简介：Introduction,Theroleofleftventriculographyhasevolvedradicallyoverthelasthalf-century,buthasreceivedlittlenoticeintheacademicliterature.ThetechniqueandfrequencyofuseofleftventriculographyvaryacrossregionsoftheUnitedStates,institutions,andindividuals.

简介：ObjectivesToexploretheeffectoflosartanoncardiacandrenalfunctioninpatientswithchronicheartfailure(CHF).MethodsSixty-fivepatientswithCHFweredividedintotwogroupsusingarandomized,controlandsingleblindmethod:losartangroup(n=30)andconventiongroup(n=35),withatreatmentcourseof8weeksforbothgroups.TheconcentrationsofcystatinC(cysC)inserum,microamountalbumin(MA)inurineweremeasuredbyimmunoturbidimetry.Theconcentrationofaquaporin-2(AQP-2)wasdeterminedbyenzyme-linked-immunosorbentassay(ELISA)andtheheartcontractilefunctionwasmeasuredbyechocardiographybeforeandaftertreatmentrespectively.ResultsComparingwithroutinetreatmentgroup,leftventricularend-diastolicdimension(LVEDd)decreasedsignificantly,whileleftventricularejectionfraction(LVEF)andleftventricularfractionalshortening(LVFS)increasedsignificantlyinlosartangroup.ThelevelsofcysCinserumandMA,AQP-2inurineweresignificantlylowerinlosartangroupthaninroutinetreatmentgroup.ConclusionLosartancanimprovecardiacandrenalfunctioninpatientswithCHF.

简介：ObjectDiastolicfunction’sassessmentisvitalinordertoproduceinformationrelevanttopatients’functionalclass,managementandprognosis.Wesoughttoinvestigatediastolicdysfunctioninessentialhypertension(EH)withorwithoutcoronaryheartdisease(CAD)usingcolorM-modeDopplerechocardiographyandtostudytherelationbetweendiastolicdysfunctionandleftventricularmassindex(LVMI)andgeometryofLV,andtodemonstratepartlythecauseofincreasedcardiovascularriskofanechocardiographicpatternofLVgeometry.Methods36normalsubjects(GroupⅠ)and107patientswithessentialhypertension(GroupⅡ)werestudiedusingcolorM-modeDopplerechocardiography.FourdifferentLVanatomicadaptationtohypertensionwerei-dentifiedbycategorizingpatientsaccordingtovaluesofend-diastolicrelativewallthickness(RWT)andLVMI.Wemeasuredtherateofpropagationofpeakearlyfillingflowvelocity(Vp),timedelay(TD)ofthepeakearlyfillingflowvelocityfrommitral

简介：BackgroundThoracoscopicminimallyinvasivepectusexcavatumrepair(Nussoperation)featuresitslittletrauma,simple,shortoperationtime,andgoodoutcomecomparedwithtraditionaltreatmentofpectusexcavatumsurgery-sternalelevation(Ravitchoperation)andsternalturnover.Theeffectoftheoperationonpatients’heartandheartfunctionremainsunclear.ThisstudyaimedtounderstandthechangesofelectrocardiogramandcardiacfunctionafterNussprocedure.MethodsFrom2008Januaryto2013July,thoracoscopicNussoperationwasperformedin217patientswithpectusexcavatum.Allthepatientsunderwentthepreoperative,postoperativedetectionofECGandcardiacfunctionin3monthsto1yearafteroperation.ResultsAfter3monthsto1yearfollow-up,arrhythmiaspersistedin46outof135patientswithpreoperativesymptoms(P<0.05);Strokevolumeandcardiacoutputsignificantlyincreased(P<0.05);Andcardiacparametersgreatlyimproved(P<0.05).ConclusionsMinimallyinvasiverepairofpectusexcavatumdeformitycancorrectthechestmalformation,alleviatearrhythmia,andimprovecardiacfunction.

简介：ObjectivesTounderstandtheeffectofcarvedilolonthecoronaryvascularendothelialfunctionofthepatientswithcoronaryheartdiseaseafterpercutaneoustransluminalcoronaryangioplasty(PTCA).Methods51cases,havingoneormorethantwobranchesnarrow(≥70%),werediagnosedbycoronaryangiography.Thesepatientsweredividedrandomlyintocarvedilolgroup(n=28)andcontrolgroup(n=23)whodidnottakecarvedilol.Endothelin(ET)andnitrodioxide(NO)levelsofperipheralbloodweremeasuredbeforeandafterPTCA,beforeandaftertwoweeksbytakingcarvedilol.ResuitsComparedwiththeETandNOlevelsbeforePTCA,ETweremarkedlyincreasedandNOweredecreasedafterPTCA(p<0.05);comparedwiththeETandNOlevelsbeforetakingcarvedilol,ETweredecreasedandNOwereincreasedaftertwoweek(p<0.05),buttheETandNOlevelsofthecontrolgroupdidnotchangeintheperiodoftwoweeksobservation(p>0.05).ConclusionsCarvedilolmayimprovethecoronaryvascularendothelialfunctionafterPTCA.

简介：BackgroundIt'saneffectivetreatmenttoachievepercutaneouscoronaryinterventioninAMIpatients,whichrapidlyimprovesthebloodsupplyofcoronaryartery.StudieshaveshownthatdifferentmodesofPCItherapyhavedifferenteffectsinAMIpatients.TheaimofthisstudywastoexploretheeffectsandclinicalsignificancesofemergencyorlatePCItherapyonleftventricularremodelingandcardiacautonomicfunctioninacutemyocardialinfarction(AMI)patients.MethodsOnehundredandfiftycasesofAMIpatientswererandomlydividedintothreegroups,whichallweregiventheroutinemedicine.ThetwotherapygroupsweretheemergencyPCIgroup(n=60)andthelatePCIgroup(n=50).Thevariationsofheartrateturbulence(HRT)andheartratevariability(HRV)parameterswereobservedafter2weeksoftreatmentby24-hourambulatoryECG.ResultsComparedwiththecontrolgroup,after2weeksoftreatment,thelevelsofTS,SDNNandSDANNoftwoPCI-treatedgroupwassignificantlyhigher(P<0.01),TOwerelower(P<0.01)thanwhichinthecontrolgroup.ThereweresignificantdifferencesinTS,SDNN,SDANNandTObetweenthetwoPCItreatmentgroup(P<0.05).ConclusionEmergencyPCIorlatePCImaygivecoronaryeffectivereperfusion,improveleftventricularfunctionandautonomicnervousfunction,andpreventmalignantarrhythmiastooccur.ThetreatmentofprimaryPCIissuperiortodelayedPCI.

简介：Thisstudyinvestigatedtheeffectofcatheter-basedrenalsympatheticdenervation(RD)onleftventricularhypertrophy(LVH)andsystolicanddiastolicfunctioninpatientswithresistanthypertension.LVHanddiastolicdysfunctionareassociatedwithelevatedsympatheticactivityandincreasedmorbidityandmortality.TheeffectofRDonLVHandLVfunctionisunclear.MethodsandResultsForty-sixpatientsunderwentbilateralRD,and18patientsservedascontrols.Transthoracicechocardiographywasperformedatbaseline,andafter1monthand6months.Besidesreductionofsystolicanddiastolicbloodpressure(-22.5/-7.2mmHgat1monthand-27.8/-8.8mmHgat6months,P<0.001ateachtimepoint),RDsignificantlyreducedmeaninterventricularseptumthicknessfrom14.1±1.9mmto13.4±2.1mmand12.5±1.4mm(P=0.007),andLVmassindexfrom53.9±15.6g/m(2.7)(112.4±33.9g/m(2))to47.0±14.2g/m(2.7)(103.6±30.5g/m(2))and44.7±14.9g/m(2.7)(94.9±29.8g/m(2))(P<0.001)at1monthand6months,respectively.ThemitralvalvelateralE/E'decreasedafterRDfrom9.9±4.0to7.9±2.2at1monthand7.4±2.7at6months(P<0.001),indicatingreductionofLVfillingpressures.Isovolumicrelaxationtimeshortened(baseline109.1±21.7msvs.85.6±24.4msat6months,P=0.006),whereasejectionfractionsignificantlyincreasedafterRD(baseline:63.1±8.1%vs.70.1±11.5%at6months,P<0.001).Nosignificantchangeswereobtainedincontrolpatients.ConslusionsBesidestheknowneffectonbloodpressure,ourstudyshowedforthefirsttimethatRDsignificantlyreducesLVmassandimprovesdiastolicfunction,whichmighthaveimportantprognosticimplicationsinpatientswithresistanthypertensionathighcardiovascularrisk.

简介：ObjectivesToob-servetheeffectofdifferentestrogenlevelsonthesecretoryfunctionofvascularendothelialcellsoffemalerats,andstudytheeffectofmodulationofestrogenlevelontheexpressionofvascularcelladhesionmolecule-1andtheconcentrationofestrogenreceptorinvascularendothelialcells.MethodsRadioim-munologywasusedtomeasuretheserumconcentrationofendothelinandPGI2,andcopper-cadmiumreductionwasemployedtomeasuretheserumcontentofnitrogenmonoxide.Radioligandbindingandflowcy-tometrywereusedtomeasuretheexpressionofestrogenreceptorandvascularcelladhesionmolecule(VCAM-1)ofvascularendothelialcellsrespectively.Results1.TheserumconcentrationofnitricoxideandPGI2decreasedwhentheovariesoffemaleratswereremoved.Inovariectomizedrats,givenestrogen,theconcentrationrose(P<0.05),buttheplasmaconcentrationofendothelinwasadversetoit.2.Theconcentrationofestrogenreceptorofvascularendothelialcel

简介：FollowingreparativesurgeryfortetralogyofFallotorcriticalpulmonarystenosis(PS),patientsfrequentlypresentwithsevererightventricular(RV)volumeoverloadduetopulmonaryregurgitation,resultingindecreasedRVfunction.Surgicalpulmonaryvalvereplacement(PVR)isknowntoimproveRVfunction,butchangesinleftventricular(LV)functionafterPVRhaverarelybeendescribed.WesoughttodeterminethemidtermresultsregardingLVsystolicfunctionafterPVRusingcardiacMRIin40consecutivepatientswithrepairedTOF(31patients)orPS(9patients)withanageof29±9yearswhounderwentPVRfrom2006to2011atasinglecenter.CardiacMRIRVandLVvolumesbeforeandafterPVRwereanalyzed.Demographics,clinicalvariables,cardiopulmonarybypassduration,andmedicationswerereviewed.LVejectionfraction(LVEF)increasedfrom(54±8)to(57±6)%(P=0.02).BeforePVR,26patientshaddepressedLVEFof(49±5)%(range36–54%).Inthisgroup,LVEFincreasedby(7±7)%(P<0.0001)afterPVR.LowLVEFbeforePVRwascorrelatedwithincreasedLVEFafterPVR(regressioncoefficient-0.7,R2=0.59,P<0.0001).Demographics,medications,priorpregnancies,andcardiopulmonarybypassdurationhadnoeffectonLVEFafterPVR.TheincreaseinLVEFwasmostsignificantinpatientswithlowpre-PVRLVEF.

简介：ObjectivesThestudywasperformedtoassesstheleftventricular(LV)regionalandglobaldiastolicfunction,leftventricularwallmotionfeaturesinpatientswithHypertrophiccardiomyopathybyQuantitativeTissueVelocityImaging(QTVI).Methods42patientswithhypertrophiccardiomyopathyand36age-matchednormalsubjectsunderwentQTVIstudy.Off-lineLVregionalmusculartissuevelocityImagingalongLVapicallong-axisviewwereobtained.RegionaldiastolicfunctionwasassessedinusingpeaktissuevelocitiesofLVregionalmusculartissueduringearlydiastole(Ve)andLAcontraction(Va),Ve/Varatio,derivedfromTissueVelocityImaging.Globaldiastolicfunctionwasreflectedbyisovolumicrelaxationtime(IRT)andmitralvalvepeakflowvelocity(E/A)calculatedwithpulsedwavedoppler.Theend-diastolicinterventricularseptalthickness(IVSt)wasmeasuredbyconventional2-dimensionechocardiography.Results①Ve,Va,Ve/Vainthesegmentsofhypertrophicinterventricularseptum(IVS)reducedwlhileE/AratiosignificantlyreducedandIRTmarkedlyprolongedinHCMpatientsthaninnormalsubjects.②Ve,Ve/VaweresignificantreducedinthesegmentsofhypertrophicinterventricularseptumcomparedwithotherLVsegmentsinHCMpatients.③TherewasacorrelationbetweenVe/VaandE/AinHCMpatientswithabnormalE/Aratio(r=0.70).④TherewasanegativecorrelationbetweenVe/VaandIVStinnon-obstructionHCMpatients(Bgroup,r=-0.61)ConclusionsQTVIoffersanewermethodinclinicalpracticewhichhasahighersensibilityandaccuracyinevaluatingtheLVregionalandglobaldiastolicfunctioninHCMpatients.

简介：BackgroundAcuteinferiorandanteriormyocardialinfarctionoftenleadstorightventricular(RV)functiondecrease.EstimationofRVfunctionischallengingduetothecomplexRVgeometry.Fewstudieshavebeenconductedtoinvestiogatetheeffectsofacutemyocardialinfarction(AMI)onrightventricularfunctions(RVFs).Two-dimensionSpeckleTrackingImaging(STI)isanovelmethodthatallowsforasegmentbasedmeasurementofmyocardialdeformationandmayhavethepotentialtoquantifyRVdysfunctionmorepreciselythantheconventionalparametersofRVfunction.Therefore,inthisstudyweanalyzedtheRVfunctioninAMIpatientsbyusingthisnoveltechnique.MethodsThirty-fourpatientswithacuteinferiormyocardialinfarction(AIMI),31patientswithacuteanteriormyocardialinfarction(AAMIand30agematchedhealthyindividualswereenrolledforthestudy.2Dspeckletrackingimaging(STI)wasusedtoobtain2Dimagingattheapicalfour-chamberviewunderrestcondition.Peaksystolicstrainsandstrainratesofallsegmentsinrightventricularfreewallwereanalyzed.ResultsComparedtothenormalcontrolgroup,longitudinalpeaksystolicstrain(ε),strainrate(SRs),earlydiastolicstrainrate(SRe)andlatediastolicstrainrate(SRa)inallsegmentsofrightventricularfreewallweresignificantlylowerinAMIpatients.ε,SRs,SReandSRaofeachsegmentofRVintheAIMIgroupweredecreasedsignificantlythanthoseofthenormalcontrolgroup(P<0.05).ε,SRs,SReandSRaofeachsegmentofRVintheAAMIgroupwerelowerthantheseinthecontrolgroup.ExceptforbasalsegmentalSRa,thereweresignificantdifferencesamongotherparameters(P<0.05).ConclusionsRVFsareimpairedinAMIpatients.RVFscouldbeaccuratelyandsensitivelyassessedwithSTI.

简介：ObjectivesThelong-termbenefitoflatereperfusionofinfarct-relatedartery(IRA)afteracutemyocardialinfarction(AMI)iscontroversial,andthebenefitmechanismsremainuncertain.Lowdosedobutaminestressechocardiography(LDSE)canidentifyviablemyocardiumandpredictimprovementofwallmotionafterrevascularization.MethodsSixty-ninepatientswithfirstAMIwhodidnotreceivedearlyreperfusiontherapywerestudiedbyLDSEat5to10daysafterAMI.Wallmotionabnormalityandleftventricularsizeweremeasuredatthesametime.SuccessfulPCIweredoneinallpatientsat10to21daysafterAMIonset.Patientsweredividedintwogroupsbasedonthepresenceorabsenceofviablemyocardium.Echocardiographywasrepeatedsixmonthslater.ResultsTherewere157motionabnormalitysegments.89segments(57%)wereviableduringLDSE.26patients(38%)withviabilityand43(62%)without.Inviablegroup,leftventricularejectionfraction(LVEF)wasincreased(P<0.05),andleftventricularendsystolicvolumeindex(LVESVI)andwallmotionscore(WMS)weredecreased(P<0.05andP<0.01)significantlyat6monthscomparedwithbaseline.Butinpatientswithoutviability,LVEFwasdecreased(P<0.01),andLVESVIandleftventricularenddiastolicvolumeindex(LVEDVI)wereincreased(P<0.05)significantlyafter6months,andtheWMSdidnotchanged(P>0.05).LVEFincreased(P<0.05)andWMSdecreased(P<0.05)onLDSEduringacutephaseinpatientswithviability,buttheywerenotchangedinthenonviablegroup.ConclusionsLaterevascularizationofIRAinpatientswithpresenceofviablemyocardiumafterAMIisassociatedwithlong-termpreservationleftventricularfunctionandlessventricularremodeling.ImprovementofleftventricularsystolicfunctiononLDSEindicateslatephaserecoveryofleftventricularfunctionafterlaterevascularization.

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简介：ObjectivesTocomparethedifferenteffectsoflatesuccessfulreperfusionwithPCIonleftventricularfunctionanditsrelationshipwithviablemyocardiumafteracuteanteriorwallmyocardialinfarctioninpatientswithorwithoutdiabetes.MethodsAtotalof125consecutivesubjectswithacuteanteriorwallmyocardialinfarctionwereselected,anddividedintodiabetesmellitus(DM)group(n=43)andNon-DMgroup(n=82)accordingtoWHOdiabetesdiagnosiscriteria.AllpatientsreceivedsuccessfulPCIat12±8daysfromonset.Ischemicviablemyocardiumwasdetectedwithlow-dosedobutamineechocardiography,andleftventricularfunctionandwallmotionabnormalitywerealsoassessedwithechocardiographybeforePCI.ThedataofclinicalmanifestationsandangiogramsbeforeandafterPCIwereanalyzed.Levelsofcreatininekinase-MB(CK-MB),andtroponinT(TnT)beforePCI,6hoursand24hoursafterPCIwereassessed.Allpatientsreceivedclinicandechocardiographyfollow-upfor6months.ResultsHigherrateofTIMI2flow,andlowerrateofTIMI3flowinDMgroupweredemonstratedimmediatelyafterPCI,andtherateofserumCK-MBand/orTnTlevelswerehigherinDMgroup,comparedwithNon-DMgroup(P<0.05).63%ofDMpatientsand56%ofnon-DMpatientshadviablemyocardiumbeforePCI(P>0.05).Therewerenosignificantdifferencesofleftventricularejectionfraction(LVEF),leftventricularenddiastolicvolumeindex(LVEDVI),leftventricularendsystolicvolumeindex(LVESVI),andwallmotionscore(WMS)betweentwogroupsatbaselinebeforePCI(P>0.05).Aftersixmonths,WMSwasdecreasedandLVEFwasincreasedinNon-DMgroup,buttheWMSandtheLVEFdidnotchanged,andtheLVEDVIwasincreasedinDMgroupcomparedwithbaseline;theLVEDVI,LVESVI,LVEF,andWMSweresignificantlydifferentbetweentwogroups(P<0.05orP<0.01).ConclusionsComparedwithnon-diabetics,delayedsuccessfulrevascularizationwithPCIindiabeticspatientwithacutemyocardialinfarctionhaslessbenefitialeffectontheimprovementoflatephasel

简介：BackgroundTotheeffectofpercutaneouscoronaryintervention(PCI)onplasmalevelofN-terminalpro-Btypenatriureticpeptide(NT-proBNP)inpatientswithcoronaryheartdisease(CHD)andnormalleftventricularfunction.MethodsOnehundredandfivepatientswithCHDandnormalventricularfunctionwereenrolled.BloodsamplesforassessmentofNT-proBNPandcTn-TwerecollectedbeforeandafterPCI.ResultsThemeanleftventricularejectionfractionwas60.3±5.3%.Afterrevascularization,theleveloflgNT-proBNPwassignificantlyreduced(2.40±0.44vs2.23±0.43,P<0.001).SubgroupanalysisshowedthattheleveloflgNT-proBNPwasconsistentlydecreasedindifferentclinicalclassifications(stableangina45,unstableangina31andacutemyocardialinfarction29)andtarget-vesselrevascularization(leftanteriordescendingartery30,leftcircumflexartery26andrightcoronaryartery49),andin99patientswithoutelevationofpost-proceduralcTnT,butitshowedatrendofnon-significantincreasein6patientswithelevatedcTn-T.ConclusionsOurstudydemonstratesthatsuccessfulPCIreducesplasmaNT-proBNPconcentrationinpatientswithCHDandnormalventricularfunction.ThisimplicatesthattheimpactofPCIshouldbeconsideredintheinterpretationofNT-proBNPchangeinclinicalpractice,andfurtherstudiesarenecessarytoinvestigatethedirectand/orindirecteffectofmyocardialischemiaonBNP/NT-proBNP.

简介：ObjectiveTocomparetheacutehemodynamiceffectsoffivedifferentpacingmodesinpatientswithcardiacfunctionNYHAclassⅠtoⅡwithoutbundlebranchblock(BBB).MethodsThisstudyincluded12patients(SSS7,Ⅲ°AVB5)undergoingpacemakerimplantation.Rightventricularapex(RVA),rightventricularoutflowtract(RVOT),rightventricularbifocal(RV-Bi),leftventricularbase(LVB)andbi-ventricular(Bi-V)pacingat60-80ppmweredoneinVVImodepriortoimplantationofDDDpacemaker.Thecardiacindex(CI),meanpulmonaryarterypressure(mPAP)andpulmonarycapillarywedgepressure(PCWP)weremeasuredwithSwan-Ganzthermodilutioncatheterafter5minutesofeachpacingmode.Results(1)ComparingtopacingatRVA(CI:2.41±0.38L/minperm2,PCWP:16.7±3.3mmHg),theCIincreasedandthePCWPdecreasedsignificantlyinpacingatRVOT(CI:2.63±0.46,PCWP:13.8±2.3),LVB(CI:2.78±0.52,PCWP:14.4±3.1),RV-Bi(CI:2.83±0.57,PCWP:12.8±2.5)andBi-Vpacing(CI:2.

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简介：BackgroundCoronaryslowflow(CSF)duringprimarypercutaneouscoronaryintervention(PCI)iscloselyrelatedtotheprognosisofpatientswithacutemyocardialinfarction(AMI).WhetherEnhancedExternalCounterPulsation(EECP)couldimprovethephenomenonandenhancecardiacfunctioninthesepatientshasnotbeenstudied.MethodsSeventy-eightAMIpatientsundergoingprimaryPCIwereenrolledanddividedinto2groups,EECPgroupandshamgroup.InEECPgroup,thepatientsweretreatedwithEECPfor30minaftercoronaryarterystentimplantation;andinshamgroup,thepatientsaftercoronaryarterystentimplantationweretreatedwithcuffswrappedfor30min.HemodynamicsandcorrectedTIMIFrameCount(cTFC)wererecordedatdifferenttimepointsinbothgroups.CRP,HCY,NT-proBNPandKillipclasswerealsodetectedbeforeoperationandaftertreatment.ResultsInEECPgroup,comparedtopre-andpost-EECPtreatment,thesystolicbloodpressure(SBP)wasmuchlower(P<0.05),diastolicbloodpressure(DBP)andmeanarterialbloodpressure(MBP)weremuchhigher(P<0.05).Theheartrate(HR)wasnotchangedduringEECPtreatment(P>0.05).Inshamgroup,SBP,DBP,MBPandHRwerenotsignificantlychangedduringtheseperiod(P>0.05).InEECPgroup,thecTFCofpatientswithCSFdecreasedsignificantlyaftertreatment(P<0.05);andtherewasnodifferenceinshamgroup(P>0.05).Comparedwithpre-EECPtreatment,CRPandHCYwereincreasedinpost-EECPtreatmentofbothgroups(P<0.05),while,theyweremuchlowerinEECPgroup(P<0.05).TheexpressionofNTproBNPwasdecreasedaftertreatmentinbothgroups(P<0.05),anditwasmuchlowerinEECPgroupthaninshamgroup(P<0.05).TheKillipclasswasmuchloweraftertreatmentthanbeforeoperationinEECPgroup(P<0.05),andtherewasnochangeinshamgroup(P>0.05).ConclusionsTheresultssuggestthatEECPishelpfulinashorttimetotheimprovementofCSFandrecoveryofcardiacfunctioninAMIpatientsduringprimaryPCI,andthatCRPandHCYmaybeinvolvedinthispr