This study investigated the effect of catheter-based renal sympathetic denervation （RD） on left ventricular hypertrophy （LVH） and systolic and diastolic function in patients with resistant hypertension. LVH and di...This study investigated the effect of catheter-based renal sympathetic denervation （RD） on left ventricular hypertrophy （LVH） and systolic and diastolic function in patients with resistant hypertension. LVH and diastolic dysfunction are associated with elevated sympathetic activity and increased morbidity and mortality. The effect of RD on LVH and LV function is unclear展开更多
Objective: Early detection of LV mechanical abnormalities in patients with cardiac syndrome X (CSX) by speckle tracking echocardiography (STE). Background: Cardiac syndrome X is a triad of angina pectoris, positive st...Objective: Early detection of LV mechanical abnormalities in patients with cardiac syndrome X (CSX) by speckle tracking echocardiography (STE). Background: Cardiac syndrome X is a triad of angina pectoris, positive stress test for myocardial ischemia and angiographically free coronary arteries. Two dimensional speckle tracking?echocardiography (2D-STE) provides a more sensitive method for evaluation of global and segmental LV function than conventional two dimensional echocardiographic parameters. Subjects and Methods: Seventy patients proved to have CSX and 20 healthy control volunteers were included with a mean age of 49.43 ± 5.92 vs. 49.40 ±6.27 years respectively with no difference regarding sex for both patients and controls. Patients with hypertension, diabetes mellitus, valvular heart disease, cardiomyopathies, inflammatory diseases, myocarditis and arrhythmias were excluded. All included individuals were subjected to complete conventional echocardiographic assessment and left ventricular global and segmental mechanical function was assessed using 2D based strain and strain rate (longitudinal, radial and circumferential) imaging. Results: There was no statistically significant difference in LV conventional echo parameters between patients and controls. However, global mean longitudinal strain was significantly lower in patients than controls (-15.05 ± 3.28 vs. -20.22 ± 2.49;p 0.001). For radial and circumferential strain stain, there was no significant changes between patients vs. controls (29.75 ± 18.26 vs. 28.09 ± 15.48;p = 0.74) and (-19.88 ± 8.63 vs. -21.93 ± 5.69;p 0.05) respectively. Conclusion: In spite of normal conventional echo parameters among patients and controls, LV longitudinal strain and strain rate by 2D speckle tracking imaging were lower in the patients denoting subclinical left ventricular mechanical dysfunction in patients with CSX.展开更多
Annually, an estimated 1,285,000 in-patient angioplasty procedures, 1,471,000 inpatient diagnostic cardiac catheteri-zations and 68,000 inpatient defibrillator implantations are performed. The direct and indirect cost...Annually, an estimated 1,285,000 in-patient angioplasty procedures, 1,471,000 inpatient diagnostic cardiac catheteri-zations and 68,000 inpatient defibrillator implantations are performed. The direct and indirect cost of cardiovascular diseases for 2007 is approximately $431.8 billion. The occurrence of plaque rupture with subsequent microemboli of atherosclerotic and thrombolytic debris into small coronary vessels has been confirmed. Microinfarction results from microemboli that are shed following coronary interventions. The aims of this review are to: 1) detect heterogeneous microinfarction using viability imaging, 2) characterize the consequences of distal coronary microembolization on left ventricle function and perfusion and 3) illustrate the progress of non-invasive imaging modalities in assessing distal coronary microembolization.展开更多
The present study investigated the role of cardiac nerves on homeometric autoregulation in anesthetized dogs during acute volume loading. Ventricular pressure-volume loops (conductance catheter method) were constructe...The present study investigated the role of cardiac nerves on homeometric autoregulation in anesthetized dogs during acute volume loading. Ventricular pressure-volume loops (conductance catheter method) were constructed during acute volume loading with intact cardiac nerves (ICN) and after cardiac decentralization (DCN;bilateral ablation of thoracic vagosympathetic complexes, stellate ganglia and anterior and posterior ansae subclavia). Arterial pressure increased as expected after volume loading but no significant changes were observed for heart rate and other hemodynamic parameters. Coronary sinus venous oxygen content was also higher regardless of nerve status in response to the overall increase in cardiac work. Pressure-volume catheter data showed markedly higher end-systolic volumes after volume loading under ICN and DCN conditions;stroke volume (mL/beat) and stroke work (mL/mm Hg) were not changed but LV ejection fraction was significantly lower. End-diastolic volume and cardiac output did not change. In addition, systemic vascular resistance and tau were higher with volume loading but no differences between ICN and DCN were observed. These findings show that acute volume loading produces an immediate influence on LV function independent of cardiac nerve status.展开更多
肝硬化心肌病(cirrhotic cardiomyopathy,CCM)是一种在排除其他既往心脏疾病的情况下,肝硬化患者心脏出现收缩和/或舒张功能障碍及电生理异常的一类心肌病。由于早期诊断难度较大,传统影像学方法的局限性,例如可能无法检测到早期的舒张...肝硬化心肌病(cirrhotic cardiomyopathy,CCM)是一种在排除其他既往心脏疾病的情况下,肝硬化患者心脏出现收缩和/或舒张功能障碍及电生理异常的一类心肌病。由于早期诊断难度较大,传统影像学方法的局限性,例如可能无法检测到早期的舒张功能异常、心肌纤维化及微小结构改变,心脏磁共振(cardiac magnetic resonance,CMR)作为一种无创、高分辨率、能够定量评估心脏结构和功能的技术,越来越多地被应用于CCM的诊断与评估。本文综合现有研究,综述了CMR在CCM中的应用进展,包括其在心肌功能、心肌结构、纤维化评估等方面的优势,并讨论了当前研究的挑战和未来的研究方向,以期提高临床医生对CCM的认识和诊断,从而最终改善CCM患者生活质量和预后。展开更多
目的探讨高血压合并左心室肥厚患者冠状动脉介入治疗后心肌灌注与心功能远期转归的相关性。方法选取2021年1月至2024年1月的100例高血压合并左心室肥厚患者,比较所有患者治疗前及介入治疗即刻心肌灌注水平,介入治疗前、治疗后7 d及1年...目的探讨高血压合并左心室肥厚患者冠状动脉介入治疗后心肌灌注与心功能远期转归的相关性。方法选取2021年1月至2024年1月的100例高血压合并左心室肥厚患者,比较所有患者治疗前及介入治疗即刻心肌灌注水平,介入治疗前、治疗后7 d及1年左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)及左室射血分数(LVEF)水平变化。对所有患者进行1年随访,依照心功能远期转归情况进行分组,分为心功能改善或维持组(75例)及心功能恶化组(25例),比较其一般临床资料,采用Logistic回归模型分析高血压合并左心室肥厚患者冠状动脉介入治疗后心功能远期转归的影响因素,并建立受试者工作特征(ROC)曲线,分析冠状动脉介入治疗后心肌灌注水平对心功能远期转归的预测价值。结果介入治疗后所有患者心肌梗死溶栓治疗临床试验(TIMI)血流分级优于治疗前,差异具有统计学意义(P<0.05);治疗后1年与治疗后7 d LVESD、LVEDD、LVEF水平对比,差异无统计学意义(P>0.05),治疗后1年、治疗后7 d LVESD、LVEDD、LVEF水平均低于治疗前,差异具有统计学意义(P<0.05);心功能改善或维持组年龄、舒张压、收缩压水平低于心功能恶化组,治疗后TIMI血流分级优于心功能恶化组,差异具有统计学意义(P<0.05);以心功能远期转归情况作为因变量(心功能改善或维持=0,心功能恶化=1),结果显示,年龄、治疗后TIMI血流分级为高血压合并左心室肥厚患者冠状动脉介入治疗后心功能远期转归的重要影响因素(P<0.05);TIMI血流分级预测心功能远期转归的曲线下面积(AUC)为0.899,灵敏度为71.4%,特异度为93.9%。结论高血压合并左心室肥厚患者冠状动脉介入治疗后心肌灌注水平及心功能均有所改善,且通过评价患者治疗后心肌灌注水平可早期预测患者心功能远期转归情况。展开更多
文摘This study investigated the effect of catheter-based renal sympathetic denervation （RD） on left ventricular hypertrophy （LVH） and systolic and diastolic function in patients with resistant hypertension. LVH and diastolic dysfunction are associated with elevated sympathetic activity and increased morbidity and mortality. The effect of RD on LVH and LV function is unclear
文摘Objective: Early detection of LV mechanical abnormalities in patients with cardiac syndrome X (CSX) by speckle tracking echocardiography (STE). Background: Cardiac syndrome X is a triad of angina pectoris, positive stress test for myocardial ischemia and angiographically free coronary arteries. Two dimensional speckle tracking?echocardiography (2D-STE) provides a more sensitive method for evaluation of global and segmental LV function than conventional two dimensional echocardiographic parameters. Subjects and Methods: Seventy patients proved to have CSX and 20 healthy control volunteers were included with a mean age of 49.43 ± 5.92 vs. 49.40 ±6.27 years respectively with no difference regarding sex for both patients and controls. Patients with hypertension, diabetes mellitus, valvular heart disease, cardiomyopathies, inflammatory diseases, myocarditis and arrhythmias were excluded. All included individuals were subjected to complete conventional echocardiographic assessment and left ventricular global and segmental mechanical function was assessed using 2D based strain and strain rate (longitudinal, radial and circumferential) imaging. Results: There was no statistically significant difference in LV conventional echo parameters between patients and controls. However, global mean longitudinal strain was significantly lower in patients than controls (-15.05 ± 3.28 vs. -20.22 ± 2.49;p 0.001). For radial and circumferential strain stain, there was no significant changes between patients vs. controls (29.75 ± 18.26 vs. 28.09 ± 15.48;p = 0.74) and (-19.88 ± 8.63 vs. -21.93 ± 5.69;p 0.05) respectively. Conclusion: In spite of normal conventional echo parameters among patients and controls, LV longitudinal strain and strain rate by 2D speckle tracking imaging were lower in the patients denoting subclinical left ventricular mechanical dysfunction in patients with CSX.
文摘Annually, an estimated 1,285,000 in-patient angioplasty procedures, 1,471,000 inpatient diagnostic cardiac catheteri-zations and 68,000 inpatient defibrillator implantations are performed. The direct and indirect cost of cardiovascular diseases for 2007 is approximately $431.8 billion. The occurrence of plaque rupture with subsequent microemboli of atherosclerotic and thrombolytic debris into small coronary vessels has been confirmed. Microinfarction results from microemboli that are shed following coronary interventions. The aims of this review are to: 1) detect heterogeneous microinfarction using viability imaging, 2) characterize the consequences of distal coronary microembolization on left ventricle function and perfusion and 3) illustrate the progress of non-invasive imaging modalities in assessing distal coronary microembolization.
文摘The present study investigated the role of cardiac nerves on homeometric autoregulation in anesthetized dogs during acute volume loading. Ventricular pressure-volume loops (conductance catheter method) were constructed during acute volume loading with intact cardiac nerves (ICN) and after cardiac decentralization (DCN;bilateral ablation of thoracic vagosympathetic complexes, stellate ganglia and anterior and posterior ansae subclavia). Arterial pressure increased as expected after volume loading but no significant changes were observed for heart rate and other hemodynamic parameters. Coronary sinus venous oxygen content was also higher regardless of nerve status in response to the overall increase in cardiac work. Pressure-volume catheter data showed markedly higher end-systolic volumes after volume loading under ICN and DCN conditions;stroke volume (mL/beat) and stroke work (mL/mm Hg) were not changed but LV ejection fraction was significantly lower. End-diastolic volume and cardiac output did not change. In addition, systemic vascular resistance and tau were higher with volume loading but no differences between ICN and DCN were observed. These findings show that acute volume loading produces an immediate influence on LV function independent of cardiac nerve status.
文摘肝硬化心肌病(cirrhotic cardiomyopathy,CCM)是一种在排除其他既往心脏疾病的情况下,肝硬化患者心脏出现收缩和/或舒张功能障碍及电生理异常的一类心肌病。由于早期诊断难度较大,传统影像学方法的局限性,例如可能无法检测到早期的舒张功能异常、心肌纤维化及微小结构改变,心脏磁共振(cardiac magnetic resonance,CMR)作为一种无创、高分辨率、能够定量评估心脏结构和功能的技术,越来越多地被应用于CCM的诊断与评估。本文综合现有研究,综述了CMR在CCM中的应用进展,包括其在心肌功能、心肌结构、纤维化评估等方面的优势,并讨论了当前研究的挑战和未来的研究方向,以期提高临床医生对CCM的认识和诊断,从而最终改善CCM患者生活质量和预后。
文摘目的探讨高血压合并左心室肥厚患者冠状动脉介入治疗后心肌灌注与心功能远期转归的相关性。方法选取2021年1月至2024年1月的100例高血压合并左心室肥厚患者,比较所有患者治疗前及介入治疗即刻心肌灌注水平,介入治疗前、治疗后7 d及1年左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)及左室射血分数(LVEF)水平变化。对所有患者进行1年随访,依照心功能远期转归情况进行分组,分为心功能改善或维持组(75例)及心功能恶化组(25例),比较其一般临床资料,采用Logistic回归模型分析高血压合并左心室肥厚患者冠状动脉介入治疗后心功能远期转归的影响因素,并建立受试者工作特征(ROC)曲线,分析冠状动脉介入治疗后心肌灌注水平对心功能远期转归的预测价值。结果介入治疗后所有患者心肌梗死溶栓治疗临床试验(TIMI)血流分级优于治疗前,差异具有统计学意义(P<0.05);治疗后1年与治疗后7 d LVESD、LVEDD、LVEF水平对比,差异无统计学意义(P>0.05),治疗后1年、治疗后7 d LVESD、LVEDD、LVEF水平均低于治疗前,差异具有统计学意义(P<0.05);心功能改善或维持组年龄、舒张压、收缩压水平低于心功能恶化组,治疗后TIMI血流分级优于心功能恶化组,差异具有统计学意义(P<0.05);以心功能远期转归情况作为因变量(心功能改善或维持=0,心功能恶化=1),结果显示,年龄、治疗后TIMI血流分级为高血压合并左心室肥厚患者冠状动脉介入治疗后心功能远期转归的重要影响因素(P<0.05);TIMI血流分级预测心功能远期转归的曲线下面积(AUC)为0.899,灵敏度为71.4%,特异度为93.9%。结论高血压合并左心室肥厚患者冠状动脉介入治疗后心肌灌注水平及心功能均有所改善,且通过评价患者治疗后心肌灌注水平可早期预测患者心功能远期转归情况。
