BACKGROUND Chronic heart failure(CHF)is a severe cardiovascular disease that significantly threatens human health.Depression,a common comorbidity,may substantially impact cardiac structure and function.However,the exa...BACKGROUND Chronic heart failure(CHF)is a severe cardiovascular disease that significantly threatens human health.Depression,a common comorbidity,may substantially impact cardiac structure and function.However,the exact relationship between depression and cardiac remodeling and left ventricular functional changes remains incompletely understood.This study sets out to explore,with a clinically grounded perspective,how depressive states may subtly or profoundly influence the trajectory of cardiac remodeling and the functional dynamics of the left ventricle in individuals grappling with CHF.Beyond mere observation,it also aims to untangle the underlying physiological or neurohormonal pathways that might bridge emotional distress and cardiac dysfunction.AIM To delve into how depressive symptoms might shape the progression of cardiac remodeling and impair left ventricular function among individuals living with CHF.Particular attention is given to the role of inflammatory signaling and disruptions in neuroendocrine balance as possible mediating factors.By examining these intertwined physiological and psychological processes,the study seeks to shed light on the reciprocal link between emotional distress and CHF,offering insights that may inform more precise,mechanism-based treatment strategies.METHODS In this retrospective clinical trial,248 patients diagnosed with CHF were analyzed in the tertiary treatment center between January 2018 and December 2022.According to Hamilton's Depression Scale score,participants were classified into two cohort of depression(score 17)and no significant depression characteristics(score 17).Cardiac morphology and functional parameters were assessed using a combination of hyperechocardiocardiocardiography,heart magnetic resonance,and associated blood biomarkers.RESULTS The results of this study underscore the significant effects that depression can have on both the structure and function of the heart in patients with CHF.In particular,the individuals in the cohort with depression were 42.3%±6.7%of the individuals without depression vs 51.6%±5.9%,P<0.01)In comparison,the left ventricular ejection fraction,an important measure of contractional performance,was significantly reduced,underlining the harmful physiological interaction between mood disorders and cardiac efficiency.The measurement of the left ventricular end-diastolic diameter showed a significant expansion of the ventricular envelope in the depression group(68.2±7.5 mm vs 59.6±6.3 mm,P<0.01).Inflammatory markers,including high-sensitivity C-reactive protein(hs-CRP)and tumor necrosis factor-α(TNF-α),were significantly elevated in the depressed group(hs-CRP:8.7±2.3 mg/L vs 4.5±1.6 mg/L;TNF-α:42.5±7.6 pg/mL vs 28.3±5.4 pg/mL).Both B-type natriuretic peptide(1256±345 pg/mL vs 756±234 pg/mL)and angiotensin II(86.4±15.7 ng/mL vs 62.5±12.3 ng/mL)levels were significantly higher in the depressed group.CONCLUSION Among people with CHF,the presence of depressive symptoms appears to be closely related to pronounced changes in heart structure and impaired functional abilities.It is likely that depressive states contribute to the progress of heart reform and deterioration of left stomach function,possibly due to increased inflammatory cascades and increased activation of neuroendocrine regulatory pathways.展开更多
Objective A novel index based on fi-equency-domain analysis of heart rate variability （HRV） was tested on patients with reduced left ventricular systolic function. This index, namely VHFI, was defined as the very hi...Objective A novel index based on fi-equency-domain analysis of heart rate variability （HRV） was tested on patients with reduced left ventricular systolic function. This index, namely VHFI, was defined as the very high frequency （VHF） component of the power spectrum normalized to represent its relative value in proportion to the total power minus the very low frequency component. Methods Patients （n = 130） were divided into a study group, consisting 66 patients with decreased left ventricular systolic function, and a control group, consisting 64 patients with normal heart structure and function and without severe coronary artery stenosis （〈 50%）. Results VHFI in the study group was significantly higher than that in the control group （19.17 ± 13.35 vs 11.37 ± 10.77, P 〈 0.001）. Cardiac events occurred in 18 patients during follow-up （33.34 i 3.26 months）. Defining the positive test as VHFI =15 and negative test as VHFI 〈15, achieved a sensitivity of 57.58% and a specificity of78.13% for predicting decreased left ventricular systolic function, and achieved a sensitivity of 66.67% and a specificity of 64.29% for predicting cardiac events. Univariate Cox regression analysis showed that positive VHFI test was an independent variable in predictive cardiac events. Conclusions The results suggest that VHFI is a useful tool for quick evaluation of left ventricular systolic function and prediction of prognosis展开更多
Cardiovascular magnetic resonance (CMR) has become a reference standard for the measure-ment of cardiac volumes, function, and mass. This study aims to reconstruct three dimen-sional modeling of the left ventricle (LV...Cardiovascular magnetic resonance (CMR) has become a reference standard for the measure-ment of cardiac volumes, function, and mass. This study aims to reconstruct three dimen-sional modeling of the left ventricle (LV) in pa-tients with heart failure (HF) using CMRtools and thereby derive the LV functional indices. CMR images were acquired in 41 subjects (6 females) with heart failure (HF) and 12 normal controls (4 females). Five comparisons were made (i) nor-mal and dilated heart failure subjects, (ii) male and female normal heart, (iii) male and female dilated heart, (iv) male normal and dilated heart failure and (v) female normal and dilated heart failure. In HF, a significant higher values of EDV (320 刡 79 vs. 126 刡 22 ml, P&amp;amp;amp;amp;lt;0.0001), ESV (255 刡 68 vs. 54 刡 12 ml, P&amp;amp;amp;amp;lt;0.00001) and lower values of EF (20 刡 7 vs. 58 刡 5 %) were found compared that of normal control. There were significant difference on LV EDV and ESV between sex in both normal and HF subjects.展开更多
Objective: To investigate the effect of telmisartan combined with Nifedipine Controlled Release Tablet on inflammatory factors, vascular endothelial function and left ventricular function in patients with coronary hea...Objective: To investigate the effect of telmisartan combined with Nifedipine Controlled Release Tablet on inflammatory factors, vascular endothelial function and left ventricular function in patients with coronary heart disease with mild to moderate hypertension. Methods:A total of 92 cases of patients with coronary heart disease with mild to moderate hypertension were selected as the object of observation, according to the random data table, they were divided into the control group (n=46) and observation group (n=46), and patients in the control group were treated with Nifedipine Controlled Release Table therapy, on this basis, the observation group patients were given telmisartan treatment, two groups were treated for 6 months. The levels of the blood pressure, inflammatory factors, vascular endothelial function and left ventricular function compared between the two groups before and after treatment. Results: There were no significant differences in the levels of SBP, DBP, hs-CRP, TNF-α, NO, ET-1, LVEF, LVEDD and LVESD in the two groups before treatment. After treatment, two groups of SBP, DBP, hs-CRP, TNF-α, ET-1, LVEDD and LVESD levels were significantly lower than those in the same group before treatment, and after treatment, the levels of SBP, DBP, hs-CRP, TNF-α, ET-1 and LVESD in the observation group were significantly lower than those in the control group, while there were no significant difference in the level of LVEDD between the two groups after treatment;Compared with level in the group before treatment, the levels of NO and LVEF in the two groups were significantly increased, and the observation group [(82.13±19.01) μmol/L, (52.83±7.45)%] was significantly higher than the control group ((67.37±13.08) μmol/L, (49.47±6.96)%)Conclusion: Telmisartan combined with Nifedipine Controlled Release Table in treating coronary heart disease with mild to moderate hypertension, can effectively control blood pressure, reduce the inflammatory stress, improve vascular endothelial function and left ventricular function of patients, has an important clinical value.展开更多
Fifty-six patients with chest pain underwent selective coronaryangiography,radionuclide ventriculography (RNV) and frequency domaincardiography (FCG) to evaluate left ventricular function in coronary artery dis-ease (...Fifty-six patients with chest pain underwent selective coronaryangiography,radionuclide ventriculography (RNV) and frequency domaincardiography (FCG) to evaluate left ventricular function in coronary artery dis-ease (CAD).The sensitivity,specificity and accuracy of FCG were 87.5%,77.8%and 82.9%,respectively,which were slightly less than those of RNV (92.5%,88.9% and 90.8%,respectively).The changes of FCG scores were negatively corre-lated with changes of LVEF (r=-0.586,P【0.01),and TS (r=-0.679,P【0.01).These results indicate that FCG may be useful for the evaluation of leftventricular function in patients with CAD.展开更多
Background The effects of trimetazidine on patients with dilated cardiomyopathy（DCM） and left bundle branch block（LBBB） are not clear. Methods Sixty consecutive patients with DCM, LBBB and heart dysfunction（35% ...Background The effects of trimetazidine on patients with dilated cardiomyopathy（DCM） and left bundle branch block（LBBB） are not clear. Methods Sixty consecutive patients with DCM, LBBB and heart dysfunction（35% ≤ LVEF ≤ 45%） were randomly allocated to heart failure therapy plus trimetazidine group（20 mg three times a day; 30 patients） or heart failure therapy alone group（30 patients）. During follow-up of 6months, QRS morphology, plasma NT-proBNP, 6-minute walk test（6MWT） and echocardiographic indexes were measured. Results At the 6th month, a significant functional improvement was noted in patients receiving trimetazidine added to heart failure treatment. In patients from the trimetazidine group, an increase of left ventricular ejection fraction（LVEF） was noted（from 38 ± 5.5% to 47 ± 7.1%, P = 0.020）. The increase of LVEF in the trimetazidine group was associated with a more significant reduction of the left ventricular endsystolic diameter（LVESD） compared with the control group at 6-month follow-up. The NT-pro BNP levels decreased significantly in the trimetazidine group（3.11 ± 0.47 at baseline and 2.77 ± 0.45 at 6-month followup, P 〈 0.01） and the 6MWT increased significantly in the trimetazidine group（325 ± 44 m at baseline and419 ± 56 m at 6-month follow-up, P 〈 0.01）. The differences in NT-pro BNP levels（2.77 ± 0.45 vs 2.96 ±0.46, P = 0.036） and 6MWT（419 ± 56 m vs 366 ± 54 m, P = 0.032） between the two groups were significant at 6-month follow-up. Conclusions Trimetazidine can improve LV function caused by DCM and LBBB. The positive effects of trimetazidine on LV function are especially evident in patients with optimization of drug therapy for heart failure, which strongly suggests an additive effect of these therapy modalities.展开更多
Isoptin SR was used in 65 essential hypertensive patients.240mg Isoptin SR(German Knoll Pharmaceutical company) Per day was used in group A(35 cases)for 6 weeks,and in guoup B(30 cases)for 24 weeks,BP in group a and B...Isoptin SR was used in 65 essential hypertensive patients.240mg Isoptin SR(German Knoll Pharmaceutical company) Per day was used in group A(35 cases)for 6 weeks,and in guoup B(30 cases)for 24 weeks,BP in group a and B decreased obviously in the first and second week after treament.展开更多
BACKGROUND Coronary heart disease(CHD)causes many adverse cardiovascular events and poses a threat to the patient’s health and quality of life.AIM To evaluate ultrasonography for evaluation of cardiac function and le...BACKGROUND Coronary heart disease(CHD)causes many adverse cardiovascular events and poses a threat to the patient’s health and quality of life.AIM To evaluate ultrasonography for evaluation of cardiac function and lesion degree in patients with CHD.METHODS A total of 106 patients with CHD(study group)and 106 healthy individuals(control group)in our hospital from March 2019 to September 2020 were selected for this study.All subjects were examined by ultrasound,and the mitral orifice’s early-to-late diastolic blood flow velocity ratio(E/A),left ventricular end-diastolic volume(LVDd),and left atrial diameter(LAD)were measured.Values were compared between the study group and healthy group,and the correlation between the ultrasonic parameters of patients with different cardiac function grades and the degree of CHD were assessed.In addition,the ultrasonic parameters of patients with different prognoses were compared after a follow-up for 6 mo.RESULTS E/A(1.46±0.34)of the study group was smaller than that of the control group(1.88±0.44),while LVDd(58.24±5.05 mm)and LAD(43.31±4.38 mm)were larger(48.15±3.93 and 34.94±2.81,respectively;P<0.05).E/A for patients with grade III disease(1.41±0.43)was smaller and their LVDd(60.04±4.21 mm)and LA(44.16±2.79 mm)were larger than those in patients with grade II disease(1.71±0.48,52.18±3.67 mm,and 39.68±2.37,respectively;P<0.05).Patients with grade IV disease had smaller E/A(1.08±0.39)and larger LVDd(66.81±5.39 mm)and LAD(48.81±3.95 mm)than patients with grade II and III disease(P<0.05).In patients with moderate disease,E/A(1.44±0.41)was smaller and LVDd(59.95±4.14 mm)and LAD(45.15±2.97 mm)were larger than in patients with mild disease(1.69±0.50,51.97±3.88 and 38.81±2.56 mm,respectively;P<0.05).In patients with severe disease,E/A(1.13±0.36)was smaller and LVDd(67.70±6.11 mm)and LAD(49.09±4.05 mm)were larger than in patients with moderate disease(P<0.05).E/A was negatively correlated with cardiac function classi-fication and disease severity,while LVDd and LAD were positively correlated with cardiac function classification and disease severity(P<0.05).E/A(1.83±0.51)for patients with good prognosis was higher than that for those with poor prognosis(1.39±0.32),while LVDd(49.60±4.39 mm)and LAD(36.13±3.05 mm)were lower(P<0.05).CONCLUSION The ultrasonic parameters of patients with CHD are abnormal,and differ significantly in patients with different cardiac function grades,lesion degree,and prognosis.展开更多
The present study investigated the application of echocardiography to evaluation of cardiac dyssynchrony in patients with congestive heart failure（CHF）. A total of 348 consecutive CHF patients who were admitted for ...The present study investigated the application of echocardiography to evaluation of cardiac dyssynchrony in patients with congestive heart failure（CHF）. A total of 348 consecutive CHF patients who were admitted for cardiac resynchronization（CRT） and presented with low ejection fraction（EF） and wide QRS duration were enrolled in this study, along with 388 healthy individuals. Dyssynchrony was assessed based on filling time ratio（FT/RR）, left ventricular pre-ejection delay（PED）, interventricular mechanical delay（IVMD）, longitudinal opposing wall delay（LOWD） and radial septal to posterior wall delay（RSPWD）. Response to CRT was defined as a ≥15% increase in EF. The results showed that FT/RR was decreased while PED, IVMD, LOWD and RSPWD were increased in the CHF group compared with the control group（P〈0.01）. In the CHF group, FT/RR was negatively correlated with the QRS duration, LV end-diastolic diameter（LVESd）, LV end-diastolic volume（LVEDV） and LV end-systolic volume（LVESV）（P〈0.01）, but positively with the LVEF（P〈0.01）. Additionally, PED, IVMD, LOWD and RSPWD were positively correlated with the QRS duration, LVESd, LVEDV and LVESV（P〈0.01）, but negatively with the LVEF（P〈0.01）. The CHF group was divided into three subgroups according to the varying degrees of LVEF. FT/RR decreased successively from the LVEF-1 group to the LVEF-2 group to the LVEF-3 group, while the PED, IVMD, LOWD and RSPWD successively increased in the same order（P〈0.01）. The CHF group was divided into three subgroups according to the varying degrees of QRS duration, and FT/RR decreased successively in a sequence from the QRS-1 group to the QRS-2 group to the QRS-3 group, while the PED, IVMD, LOWD and RSPWD successively increased in the same order（P〈0.01）. Speckle tracking radial dyssynchrony ≥130 ms was predictive of an EF response in patients in QRS-1 group（78% sensitivity, 83% specificity）, those in QRS-2 group（83% sensitivity, 77% specificity） and in QRS-3 group（89% sensitivity, 79% specificity）. In conclusion, echocardiography is a convenient and sensitive method for evaluating cardiac dyssynchrony in patients with CHF.展开更多
Approximately 50% of all heart failure patients in the US are above 75 years of age, which is almost similar to most European countries and the Middle and the Far East. Even though aging is an independent molecular pr...Approximately 50% of all heart failure patients in the US are above 75 years of age, which is almost similar to most European countries and the Middle and the Far East. Even though aging is an independent molecular process with a multitude of genetic predetermination and biochemical mediations, aging itself does not automatically result in cardiac insufficiency. On the other hand, with increasing age, cardioprotective mechanisms in response to stress are lost, and progressive cardiomyocyte degeneration with replace- ment fibrosis is often seen in older hearts, even though the exact triggers are not completely understood. Older patients with heart failure have distinct features that require special attention in diagnosis as well as therapy. The elderly more frequently suffer from multiple co-morbidities and might have atypical clinical presentations. Several precautions are essential in the treatment of heart failure in the elderly due to co-existing morbidities and the pharmacokinetic and pharmacodynamic changes related to increased age. Also, treatment expectations, compliance, mental status and cognitive function might play a major role regarding optimized treatment and monitoring options in the elderly suffering from heart failure. This review summarizes current issues of heart failure management in the elderly.展开更多
Therapy with glucagon-like peptide 1(GLP1)receptor agonists has raised great interest for its beneficial cardiovascular effects in preventing atherosclerosis and heart failure-related outcomes.However,while evidence a...Therapy with glucagon-like peptide 1(GLP1)receptor agonists has raised great interest for its beneficial cardiovascular effects in preventing atherosclerosis and heart failure-related outcomes.However,while evidence about atherosclerosis consistently suggests a cardioprotective potential with class effect,controversies remain on its impact on heart failure.GLP1 receptor agonists appear to prevent hospitalization for new-onset heart failure and reduce symptoms in heart failure with preserved ejection fraction(as demonstrated by the recent STEP-HFpEF Trial).Still,GLP1 agonism has resulted in neutral or even harmful effects in patients with established heart failure with reduced ejection fraction(the LIVE trial).GLP1 receptor agonists benefit the cardiovascular system indirectly through their marked metabolic effects(improved weight management,glycemic control,blood pressure,systemic and tissue inflammation),while direct effects on the heart have been questioned.Nonetheless,weight loss alone achieved through GLP1 receptor agonists has failed in improving left ventricular functions.Tirzepatide is a dual agonist of GLP1 and glucose-dependent insulinotropic polypeptide,representing an innovative treatment option in diabetes with a major impact on weight loss and promising cardiovascular benefits.Whether this class of therapies is going to change the history of heart failure is an ongoing debate.展开更多
文摘BACKGROUND Chronic heart failure(CHF)is a severe cardiovascular disease that significantly threatens human health.Depression,a common comorbidity,may substantially impact cardiac structure and function.However,the exact relationship between depression and cardiac remodeling and left ventricular functional changes remains incompletely understood.This study sets out to explore,with a clinically grounded perspective,how depressive states may subtly or profoundly influence the trajectory of cardiac remodeling and the functional dynamics of the left ventricle in individuals grappling with CHF.Beyond mere observation,it also aims to untangle the underlying physiological or neurohormonal pathways that might bridge emotional distress and cardiac dysfunction.AIM To delve into how depressive symptoms might shape the progression of cardiac remodeling and impair left ventricular function among individuals living with CHF.Particular attention is given to the role of inflammatory signaling and disruptions in neuroendocrine balance as possible mediating factors.By examining these intertwined physiological and psychological processes,the study seeks to shed light on the reciprocal link between emotional distress and CHF,offering insights that may inform more precise,mechanism-based treatment strategies.METHODS In this retrospective clinical trial,248 patients diagnosed with CHF were analyzed in the tertiary treatment center between January 2018 and December 2022.According to Hamilton's Depression Scale score,participants were classified into two cohort of depression(score 17)and no significant depression characteristics(score 17).Cardiac morphology and functional parameters were assessed using a combination of hyperechocardiocardiocardiography,heart magnetic resonance,and associated blood biomarkers.RESULTS The results of this study underscore the significant effects that depression can have on both the structure and function of the heart in patients with CHF.In particular,the individuals in the cohort with depression were 42.3%±6.7%of the individuals without depression vs 51.6%±5.9%,P<0.01)In comparison,the left ventricular ejection fraction,an important measure of contractional performance,was significantly reduced,underlining the harmful physiological interaction between mood disorders and cardiac efficiency.The measurement of the left ventricular end-diastolic diameter showed a significant expansion of the ventricular envelope in the depression group(68.2±7.5 mm vs 59.6±6.3 mm,P<0.01).Inflammatory markers,including high-sensitivity C-reactive protein(hs-CRP)and tumor necrosis factor-α(TNF-α),were significantly elevated in the depressed group(hs-CRP:8.7±2.3 mg/L vs 4.5±1.6 mg/L;TNF-α:42.5±7.6 pg/mL vs 28.3±5.4 pg/mL).Both B-type natriuretic peptide(1256±345 pg/mL vs 756±234 pg/mL)and angiotensin II(86.4±15.7 ng/mL vs 62.5±12.3 ng/mL)levels were significantly higher in the depressed group.CONCLUSION Among people with CHF,the presence of depressive symptoms appears to be closely related to pronounced changes in heart structure and impaired functional abilities.It is likely that depressive states contribute to the progress of heart reform and deterioration of left stomach function,possibly due to increased inflammatory cascades and increased activation of neuroendocrine regulatory pathways.
文摘Objective A novel index based on fi-equency-domain analysis of heart rate variability （HRV） was tested on patients with reduced left ventricular systolic function. This index, namely VHFI, was defined as the very high frequency （VHF） component of the power spectrum normalized to represent its relative value in proportion to the total power minus the very low frequency component. Methods Patients （n = 130） were divided into a study group, consisting 66 patients with decreased left ventricular systolic function, and a control group, consisting 64 patients with normal heart structure and function and without severe coronary artery stenosis （〈 50%）. Results VHFI in the study group was significantly higher than that in the control group （19.17 ± 13.35 vs 11.37 ± 10.77, P 〈 0.001）. Cardiac events occurred in 18 patients during follow-up （33.34 i 3.26 months）. Defining the positive test as VHFI =15 and negative test as VHFI 〈15, achieved a sensitivity of 57.58% and a specificity of78.13% for predicting decreased left ventricular systolic function, and achieved a sensitivity of 66.67% and a specificity of 64.29% for predicting cardiac events. Univariate Cox regression analysis showed that positive VHFI test was an independent variable in predictive cardiac events. Conclusions The results suggest that VHFI is a useful tool for quick evaluation of left ventricular systolic function and prediction of prognosis
文摘Cardiovascular magnetic resonance (CMR) has become a reference standard for the measure-ment of cardiac volumes, function, and mass. This study aims to reconstruct three dimen-sional modeling of the left ventricle (LV) in pa-tients with heart failure (HF) using CMRtools and thereby derive the LV functional indices. CMR images were acquired in 41 subjects (6 females) with heart failure (HF) and 12 normal controls (4 females). Five comparisons were made (i) nor-mal and dilated heart failure subjects, (ii) male and female normal heart, (iii) male and female dilated heart, (iv) male normal and dilated heart failure and (v) female normal and dilated heart failure. In HF, a significant higher values of EDV (320 刡 79 vs. 126 刡 22 ml, P&amp;amp;amp;amp;lt;0.0001), ESV (255 刡 68 vs. 54 刡 12 ml, P&amp;amp;amp;amp;lt;0.00001) and lower values of EF (20 刡 7 vs. 58 刡 5 %) were found compared that of normal control. There were significant difference on LV EDV and ESV between sex in both normal and HF subjects.
文摘Objective: To investigate the effect of telmisartan combined with Nifedipine Controlled Release Tablet on inflammatory factors, vascular endothelial function and left ventricular function in patients with coronary heart disease with mild to moderate hypertension. Methods:A total of 92 cases of patients with coronary heart disease with mild to moderate hypertension were selected as the object of observation, according to the random data table, they were divided into the control group (n=46) and observation group (n=46), and patients in the control group were treated with Nifedipine Controlled Release Table therapy, on this basis, the observation group patients were given telmisartan treatment, two groups were treated for 6 months. The levels of the blood pressure, inflammatory factors, vascular endothelial function and left ventricular function compared between the two groups before and after treatment. Results: There were no significant differences in the levels of SBP, DBP, hs-CRP, TNF-α, NO, ET-1, LVEF, LVEDD and LVESD in the two groups before treatment. After treatment, two groups of SBP, DBP, hs-CRP, TNF-α, ET-1, LVEDD and LVESD levels were significantly lower than those in the same group before treatment, and after treatment, the levels of SBP, DBP, hs-CRP, TNF-α, ET-1 and LVESD in the observation group were significantly lower than those in the control group, while there were no significant difference in the level of LVEDD between the two groups after treatment;Compared with level in the group before treatment, the levels of NO and LVEF in the two groups were significantly increased, and the observation group [(82.13±19.01) μmol/L, (52.83±7.45)%] was significantly higher than the control group ((67.37±13.08) μmol/L, (49.47±6.96)%)Conclusion: Telmisartan combined with Nifedipine Controlled Release Table in treating coronary heart disease with mild to moderate hypertension, can effectively control blood pressure, reduce the inflammatory stress, improve vascular endothelial function and left ventricular function of patients, has an important clinical value.
文摘Fifty-six patients with chest pain underwent selective coronaryangiography,radionuclide ventriculography (RNV) and frequency domaincardiography (FCG) to evaluate left ventricular function in coronary artery dis-ease (CAD).The sensitivity,specificity and accuracy of FCG were 87.5%,77.8%and 82.9%,respectively,which were slightly less than those of RNV (92.5%,88.9% and 90.8%,respectively).The changes of FCG scores were negatively corre-lated with changes of LVEF (r=-0.586,P【0.01),and TS (r=-0.679,P【0.01).These results indicate that FCG may be useful for the evaluation of leftventricular function in patients with CAD.
基金supported by Science and Technology Key Foundation of Guangdong Province(No.2010B031600166)the Science and Technology Foundation of Guangdong Province(No.2011B061300072)the Natural Science Foundation of Guangdong Province(No.7001020)
文摘Background The effects of trimetazidine on patients with dilated cardiomyopathy（DCM） and left bundle branch block（LBBB） are not clear. Methods Sixty consecutive patients with DCM, LBBB and heart dysfunction（35% ≤ LVEF ≤ 45%） were randomly allocated to heart failure therapy plus trimetazidine group（20 mg three times a day; 30 patients） or heart failure therapy alone group（30 patients）. During follow-up of 6months, QRS morphology, plasma NT-proBNP, 6-minute walk test（6MWT） and echocardiographic indexes were measured. Results At the 6th month, a significant functional improvement was noted in patients receiving trimetazidine added to heart failure treatment. In patients from the trimetazidine group, an increase of left ventricular ejection fraction（LVEF） was noted（from 38 ± 5.5% to 47 ± 7.1%, P = 0.020）. The increase of LVEF in the trimetazidine group was associated with a more significant reduction of the left ventricular endsystolic diameter（LVESD） compared with the control group at 6-month follow-up. The NT-pro BNP levels decreased significantly in the trimetazidine group（3.11 ± 0.47 at baseline and 2.77 ± 0.45 at 6-month followup, P 〈 0.01） and the 6MWT increased significantly in the trimetazidine group（325 ± 44 m at baseline and419 ± 56 m at 6-month follow-up, P 〈 0.01）. The differences in NT-pro BNP levels（2.77 ± 0.45 vs 2.96 ±0.46, P = 0.036） and 6MWT（419 ± 56 m vs 366 ± 54 m, P = 0.032） between the two groups were significant at 6-month follow-up. Conclusions Trimetazidine can improve LV function caused by DCM and LBBB. The positive effects of trimetazidine on LV function are especially evident in patients with optimization of drug therapy for heart failure, which strongly suggests an additive effect of these therapy modalities.
文摘Isoptin SR was used in 65 essential hypertensive patients.240mg Isoptin SR(German Knoll Pharmaceutical company) Per day was used in group A(35 cases)for 6 weeks,and in guoup B(30 cases)for 24 weeks,BP in group a and B decreased obviously in the first and second week after treament.
文摘BACKGROUND Coronary heart disease(CHD)causes many adverse cardiovascular events and poses a threat to the patient’s health and quality of life.AIM To evaluate ultrasonography for evaluation of cardiac function and lesion degree in patients with CHD.METHODS A total of 106 patients with CHD(study group)and 106 healthy individuals(control group)in our hospital from March 2019 to September 2020 were selected for this study.All subjects were examined by ultrasound,and the mitral orifice’s early-to-late diastolic blood flow velocity ratio(E/A),left ventricular end-diastolic volume(LVDd),and left atrial diameter(LAD)were measured.Values were compared between the study group and healthy group,and the correlation between the ultrasonic parameters of patients with different cardiac function grades and the degree of CHD were assessed.In addition,the ultrasonic parameters of patients with different prognoses were compared after a follow-up for 6 mo.RESULTS E/A(1.46±0.34)of the study group was smaller than that of the control group(1.88±0.44),while LVDd(58.24±5.05 mm)and LAD(43.31±4.38 mm)were larger(48.15±3.93 and 34.94±2.81,respectively;P<0.05).E/A for patients with grade III disease(1.41±0.43)was smaller and their LVDd(60.04±4.21 mm)and LA(44.16±2.79 mm)were larger than those in patients with grade II disease(1.71±0.48,52.18±3.67 mm,and 39.68±2.37,respectively;P<0.05).Patients with grade IV disease had smaller E/A(1.08±0.39)and larger LVDd(66.81±5.39 mm)and LAD(48.81±3.95 mm)than patients with grade II and III disease(P<0.05).In patients with moderate disease,E/A(1.44±0.41)was smaller and LVDd(59.95±4.14 mm)and LAD(45.15±2.97 mm)were larger than in patients with mild disease(1.69±0.50,51.97±3.88 and 38.81±2.56 mm,respectively;P<0.05).In patients with severe disease,E/A(1.13±0.36)was smaller and LVDd(67.70±6.11 mm)and LAD(49.09±4.05 mm)were larger than in patients with moderate disease(P<0.05).E/A was negatively correlated with cardiac function classi-fication and disease severity,while LVDd and LAD were positively correlated with cardiac function classification and disease severity(P<0.05).E/A(1.83±0.51)for patients with good prognosis was higher than that for those with poor prognosis(1.39±0.32),while LVDd(49.60±4.39 mm)and LAD(36.13±3.05 mm)were lower(P<0.05).CONCLUSION The ultrasonic parameters of patients with CHD are abnormal,and differ significantly in patients with different cardiac function grades,lesion degree,and prognosis.
文摘The present study investigated the application of echocardiography to evaluation of cardiac dyssynchrony in patients with congestive heart failure（CHF）. A total of 348 consecutive CHF patients who were admitted for cardiac resynchronization（CRT） and presented with low ejection fraction（EF） and wide QRS duration were enrolled in this study, along with 388 healthy individuals. Dyssynchrony was assessed based on filling time ratio（FT/RR）, left ventricular pre-ejection delay（PED）, interventricular mechanical delay（IVMD）, longitudinal opposing wall delay（LOWD） and radial septal to posterior wall delay（RSPWD）. Response to CRT was defined as a ≥15% increase in EF. The results showed that FT/RR was decreased while PED, IVMD, LOWD and RSPWD were increased in the CHF group compared with the control group（P〈0.01）. In the CHF group, FT/RR was negatively correlated with the QRS duration, LV end-diastolic diameter（LVESd）, LV end-diastolic volume（LVEDV） and LV end-systolic volume（LVESV）（P〈0.01）, but positively with the LVEF（P〈0.01）. Additionally, PED, IVMD, LOWD and RSPWD were positively correlated with the QRS duration, LVESd, LVEDV and LVESV（P〈0.01）, but negatively with the LVEF（P〈0.01）. The CHF group was divided into three subgroups according to the varying degrees of LVEF. FT/RR decreased successively from the LVEF-1 group to the LVEF-2 group to the LVEF-3 group, while the PED, IVMD, LOWD and RSPWD successively increased in the same order（P〈0.01）. The CHF group was divided into three subgroups according to the varying degrees of QRS duration, and FT/RR decreased successively in a sequence from the QRS-1 group to the QRS-2 group to the QRS-3 group, while the PED, IVMD, LOWD and RSPWD successively increased in the same order（P〈0.01）. Speckle tracking radial dyssynchrony ≥130 ms was predictive of an EF response in patients in QRS-1 group（78% sensitivity, 83% specificity）, those in QRS-2 group（83% sensitivity, 77% specificity） and in QRS-3 group（89% sensitivity, 79% specificity）. In conclusion, echocardiography is a convenient and sensitive method for evaluating cardiac dyssynchrony in patients with CHF.
文摘Approximately 50% of all heart failure patients in the US are above 75 years of age, which is almost similar to most European countries and the Middle and the Far East. Even though aging is an independent molecular process with a multitude of genetic predetermination and biochemical mediations, aging itself does not automatically result in cardiac insufficiency. On the other hand, with increasing age, cardioprotective mechanisms in response to stress are lost, and progressive cardiomyocyte degeneration with replace- ment fibrosis is often seen in older hearts, even though the exact triggers are not completely understood. Older patients with heart failure have distinct features that require special attention in diagnosis as well as therapy. The elderly more frequently suffer from multiple co-morbidities and might have atypical clinical presentations. Several precautions are essential in the treatment of heart failure in the elderly due to co-existing morbidities and the pharmacokinetic and pharmacodynamic changes related to increased age. Also, treatment expectations, compliance, mental status and cognitive function might play a major role regarding optimized treatment and monitoring options in the elderly suffering from heart failure. This review summarizes current issues of heart failure management in the elderly.
文摘Therapy with glucagon-like peptide 1(GLP1)receptor agonists has raised great interest for its beneficial cardiovascular effects in preventing atherosclerosis and heart failure-related outcomes.However,while evidence about atherosclerosis consistently suggests a cardioprotective potential with class effect,controversies remain on its impact on heart failure.GLP1 receptor agonists appear to prevent hospitalization for new-onset heart failure and reduce symptoms in heart failure with preserved ejection fraction(as demonstrated by the recent STEP-HFpEF Trial).Still,GLP1 agonism has resulted in neutral or even harmful effects in patients with established heart failure with reduced ejection fraction(the LIVE trial).GLP1 receptor agonists benefit the cardiovascular system indirectly through their marked metabolic effects(improved weight management,glycemic control,blood pressure,systemic and tissue inflammation),while direct effects on the heart have been questioned.Nonetheless,weight loss alone achieved through GLP1 receptor agonists has failed in improving left ventricular functions.Tirzepatide is a dual agonist of GLP1 and glucose-dependent insulinotropic polypeptide,representing an innovative treatment option in diabetes with a major impact on weight loss and promising cardiovascular benefits.Whether this class of therapies is going to change the history of heart failure is an ongoing debate.
