.36 ±16.44)mL](t＝7.16,P＜0.05).The BNP level was decreased in the treatment group after treatment [(4 036.39 ±696.24)ng／L vs.(3 621.78 ±732.57) ng／L] ( t＝3.73,P＜0.05),while the BNP level had no statistically significant change in the control group ( t＝1.47,P＝0.07).the MMP－9 level in the treatment group was lower than that before treatment [(396.21 ±97.56)ng／mL vs.(345.11 ±86.25)ng／mL](t＝3.57,P＜0.05), while the MMP－9 level in the control group had no statistically significant change (t＝1.06,P＝0.15).The MMP－9 and BNP levels decreased more significantly in the treatment group than those in the control group (t＝3.73,3.57,all P＜0.05).Conclusion Metoprolol combined with trimetazidine in the treatment of patients with chronic heart failure can significantly alleviate clinical symptoms ,reduce the expression level of MMP －9,and is safe for clinical use. Therefore,it is recommended use in clinical.

Comparative study of dualGsource CT coronary angiography and ultrasonic cardiogram on left ventricular function / 实用放射学杂志

Objective To investigate the clinical value of dualGsource CT coronary angiography in evaluation of left ventricular function.Methods A total of 5 5 patients with clinically suspected coronary heart disease in our hospital were enrolled.All patients underwent dualGsource CT coronary angiography and ultrasonic cardiogram.The measured values and correlation of the indicators of left ventricular function in dualGsource CT coronary angiography and ultrasonic cardiogram were analyzed.Results Pearson correlation analysis showed that dualGsource CT coronary angiography and ultrasonic cardiogram were highly correlated in left ventricular function measurements (r＝ 0.607－0.840,P＜0.05);The paired sample t test showed that there were no significant differences in the ej ection fraction (EF) and endGdiastolic volume (EDV)between two methods.Conclusion DualGsource CT coronary angiography is reliable in the quantitative evaluation of left ventricular function.The "oneGstop"acquiring of coronary stenosis degree and cardiac function index can provide more diagnostic information to clinic.

Effects of metoprolol combined with trimetazidine on cardiac function and matrix metalloproteinase-9 levels in patients with coronary heart disease complicated with chronic heart failure / 中国基层医药

Objective@#To observe the effect of metoprolol combined with trimetazidine on coronary heart disease with chronic congestive heart failure, and its effects on myocardial structure, plasma brain natriuretic peptide (BNP) and matrix metalloproteinase-9 (MMP-9).@*Methods@#From January 2016 to November 2017, 160 coronary heart disease patients with chronic congestive heart failure in the First People's Hospital of Wenling were randomly divided into treatment group (78 cases)and control group (77 cases)through random number table method.The control group was given conventional anti-heart failure treatment.The treatment group was treated with metoprolol and trimetazidine.After 3 months of treatment, left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume(LVESV), LVEF, BNP and changes in MMP-9 were compared.@*Results@#The total effective rate of the treatment group was 90.36%, which was significantly higher than 77.92% of the control group (χ2=5.024, P<0.05). There were no statistically significant differences in LVESV and LVEDV between the two groups before and after treatment (t=0.07, P=0.47; t=0.75, P=0.22; t=0.90, P=0.18; t=1.24, P=0.10). Compared with before treatment, the LVEF change in the control group had no statistically significant difference(P>0.05), the LVEF of the treatment group was increased[(41.38±9.26)% vs.(46.31±10.8)%] (t=-3.15, P=0.001). After treatment, the LVESV between the treatment group and control group had statistically significant difference[(124.54±16.57)mL vs.(106.36±16.44)mL](t=7.16, P<0.05). The BNP level was decreased in the treatment group after treatment[(4 036.39±696.24)ng/L vs.(3 621.78±732.57)ng/L] (t=3.73, P<0.05), while the BNP level had no statistically significant change in the control group (t=1.47, P=0.07). the MMP-9 level in the treatment group was lower than that before treatment[(396.21±97.56)ng/mL vs.(345.11±86.25)ng/mL](t=3.57, P<0.05), while the MMP-9 level in the control group had no statistically significant change (t=1.06, P=0.15). The MMP-9 and BNP levels decreased more significantly in the treatment group than those in the control group (t=3.73, 3.57, all P<0.05).@*Conclusion@#Metoprolol combined with trimetazidine in the treatment of patients with chronic heart failure can significantly alleviate clinical symptoms, reduce the expression level of MMP-9, and is safe for clinical use.Therefore, it is recommended use in clinical.

Clinical applicability of monitoring pulmonary artery blood flow acceleration time variations in monitoring fetal pulmonary artery pressure.

BACKGROUND: In recent years, pulmonary artery blood flow acceleration time (AT) has been believed to be applicable in the examination of fetal lung development. OBJECTIVES: This study aims to evaluate the clinical significance of pulmonary artery blood flow AT as a parameter in monitoring of fetal pulmonary artery pressure. MATERIAL AND METHODS: A total of 31 fetuses in midor late-term pregnancy with tricuspid regurgitation were set as the study group (congenital heart disease with a tricuspid regurgitation pressure difference of more than 20 mm Hg was excluded). A total of 68 normal fetuses in midor late-term pregnancy were selected as the control group (strictly screened for tricuspid regurgitation, congenital heart disease and other congenital diseases before inclusion). The average ATs of both groups were calculated. Correlations of pulmonary artery systolic pressure (PASP) and AT, as well as the ratio of AT to right ventricular ejection time (ET) (AT/ET ratio) of both groups were investigated by 1-way analysis of variance (ANOVA). RESULTS: The average AT of the study group was significantly lower than that of the control group (p < 0.0001). In the study group, AT negatively correlated with PASP (r = -0.52; p < 0.01), AT/ET ratio negatively correlated with PASP (r = -0.52; p < 0.01) and both showed statistical significance. CONCLUSIONS: The results indicated that fetuses in the study group showed lower ATs and AT/ET ratios than the control group. Acceleration times and AT/ET ratios decreased as PASP increased. Thus, AT and AT/ET ratio can be used clinically as new parameters for the qualitative and - to some extent - quantitative evaluation of fetal pulmonary artery pressure.

Effect of LY249002 on myocardial structure and cardiac function in rats with dilated cardiomyopathy / 中南大学学报(医学版)

Objective:To examine the role of LY294002 in cardiac function and myocardial structure in dilated cardiomyopathy (DCM) rats.Methods:Fifty-two male SD rats were randomly assigned to a control group (n=16) and a DCM group (n=36).The DCM rats were induced by intraperitoneal injection of adriamycin,and the control rats were given normal saline.After observation for 2 weeks,6 rats from each group were killed randomly.In the end of the 8th week,the 24 DCM rats were randomly assigned to a DCM group (n=12) and a LY294002 group (n=12),which were given normal saline and LY294002,respectively.In the end of the 8th week and 16th week,the cardiac function was analyzed by ultrasonic cardiogram (UCG) and the plasma was collected to test the level of N-terminal pro-brain natriuretic peptide (NT-pro BNP).HE and Van Gieson (VG) staining were performed to calculate the collagen volume fraction (CVF).Results:Compared with the control group,the left ventricular end-diastolic dimension (LVEDD),left ventricular end-systolic dimension (LVESD) and NT-proBNP level of in the DCM rats were increased obviously,while the left ventricular ejection fraction (LVEF),left ventricular fractional shortening (LVFS) in the DCM rats were decreased obviously (P＜0.01).These changes were consistent with DCM characteristics.Compared with the DCM group,the LVEDD,LVESD and NT-proBNP levels in the LY294002 group were decreased,while the LVEF and LVFS were increased (P＜0.05).Histopathology showed that the myocardium in the DCM rats was fibrotic and the CVF was increased compared with the control rats (P＜0.01).The myocardial structure was improved in the LY294002 group compared to the DCM group.Conclusion:LY294002 can reduce the myocardial fibrosis in the DCM rats and improve the cardiac function.

Models for improved diagnosis of left ventricular hypertrophy based on conventional electrocardiographic criteria.

BACKGROUND: Electrocardiogram (ECG) is commonly used clinically due to convenience, but its accuracy is insufficient for left ventricular hypertrophy (LVH) diagnosis. In this study, we attempted to improve diagnostic accuracy of LVH by establishing models with ECG parameters. METHODS: Eighty hundred and twenty eight patients were recruited in the present study which were divided into groups according to gender, age and body mass index (BMI). The sensitivity, specificity, Youden index, positive predictive value, negative predictive value and accuracy were calculated using ultrasonic cardiogram criteria of LVH as the gold standard. Area under the curve was also calculated to assess the diagnostic accuracy of 22 conventional ECG criteria in different groups. Stepwise discriminant analyses were performed to establish models of ECG for LVH. RESULTS: The diagnostic accuracy of ECG11 (S V2 + R V5,6) and ECG12 (S V1,2 + R V5,6) was significantly higher than the other 20 criteria, while ECG15 (R V5/R V6) was lowest. The ECG12 sensitivity for males was 52.5%, for <60 years old was 44.2%, and for BMI <25 kg/m2 was 46.2%,higher than for females (27.5%), for ≧60 years old (35.7%), and for BMI ≧25 kg/m2(27.6%), respectively. The difference between genders was the most obvious. Based on these observations, the following models for males and females were established:[Formula: see text]and[Formula: see text]respectively. The sensitivities of the two new models were 71.4% and 75.8%, significantly higher than the22 conventional ECG criteria. CONCLUSION: Two models developed based on gender can be considered for use to investigate the preliminary assessment of the probability of LVH.

Evaluation of cardiac magnetic resonance in 25 suspected coronary heart disease patients with ;abnormal electrocardiogram findings but normal coronary angiography / 中国介入心脏病学杂志

Objective To evaluate the diagnostic value of cardiac magnetic resonance (CMR) in suspected coronary heart disease patients with electrocardiogram abnormalities but normal coronary angiography. Methods The data of 25 suspected coronary heart disease patients with electrocardiogram abnormalities but normal coronary angiography were collected from Taiyuan central hospital between October 2010 and April 2012. Comparison was done in terms of anterior interventricular septal thickness, left ventricular posterior wall thickness, left ventricular end diastolic dimension, left ventricular end systolic dimension, left atrial diameterand ejection fraction measured by CMR and by UCG. Correlation of the aboved paremeters between the 2 imaging exams. Results 40%of patients had their diagnosis changed after CMR exam, 32%of the patients with adjusted assessment. The differences in anterior interventricular septal thickness, left ventricular posterior wall thickness, left ventricular enddiastolic dimension, left ventricular end systolic dimension, left atrial diameter, ejection fraction by CMR and by UCG were similar (P>0.05) with positive correlation (P<0.01). Conclusions CMR can provide diagnosis and evaluation information to chest pain patients with ECG abnormalities but normal CAG, and it is a good supplement for routine examination.

Clinical analysis of 21 cases of pediatric bridging bronchus / 临床儿科杂志

Objective To explore the clinical diagnosis and treatment of pediatric bridging bronchus deformity and brid-ging bronchus with pulmonary artery sling. Methods The clinical data of the 21 cases of diagnosed bronchial bridge deformity and bronchial bridge with pulmonary artery sling, the imaging findings of all the echocardiography, MSCT chest scan, enhanced CT and reconstructive image were retrospectively analyzed. Results In 21 cases, 10 were diagnosed as bronchial bridge only, among which three cases had other types of congenital heart disease;11 cases were diagnosed of pulmonary artery sling with pulmonary artery sling, among which 8 cases had other types of congenital heart disease;their average age of the 8 cases were all younger than 2 years old, except one case;most of them had the symptoms of recurrent respiratory tract infections and parox-ysmal dyspnea. According to Wells, bronchial bridge was divided into type I and typeⅡ;15 cases were type I, 6 cases were typeⅡ, 10 patients with bronchial bridge only were all type I, 5 cases of typeⅡwere associated with pulmonary artery sling. All of the 6 cases were diagnosed as typeⅡassociated with pulmonary artery sling. Conclusions Infants and young children with clini-cal recurrent respiratory tract infections should be considered the possibility of bronchus bridge deformity, and should be paid more attention to the possibility of pulmonary artery sling. MSCT plain chest scan, enhanced CT and airway reconstructive im-age are the important ways to diagnose the disease.

The therapeutic effect of enteral nutrition support on chronic cardiac failure of rats / 中华急诊医学杂志

Objective To study the therapeutic effect and mechanism of enteral nutrition support for treatment of chronic cardiac failure of rats.Methods Ligature of abdominal aorta was used to prepare SD rat model of chronic cardiac failure.The rat models of cardiac failure were randomly (random number) divided into three groups:conventional therapy group,conventional therapy plus enteral nutrition support group and non-therapy group.The rats in conventional therapy group were administrated with routinely used drugs for chronic cardiac failure.The rats in conventional therapy plus enteral nutrition support group were treated with conventionally used medicine plus enteral nutrition liquid.The rats in non-therapy group were given the same amounts of dummy medicine and normal saline.Ultrasonic cardiography,ELISA for detection of atrial natriuretic peptide (BNP) and examination of pathological change in myocardium tissues after HE staining were carried out for comparison of cardiac function of rats with chronic heart failure between pre-and post-treatment.Results The commonly used drug enabled the heart of rats with chronic heart failure to elevate the LVFS (left ventricular fraction shortening) and LVEF (left ventricular ejection fraction) levels (q=3.59,P＜0.05; q=4.01,P＜0.05),to decrease the BNP in blood plasma (u=2.285,P＜0.05) and to lessen the injury of myocardial tissue (u =2.332,P ＜ 0.05).However,compare to the chronic cardiac failure rats administrated with commonly used drug,the chronic cardiac failure rats treated by combination of the commonly used drug and enteral nutrition liquid presented significantly higher LVFS and LVEF levels (q =4.34,P ＜ 0.05 ; q =3.98,P ＜ 0.05),lower plasma BNP level (u =2.548,P ＜0.02) and milder injury of myocardial tissue (u=2.631,P＜0.02).Conclusions The commonly used drug plus enteral nutrition support promotes in higher efficiency the heart function of chronic cardiac failure rats,suggesting that this nutrition support can be used as an adjuvant therapy for patients with chronic cardiac failure in clinic.

Clinical Analysis of Cyanotic Congenital Heart Diseases in 102 Newborns / 实用儿科临床杂志

Objective To analyze the distribution and clinical characters of cyanotic congenital heart diseases in newborns.Method We examined the suspicious cases with color doppler ultrasonic cardiogram(CFM),and compared with the results of autopsies.Results The most common congenital diseases in the group were complete transposition of the great arteries,with the proportion of 34.4%, and most of them were compounded cardiovascular disorders. The most common symptom was cyanosis, took the proportion of 84.3%; some patients had no cyanosis, tachypnea and murmurs.The cases with cardiovascular disorders most were combined with type Ⅱrespiratory failure and metabolic acidosis.Conclusions There are many types of congenital heart diseases, the symptoms are untypical,so the suspicious cases shall examine with CFM as early as possible.