Due to the study of the function of heart and aoritic valve, we set up a physicalmodel of left ventricle, aortic valve and afterload and derive theoretical equation of each part from the model. Then we calculate the h...Due to the study of the function of heart and aoritic valve, we set up a physicalmodel of left ventricle, aortic valve and afterload and derive theoretical equation of each part from the model. Then we calculate the hasic equations within phystology and impair parameters. Bwsed on this, we will discus fully in the next paper the effectofleyt ventricular afterloadon valve opining, ejection and valve Jumction .etc展开更多
Introduction: Left Ventricle Postinfarction Pseudoaneurysm (LVPS)—false aneurysm occurs after a free-wall rupture contained by the adjacent pericardium. LVPS lacks the normal structure of the ventricular wall and dis...Introduction: Left Ventricle Postinfarction Pseudoaneurysm (LVPS)—false aneurysm occurs after a free-wall rupture contained by the adjacent pericardium. LVPS lacks the normal structure of the ventricular wall and disrupts the normal chamber anatomy. However, the natural history, clinical presentation and surgical outcome are still unclear. For that reason, it is necessary to describe the most relevant anatomical characteristics of LVPS and the appropriate surgical strategies currently applied. Methods: We reviewed the anatomical characteristics of several patients diagnosed of LVPS and the surgical technique performed. In this work two different anatomical types of LVPS are described in detail, with the surgical and structural implications for left ventricle reconstruction. Results: There are two different anatomical forms of LVPS: 1) Typical pseudoaneurysm, with a small gateway neck between the Left Ventricle and the false aneurysm chamber (Figure 1(A));2) Atypical pseudoaneurysm, in which the anatomical defect is bigger, without well-defined edges, extends over a large segment of infarcted and thinned myocardial tissue. In both cases, the therapeutics targets and the surgical techniques used were directed to restore the normal geometry of Left Ventricle, keeping the optimal mitral valve function. Conclusions: The surgical key-step is to preserve or to remodel the ventricular chamber anatomy. This fact restores the ventricular geometry, not only removing the wall discontinuity that generated the pseudoaneurysm. Nevertheless, final prognosis depends on the underlying ischemic cardiomyopathy and mechanical complications, such us mitral regurgitation or ventricular septal defect.展开更多
Objective:To investigate the value of two-dimensional ultrasound speckle tracking(2D-STI)and three-dimensional ultrasound speckle tracking(3D-STI)in evaluating myocardial function in children with Kawasaki disease.Met...Objective:To investigate the value of two-dimensional ultrasound speckle tracking(2D-STI)and three-dimensional ultrasound speckle tracking(3D-STI)in evaluating myocardial function in children with Kawasaki disease.Methods 92 children with Kawasaki disease admitted to our hospital from February 2017 to February 2019 were retrospectively analyzed.50 children who underwent 3D-STI examination were taken as observation group and 42 children who underwent 2D-STI examination were taken as control group.The left ventricular systolic function index,storage time and analysis time of the image,the diameter of coronary artery,the strain difference of left ventricular basal segment,middle segment,apical segment and whole segment were observed.Results The levels of left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),left ventricular myocardial mass(LVMI)in the observation group were higher than those in the control group(P<0.05),but there was no statistical difference in left ventricular ejection fraction(LVEF)between the two groups(P>0.05).The storage time and analysis time of the image in the observation group were significantly lower than those in the control group(P<0.05).The left coronary artery(LCA)and right coronary artery(RCA)in the observation group were higher than those in the control group(P<0.05).There was no statistical difference between left anterior descending(LAD)in the two groups(P>0.05).The longitudinal peak systolic strain(LS),circumferential peak systolic strain(CS)and radial peak systolic strain(RS)in the observation group were higher than those in the control group(P<0.05).The global longitudinal peak strain(GLS),global circumferential peak strain(GCS)and global radial peak strain(GRS)in the observation group were higher than those in the control group(P<0.05).LS and CS in the middle segment of the observation group were higher than those in the control group(P<0.05).Conclusions Compared with 2D-STI,3D-STI can objectively and accurately reflect the myocardial function of children with Kawasaki disease.展开更多
This work was to determine threshold values for accurate measurements of left ventricular end-diastolic volume(EDV),end-systolic volume(ESV),and ejection fraction(EF) from electrocardiography-gated myocardial perfusio...This work was to determine threshold values for accurate measurements of left ventricular end-diastolic volume(EDV),end-systolic volume(ESV),and ejection fraction(EF) from electrocardiography-gated myocardial perfusion imaging(MPI) in Chinese,and these data were compared with those of echocardiography.A total of 110 patients with definite or suspected coronary artery disease were referred for both gated MPI and echocardiography within 1 week.The EDV,ESV,and EF automatically measured by MyoMetrix and echocardiography were analyzed using Bland-Altman plot correlation and paired t test.The results showed that these parameters quantified by MyoMetrix software were correlated,moderately to highly,with those on echocardiography(ρ,r ≥0.75,P<0.01).However,the EF was not significantly correlated,with post-exercise MPI ESV of <15 mL or resting MPI ESV of <20 mL.At or above this ESV value,EF was underestimated by MyoMetrix(t≥ 4.60,P<0.01).In a word,a small ESV was underestimated by MyoMetrix,which could lead to EF overestimation.On the contrary,a normal or large ESV was overestimated by MyoMetrix,which led to EF underestimation.展开更多
Objectives To compare the different effects of late successful reperfusion with PCI on left ventricular function and its relationship with viable myocardium after acute anterior wall myocardial infarction in patients ...Objectives To compare the different effects of late successful reperfusion with PCI on left ventricular function and its relationship with viable myocardium after acute anterior wall myocardial infarction in patients with or without diabetes. Methods A total of 125 consecutive subjects with acute anterior wall myocardial infarction were selected, and divided into diabetes mellitus （DM） group （ n = 43） and Non-DM group （ n = 82） according to WHO diabetes diagnosis criteria. All patients received successful PCI at 12 ± 8 days from onset. Ischemic viable myocardium was detected with low-dose dobutamine echocardiography, and left ventricular function and wall motion abnormality were also assessed with echocardiography before PCI. The data of clinical manifestations and angiograms before and after PCI were analyzed. Levels of creatinine kinase-MB （CK-MB）, and troponin T （TnT） before PCI, 6 hours and 24 hours after PCI were assessed. All patients received clinic and echocardiography follow-up for 6 months. Results Higher rate of TIMI 2 flow, and lower rate of TIMI 3 flow in DM group were demonstrated immediately after PCI, and the rate of serum CK-MB and/or TnT levels were higher in DM group, compared with Non-DM group（P 〈 0.05）. 63% of DM patients and 56% of non-DM patients had viable myocardium before PCI（ P 〉 0. 05）. There were no significant differences of left ventricular ejection fraction （LVEF）, left ventricular end diastolic volume index （LVEDVI）, left ventricular end systolic volume index （LVESVI）, and wall motion score （WMS） between two groups at baseline before PCI（P 〉 0.05）. After six months, WMS was decreased and LVEF was increased in Non-DM group, but the WMS and the LVEF did not changed, and the LVEDVI was increased in DM group compared with baseline; the LVEDVI, LVESVI, LVEF, and WMS were significantly different between two groups （P 〈 0.05 or P 〈 0. 01 ）. Conclusions Compared with non-diabetics, delayed successful revascularization with PCI in diabetics patient with acute myocardial infarction has less benefitial effect on the improvement of late phase left ventricular function, and it may be because the insufficient reperfusion or reperfusion injury to myocardium but not the viable myocardium contributing to the poor result. （S Chin J Cardiol 2009; 10（4） ： 196 -203）展开更多
Objective To investigate the influences of previous angina pectoris on coronary collateral circulation and left ventricular function in patients with acute myocardial infarction. Methods 307 patients with a first epis...Objective To investigate the influences of previous angina pectoris on coronary collateral circulation and left ventricular function in patients with acute myocardial infarction. Methods 307 patients with a first episode acute myocardial infarction underwent selective coronary angiography and left ventriculography. The relation of previous angina pectoris to coronary collateral circulation, peak creatine kinase and left ventricular function were analyzed. Results ①In the 307 patients, there were 192 (62. 5 % ) with previous angina [PA ( + ) group] and 115 (37. 5 % ) without [PA (-) group]. ②The peak creatine kinase (CK) and CK -MB were significantly higher in PA (-) group than in PA (+) group ( P < 0. 05 for both comparisons) . ③ Collateral circulation to infarct - related artery was more likely to be present in PA ( + ) group than in PA (-) group ( P < 0. 05) . (4) The left ventricular ejection fraction was significantly increased, and the left ventricular wall motion Cortina score decreased, in PA (+) group than in PA (-) group ( P < 0. 01 for both comparisons) . Conclusion In patients with acute myocardial infarction, previous angina pectoris may have beneficial effects on coronary collateral circulation and left ventricular function.展开更多
Objectives The long-term benefit of late reperfusion of infarct-related artery （IRA） after acute myocardial infarction （AMI） is controversial, and the benefit mechanisms remain uncertain. Low dose dobutamine stres...Objectives The long-term benefit of late reperfusion of infarct-related artery （IRA） after acute myocardial infarction （AMI） is controversial, and the benefit mechanisms remain uncertain. Low dose dobutamine stress echocardiography （LDSE） can identify viable myocardium and predict improvement of wall motion after revascularization. Methods Sixtynine patients with first AMI who did not received early reperfusion therapy were studied by LDSE at 5 to 10 days after AMI. Wall motion abnormality and left ventricular size were measured at the same time. Successful PCI were done in all patients at 10 to 21 days after AMI onset. Patients were divided in two groups based on the presence or absence of viable myocardium. Echocardiography was repeated six months later. Results There were 157 motion abnormality segments. 89 segments （57%） were viable during LDSE. 26 patients （38%） with viability and 43 （62%） without. In viable group, left ventricular ejection fraction （LVEF） was increased （P 〈 0.05）, and left ventricular end systolic volume index （LVESVI） and wall motion score （WMS） were decreased （P 〈 0.05 and P 〈 0.01） significantly at 6 months compared with baseline. But in patients without viability, LVEF was decreased （P 〈 0.01）, and LVESVI and left ventricular end diastolic volume index （LVEDVI） were increased （P 〈 0.05） significantly after 6 months, and the WMS did not changed （P 〉 0.05 ）. LVEF increased （P 〈 0.05 ） and WMS decreased （P 〈 0.05） on LDSE during acute phase in patients with viability, but they were not changed in the nonviable group. Conclusions Late revascularization of IRA in patients with presence of viable myocardium after AMI is associated with long-term preservation left ventricular function and less ventricular remodeling. Improvement of left ventricular systolic function on LDSE indicates late phase recovery of left ventricular function after late revascularization.展开更多
Objective:To study the change of left ventricular ultrasonic functional parameters in patients with ACS during peri-PCI period and their relationship with degree of serum myocardial damage.Methods:A total of 76 cases ...Objective:To study the change of left ventricular ultrasonic functional parameters in patients with ACS during peri-PCI period and their relationship with degree of serum myocardial damage.Methods:A total of 76 cases of ACS patients who were treated in our hospital between June 2012 and January 2016 were selected as research subjects, treatment methods were reviewed and then all patients were divided into observation group (n=57) who underwent PCI treatment and control group (n=19) who conformed to PCI indications but underwent conservative treatment under patients' or families' insistence. Left ventricular ultrasonic functional parameter levels and serum myocardial injury index contents were compared between two groups of patients before and after treatment. Pearson test was used to evaluate the relationship between left ventricular ultrasonic functional parameters and myocardial injury in patients with ACS.Results: Before treatment, differences in left ventricular ultrasonic functional parameter levels as well as serum contents of myocardial enzyme spectrum and myocardial apoptosis indexes were not statistically significant between the two groups of patients. After treatment, left ventricular ultrasonic functional parameters LVEDD and LVESD levels in observation group were lower than those in control group while SV level was higher than that in control group;serum contents of myocardial enzyme spectrum cTnT, LDH, CK-MB and AST were lower than those in control group;serum contents of myocardial apoptosis indexes Fas, Caspase-3 and caspase-12 were lower than those in control group while Bcl-2 content was higher than that in control group. The left ventricular ultrasonic functional parameters in ACS patients were directly correlated with the degree of myocardial injury.Conclusion: PCI treatment of patients with ACS can significantly improve left ventricular function and reduce myocardial injury. After treatment, the left ventricular ultrasonic functional parameters are directly correlated with the degree of myocardial injury.展开更多
We describe a rare case of a 60-year-old woman suffering from intramyocardial dissection and left ventricular aneurysm secondary to acute myocardial infarction. A rare form of ventricular septal rupture resulted from ...We describe a rare case of a 60-year-old woman suffering from intramyocardial dissection and left ventricular aneurysm secondary to acute myocardial infarction. A rare form of ventricular septal rupture resulted from intramyocardial dissection deterioration, which was iden- tified during echocardiographic follow-up. Surgical repair under beating-heart cardiopulmonary bypass was successful.展开更多
<strong>Background:</strong><span style="font-family:Verdana;"> Heart failure is the commonest cardiovascular complication in type 2 diabetes mellitus. However, subclinical left ventricular...<strong>Background:</strong><span style="font-family:Verdana;"> Heart failure is the commonest cardiovascular complication in type 2 diabetes mellitus. However, subclinical left ventricular dysfunction can’t be detected using 2D echocardiography which </span><span style="font-family:Verdana;">is </span><span style="font-family:;" "=""><span style="font-family:Verdana;">routinely used for cardiac evaluation of diabetic patients. We aimed to determine the prevalence and factors associated to left ventricular global longitudinal strain (LV GLS) impairment in type 2 diabetes Cameroonians patients. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> We conducted a cross-sectional study from January 2019 to June 2019, including type 2 diabetes patients with preserved left ventricle ejection fraction. Clinical and echocardiographic data were collected, and LV GLS was assessed using speckle tracking technique, a value ≤</span></span><span style="font-family:Verdana;"> -</span><span style="font-family:;" "=""><span style="font-family:Verdana;">16% been considered as normal value. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> We recruited 95 patients, with a mean age of 57.4 ± 11.8 years old and median diabetes duration of 5 [2 </span></span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;"> 12] years. Echocardiographic evaluation found 56.3% of left ventricle remodelling, 51.6% of left ventricle diastolic dysfunction and mean left ventricle ejection of 63.3</span><span style="font-family:Verdana;">%</span><span style="font-family:Verdana;"> ± 6.6%. LV GLS impairment was present in 43.2% (95% CI: 32.6 </span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;"> 53.7) of the participants. After adjustment to all significantly associated factors, Obesity (aOR: 4;95% CI: 1.5 </span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;"> 10.6) and diastolic dysfunction (aOR: 3.1;95% CI: 1.2 </span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> 8.2) were independent factors associated with LV GLS. </span><b><span style="font-family:Verdana;">Conclusions:</span></b><span style="font-family:Verdana;"> Subclinical systolic dysfunction assessed by LV GLS impairment is frequent in diabetic patients. Further research should be carried out more extensively to integrate LV GLS in the type 2 diabetes patients’ routine follow up for a better prognostic outcome, especially in low-incomes countries.</span></span>展开更多
Left ventricle(LV) pseudoaneurysm is a late mechanical complication of myocardial infarction.A giant LV pseudoaneurysm is a rare presentation.We report a case of giant LV pseudoaneurysm in a post-MI patient who presen...Left ventricle(LV) pseudoaneurysm is a late mechanical complication of myocardial infarction.A giant LV pseudoaneurysm is a rare presentation.We report a case of giant LV pseudoaneurysm in a post-MI patient who presented with gross congestive heart failure.The patient had a successful surgical repair of the aneurysm and had a favorable 3-mo outcome.The imaging modality and surgical treatment of the pseudoaneurysm are discussed.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
Acute myocardial ischemia was induced by intravenous injection of pituitrin, and electroacupuncture (EA) was applied at the Heart and Lung Meridians (HM and LM), 3 points on each meridian. The changes in the left ... Acute myocardial ischemia was induced by intravenous injection of pituitrin, and electroacupuncture (EA) was applied at the Heart and Lung Meridians (HM and LM), 3 points on each meridian. The changes in the left intraventricular pressure (LVP), the maximum rise rate of intraventricular pressure (LVP dp/dtmax), the area of cardiac force loop (ACFL), and the maximum shortening velocity of myocardial contractile element (Vmax) were observed. As a result, there were significant differences in the improvement of LVP, LVP dp/dtmax, ACFL and Vmax between EA at HM and LM. The regulatory action of EA at HM on the myocardial contractile function was significantly better than that of EA at LM, indicating that HM has a close relationship with the myocardial contractile function.……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
Purpose: The aim of the present study was to evaluate the diagnostic accuracy for quantification of left ventricular (LV) volumes and LV ejection fraction (LVEF) with current echocardiographic methods of planimetry fo...Purpose: The aim of the present study was to evaluate the diagnostic accuracy for quantification of left ventricular (LV) volumes and LV ejection fraction (LVEF) with current echocardiographic methods of planimetry for analysis of LV remodeling after myocardial infarction in daily clinical routine. Methods: 26 patients were investigated directly after interventional therapy at hospital pre-discharge and at 6 month follow-up. Standardized 2D transthoracic native and contrast echocardiography were performed in all patients. Due to methodological aspects the results of LV volumes and LVEF using native echocardiography were compared to the results of LV opacification (LVO) imaging for analysis in mono-, bi- and triplane data sets using the Simpson’s rule. In addition corresponding multidimensional data sets were analyzed. Results: The assessment of LV volumes and LVEF is more accurate with contrast echocardiography. The comparison of LV volumes and LVEF shows significant increases using contrast echocardiography (p < 0.001). Larger left ventricular end-diastolic volumes (LVEDV) are measured at follow up (p < 0.05). Significant differences (p < 0.001) are found for the determination of LVEDV and LVEF relating to apical mono-, bi-, tri- and multiplane data sets. Standard deviations of the triplane approach, however, are significantly lower than using other modalities. Conclusion: Depending on the localization of the myocardial infarction LV volumes and LVEF are less reliably evaluated using the mono- or biplane approach. According to standardization and simultaneous acquisition of all LV wall segments the triplane approach is currently the best approach to determine LV systolic function. In addition, contrast echocardiography is indicated to improve endocardial border delineation in patients using the triplane or multiplane approach. To our knowledge the present study is the first systematic evaluation of all current possibilities for determination of LV volumes and LVEF by native and contrast echocardiography.展开更多
AIMTo assess the prevalence of depressed heart rate variability(HRV)after an acute myocardial infarction(MI),and to evaluate its prognostic significance in the present era of immediate reperfusion.METHODSTime-domain H...AIMTo assess the prevalence of depressed heart rate variability(HRV)after an acute myocardial infarction(MI),and to evaluate its prognostic significance in the present era of immediate reperfusion.METHODSTime-domain HRV(obtained from 24-h Holter recordings)was assessed in 326 patients(63.5±12.1 years old;80%males),two weeks after a complicated MI treated by early reperfusion:208 ST-elevation myocardial infarction(STEMI)patients(in which reperfusion was successfully obtained within 6 h of symptoms in 94%of cases)and 118 non-ST-elevation myocardial infarction(NSTEMI)patients(percutaneous coronary intervention was performed within 24 h and successful in 73%of cases).Follow-up of the patients was performed via telephone interviews a median of 25 mo after the index event(95%CI of the mean 23.3-28.0).Primary end-point was occurrence of all-cause or cardiac death;secondary end-point was occurrence of major clinical events(MCE,defined as mortality or readmission for new MI,new revascularization,episodes of heart failure or stroke).Possible correlations between HRV parameters(mainly the standard deviation of all normal RR intervals,SDNN),clinical features(age,sex,type of MI,history of diabetes,left ventricle ejection fraction),angiographic characteristics(number of coronary arteries with critical stenoses,success and completeness of revascularization)and long-term outcomes were analysed.RESULTSMarkedly depressed HRV parameters were present in a relatively small percentage of patients:SDNN<70 ms was found in 16%and SDNN<50 ms in 4%of cases.No significant differences were present between STEMI and NSTEMI cases as regards to their distribution among quartiles of SDNN(χ<sup>2</sup>=1.536,P=0.674).Female sex and history of diabetes maintained a significant correlation with lower values of SDNN at multivariate Cox regression analysis(respectively:P=0.008 and P=0.008),while no correlation was found between depressed SDNN and history of previous MI(P=0.999)or number of diseased coronary arteries(P=0.428)or unsuccessful percutaneous coronary intervention(PCI)(P=0.691).Patients with left ventricle ejection fraction(LVEF)<40%presented more often SDNN values in the lowest quartile(P<0.001).After>2 years from infarction,a total of 10 patients(3.1%)were lost to follow-up.Overall incidence of MCE at follow-up was similar between STEMI and NSTEMI(P=0.141),although all-cause and cardiac mortality were higher among NSTEMI cases(respectively:14%vs 2%,P=0.001;and 10%vs 1.5%,P=0.001).The Kaplan-Meier survival curves for all-cause mortality and for cardiac deaths did not reveal significant differences between patients with SDNN in the lowest quartile and other quartiles of SDNN(respectively:P=0.137 and P=0.527).Also the MCE-free survival curves were similar between the group of patients with SDNN in the lowest quartile vs the patients of the other SDNN quartiles(P=0.540),with no difference for STEMI(P=0.180)or NSTEMI patients(P=0.541).By the contrary,events-free survival was worse if patients presented with LVEF<40%(P=0.001).CONCLUSIONIn our group of patients with a recent complicated MI,abnormal autonomic parameters have been found with a prevalence that was similar for STEMI and NSTEMI cases,and substantially unchanged in comparison to what reported in the pre-primary-PCI era.Long-term outcomes did not correlate with level of depression of HRV parameters recorded in the subacute phase of the disease,both in STEMI and in NSTEMI patients.These results support lack of prognostic significance of traditional HRV parameters when immediate coronary reperfusion is utilised.展开更多
A 72-year-old elderly male smoker with a known history of hypertension presented with a six day history of chest pain. His blood pressure at presentation was 110/70 mmHg and there was no audible murmur. ECG showed Q w...A 72-year-old elderly male smoker with a known history of hypertension presented with a six day history of chest pain. His blood pressure at presentation was 110/70 mmHg and there was no audible murmur. ECG showed Q waves in the inferior leads （Figure IA） and troponin level was elevated （14 /.tg/L）.展开更多
文摘Due to the study of the function of heart and aoritic valve, we set up a physicalmodel of left ventricle, aortic valve and afterload and derive theoretical equation of each part from the model. Then we calculate the hasic equations within phystology and impair parameters. Bwsed on this, we will discus fully in the next paper the effectofleyt ventricular afterloadon valve opining, ejection and valve Jumction .etc
文摘Introduction: Left Ventricle Postinfarction Pseudoaneurysm (LVPS)—false aneurysm occurs after a free-wall rupture contained by the adjacent pericardium. LVPS lacks the normal structure of the ventricular wall and disrupts the normal chamber anatomy. However, the natural history, clinical presentation and surgical outcome are still unclear. For that reason, it is necessary to describe the most relevant anatomical characteristics of LVPS and the appropriate surgical strategies currently applied. Methods: We reviewed the anatomical characteristics of several patients diagnosed of LVPS and the surgical technique performed. In this work two different anatomical types of LVPS are described in detail, with the surgical and structural implications for left ventricle reconstruction. Results: There are two different anatomical forms of LVPS: 1) Typical pseudoaneurysm, with a small gateway neck between the Left Ventricle and the false aneurysm chamber (Figure 1(A));2) Atypical pseudoaneurysm, in which the anatomical defect is bigger, without well-defined edges, extends over a large segment of infarcted and thinned myocardial tissue. In both cases, the therapeutics targets and the surgical techniques used were directed to restore the normal geometry of Left Ventricle, keeping the optimal mitral valve function. Conclusions: The surgical key-step is to preserve or to remodel the ventricular chamber anatomy. This fact restores the ventricular geometry, not only removing the wall discontinuity that generated the pseudoaneurysm. Nevertheless, final prognosis depends on the underlying ischemic cardiomyopathy and mechanical complications, such us mitral regurgitation or ventricular septal defect.
基金Shaanxi key research and development plan(No.2019SF-211).
文摘Objective:To investigate the value of two-dimensional ultrasound speckle tracking(2D-STI)and three-dimensional ultrasound speckle tracking(3D-STI)in evaluating myocardial function in children with Kawasaki disease.Methods 92 children with Kawasaki disease admitted to our hospital from February 2017 to February 2019 were retrospectively analyzed.50 children who underwent 3D-STI examination were taken as observation group and 42 children who underwent 2D-STI examination were taken as control group.The left ventricular systolic function index,storage time and analysis time of the image,the diameter of coronary artery,the strain difference of left ventricular basal segment,middle segment,apical segment and whole segment were observed.Results The levels of left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),left ventricular myocardial mass(LVMI)in the observation group were higher than those in the control group(P<0.05),but there was no statistical difference in left ventricular ejection fraction(LVEF)between the two groups(P>0.05).The storage time and analysis time of the image in the observation group were significantly lower than those in the control group(P<0.05).The left coronary artery(LCA)and right coronary artery(RCA)in the observation group were higher than those in the control group(P<0.05).There was no statistical difference between left anterior descending(LAD)in the two groups(P>0.05).The longitudinal peak systolic strain(LS),circumferential peak systolic strain(CS)and radial peak systolic strain(RS)in the observation group were higher than those in the control group(P<0.05).The global longitudinal peak strain(GLS),global circumferential peak strain(GCS)and global radial peak strain(GRS)in the observation group were higher than those in the control group(P<0.05).LS and CS in the middle segment of the observation group were higher than those in the control group(P<0.05).Conclusions Compared with 2D-STI,3D-STI can objectively and accurately reflect the myocardial function of children with Kawasaki disease.
基金supported by the Natural Science Foundation of Fujian Province(No.2015J01516)
文摘This work was to determine threshold values for accurate measurements of left ventricular end-diastolic volume(EDV),end-systolic volume(ESV),and ejection fraction(EF) from electrocardiography-gated myocardial perfusion imaging(MPI) in Chinese,and these data were compared with those of echocardiography.A total of 110 patients with definite or suspected coronary artery disease were referred for both gated MPI and echocardiography within 1 week.The EDV,ESV,and EF automatically measured by MyoMetrix and echocardiography were analyzed using Bland-Altman plot correlation and paired t test.The results showed that these parameters quantified by MyoMetrix software were correlated,moderately to highly,with those on echocardiography(ρ,r ≥0.75,P<0.01).However,the EF was not significantly correlated,with post-exercise MPI ESV of <15 mL or resting MPI ESV of <20 mL.At or above this ESV value,EF was underestimated by MyoMetrix(t≥ 4.60,P<0.01).In a word,a small ESV was underestimated by MyoMetrix,which could lead to EF overestimation.On the contrary,a normal or large ESV was overestimated by MyoMetrix,which led to EF underestimation.
基金supported by the International Cooperation Foundation of Anhui Science and Technology Bureau(NO: 09080703042)
文摘Objectives To compare the different effects of late successful reperfusion with PCI on left ventricular function and its relationship with viable myocardium after acute anterior wall myocardial infarction in patients with or without diabetes. Methods A total of 125 consecutive subjects with acute anterior wall myocardial infarction were selected, and divided into diabetes mellitus （DM） group （ n = 43） and Non-DM group （ n = 82） according to WHO diabetes diagnosis criteria. All patients received successful PCI at 12 ± 8 days from onset. Ischemic viable myocardium was detected with low-dose dobutamine echocardiography, and left ventricular function and wall motion abnormality were also assessed with echocardiography before PCI. The data of clinical manifestations and angiograms before and after PCI were analyzed. Levels of creatinine kinase-MB （CK-MB）, and troponin T （TnT） before PCI, 6 hours and 24 hours after PCI were assessed. All patients received clinic and echocardiography follow-up for 6 months. Results Higher rate of TIMI 2 flow, and lower rate of TIMI 3 flow in DM group were demonstrated immediately after PCI, and the rate of serum CK-MB and/or TnT levels were higher in DM group, compared with Non-DM group（P 〈 0.05）. 63% of DM patients and 56% of non-DM patients had viable myocardium before PCI（ P 〉 0. 05）. There were no significant differences of left ventricular ejection fraction （LVEF）, left ventricular end diastolic volume index （LVEDVI）, left ventricular end systolic volume index （LVESVI）, and wall motion score （WMS） between two groups at baseline before PCI（P 〉 0.05）. After six months, WMS was decreased and LVEF was increased in Non-DM group, but the WMS and the LVEF did not changed, and the LVEDVI was increased in DM group compared with baseline; the LVEDVI, LVESVI, LVEF, and WMS were significantly different between two groups （P 〈 0.05 or P 〈 0. 01 ）. Conclusions Compared with non-diabetics, delayed successful revascularization with PCI in diabetics patient with acute myocardial infarction has less benefitial effect on the improvement of late phase left ventricular function, and it may be because the insufficient reperfusion or reperfusion injury to myocardium but not the viable myocardium contributing to the poor result. （S Chin J Cardiol 2009; 10（4） ： 196 -203）
文摘Objective To investigate the influences of previous angina pectoris on coronary collateral circulation and left ventricular function in patients with acute myocardial infarction. Methods 307 patients with a first episode acute myocardial infarction underwent selective coronary angiography and left ventriculography. The relation of previous angina pectoris to coronary collateral circulation, peak creatine kinase and left ventricular function were analyzed. Results ①In the 307 patients, there were 192 (62. 5 % ) with previous angina [PA ( + ) group] and 115 (37. 5 % ) without [PA (-) group]. ②The peak creatine kinase (CK) and CK -MB were significantly higher in PA (-) group than in PA (+) group ( P < 0. 05 for both comparisons) . ③ Collateral circulation to infarct - related artery was more likely to be present in PA ( + ) group than in PA (-) group ( P < 0. 05) . (4) The left ventricular ejection fraction was significantly increased, and the left ventricular wall motion Cortina score decreased, in PA (+) group than in PA (-) group ( P < 0. 01 for both comparisons) . Conclusion In patients with acute myocardial infarction, previous angina pectoris may have beneficial effects on coronary collateral circulation and left ventricular function.
文摘Objectives The long-term benefit of late reperfusion of infarct-related artery （IRA） after acute myocardial infarction （AMI） is controversial, and the benefit mechanisms remain uncertain. Low dose dobutamine stress echocardiography （LDSE） can identify viable myocardium and predict improvement of wall motion after revascularization. Methods Sixtynine patients with first AMI who did not received early reperfusion therapy were studied by LDSE at 5 to 10 days after AMI. Wall motion abnormality and left ventricular size were measured at the same time. Successful PCI were done in all patients at 10 to 21 days after AMI onset. Patients were divided in two groups based on the presence or absence of viable myocardium. Echocardiography was repeated six months later. Results There were 157 motion abnormality segments. 89 segments （57%） were viable during LDSE. 26 patients （38%） with viability and 43 （62%） without. In viable group, left ventricular ejection fraction （LVEF） was increased （P 〈 0.05）, and left ventricular end systolic volume index （LVESVI） and wall motion score （WMS） were decreased （P 〈 0.05 and P 〈 0.01） significantly at 6 months compared with baseline. But in patients without viability, LVEF was decreased （P 〈 0.01）, and LVESVI and left ventricular end diastolic volume index （LVEDVI） were increased （P 〈 0.05） significantly after 6 months, and the WMS did not changed （P 〉 0.05 ）. LVEF increased （P 〈 0.05 ） and WMS decreased （P 〈 0.05） on LDSE during acute phase in patients with viability, but they were not changed in the nonviable group. Conclusions Late revascularization of IRA in patients with presence of viable myocardium after AMI is associated with long-term preservation left ventricular function and less ventricular remodeling. Improvement of left ventricular systolic function on LDSE indicates late phase recovery of left ventricular function after late revascularization.
文摘Objective:To study the change of left ventricular ultrasonic functional parameters in patients with ACS during peri-PCI period and their relationship with degree of serum myocardial damage.Methods:A total of 76 cases of ACS patients who were treated in our hospital between June 2012 and January 2016 were selected as research subjects, treatment methods were reviewed and then all patients were divided into observation group (n=57) who underwent PCI treatment and control group (n=19) who conformed to PCI indications but underwent conservative treatment under patients' or families' insistence. Left ventricular ultrasonic functional parameter levels and serum myocardial injury index contents were compared between two groups of patients before and after treatment. Pearson test was used to evaluate the relationship between left ventricular ultrasonic functional parameters and myocardial injury in patients with ACS.Results: Before treatment, differences in left ventricular ultrasonic functional parameter levels as well as serum contents of myocardial enzyme spectrum and myocardial apoptosis indexes were not statistically significant between the two groups of patients. After treatment, left ventricular ultrasonic functional parameters LVEDD and LVESD levels in observation group were lower than those in control group while SV level was higher than that in control group;serum contents of myocardial enzyme spectrum cTnT, LDH, CK-MB and AST were lower than those in control group;serum contents of myocardial apoptosis indexes Fas, Caspase-3 and caspase-12 were lower than those in control group while Bcl-2 content was higher than that in control group. The left ventricular ultrasonic functional parameters in ACS patients were directly correlated with the degree of myocardial injury.Conclusion: PCI treatment of patients with ACS can significantly improve left ventricular function and reduce myocardial injury. After treatment, the left ventricular ultrasonic functional parameters are directly correlated with the degree of myocardial injury.
文摘We describe a rare case of a 60-year-old woman suffering from intramyocardial dissection and left ventricular aneurysm secondary to acute myocardial infarction. A rare form of ventricular septal rupture resulted from intramyocardial dissection deterioration, which was iden- tified during echocardiographic follow-up. Surgical repair under beating-heart cardiopulmonary bypass was successful.
文摘<strong>Background:</strong><span style="font-family:Verdana;"> Heart failure is the commonest cardiovascular complication in type 2 diabetes mellitus. However, subclinical left ventricular dysfunction can’t be detected using 2D echocardiography which </span><span style="font-family:Verdana;">is </span><span style="font-family:;" "=""><span style="font-family:Verdana;">routinely used for cardiac evaluation of diabetic patients. We aimed to determine the prevalence and factors associated to left ventricular global longitudinal strain (LV GLS) impairment in type 2 diabetes Cameroonians patients. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> We conducted a cross-sectional study from January 2019 to June 2019, including type 2 diabetes patients with preserved left ventricle ejection fraction. Clinical and echocardiographic data were collected, and LV GLS was assessed using speckle tracking technique, a value ≤</span></span><span style="font-family:Verdana;"> -</span><span style="font-family:;" "=""><span style="font-family:Verdana;">16% been considered as normal value. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> We recruited 95 patients, with a mean age of 57.4 ± 11.8 years old and median diabetes duration of 5 [2 </span></span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;"> 12] years. Echocardiographic evaluation found 56.3% of left ventricle remodelling, 51.6% of left ventricle diastolic dysfunction and mean left ventricle ejection of 63.3</span><span style="font-family:Verdana;">%</span><span style="font-family:Verdana;"> ± 6.6%. LV GLS impairment was present in 43.2% (95% CI: 32.6 </span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;"> 53.7) of the participants. After adjustment to all significantly associated factors, Obesity (aOR: 4;95% CI: 1.5 </span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;"> 10.6) and diastolic dysfunction (aOR: 3.1;95% CI: 1.2 </span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> 8.2) were independent factors associated with LV GLS. </span><b><span style="font-family:Verdana;">Conclusions:</span></b><span style="font-family:Verdana;"> Subclinical systolic dysfunction assessed by LV GLS impairment is frequent in diabetic patients. Further research should be carried out more extensively to integrate LV GLS in the type 2 diabetes patients’ routine follow up for a better prognostic outcome, especially in low-incomes countries.</span></span>
文摘Left ventricle(LV) pseudoaneurysm is a late mechanical complication of myocardial infarction.A giant LV pseudoaneurysm is a rare presentation.We report a case of giant LV pseudoaneurysm in a post-MI patient who presented with gross congestive heart failure.The patient had a successful surgical repair of the aneurysm and had a favorable 3-mo outcome.The imaging modality and surgical treatment of the pseudoaneurysm are discussed.
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.
文摘 Acute myocardial ischemia was induced by intravenous injection of pituitrin, and electroacupuncture (EA) was applied at the Heart and Lung Meridians (HM and LM), 3 points on each meridian. The changes in the left intraventricular pressure (LVP), the maximum rise rate of intraventricular pressure (LVP dp/dtmax), the area of cardiac force loop (ACFL), and the maximum shortening velocity of myocardial contractile element (Vmax) were observed. As a result, there were significant differences in the improvement of LVP, LVP dp/dtmax, ACFL and Vmax between EA at HM and LM. The regulatory action of EA at HM on the myocardial contractile function was significantly better than that of EA at LM, indicating that HM has a close relationship with the myocardial contractile function.……
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Purpose: The aim of the present study was to evaluate the diagnostic accuracy for quantification of left ventricular (LV) volumes and LV ejection fraction (LVEF) with current echocardiographic methods of planimetry for analysis of LV remodeling after myocardial infarction in daily clinical routine. Methods: 26 patients were investigated directly after interventional therapy at hospital pre-discharge and at 6 month follow-up. Standardized 2D transthoracic native and contrast echocardiography were performed in all patients. Due to methodological aspects the results of LV volumes and LVEF using native echocardiography were compared to the results of LV opacification (LVO) imaging for analysis in mono-, bi- and triplane data sets using the Simpson’s rule. In addition corresponding multidimensional data sets were analyzed. Results: The assessment of LV volumes and LVEF is more accurate with contrast echocardiography. The comparison of LV volumes and LVEF shows significant increases using contrast echocardiography (p < 0.001). Larger left ventricular end-diastolic volumes (LVEDV) are measured at follow up (p < 0.05). Significant differences (p < 0.001) are found for the determination of LVEDV and LVEF relating to apical mono-, bi-, tri- and multiplane data sets. Standard deviations of the triplane approach, however, are significantly lower than using other modalities. Conclusion: Depending on the localization of the myocardial infarction LV volumes and LVEF are less reliably evaluated using the mono- or biplane approach. According to standardization and simultaneous acquisition of all LV wall segments the triplane approach is currently the best approach to determine LV systolic function. In addition, contrast echocardiography is indicated to improve endocardial border delineation in patients using the triplane or multiplane approach. To our knowledge the present study is the first systematic evaluation of all current possibilities for determination of LV volumes and LVEF by native and contrast echocardiography.
文摘AIMTo assess the prevalence of depressed heart rate variability(HRV)after an acute myocardial infarction(MI),and to evaluate its prognostic significance in the present era of immediate reperfusion.METHODSTime-domain HRV(obtained from 24-h Holter recordings)was assessed in 326 patients(63.5±12.1 years old;80%males),two weeks after a complicated MI treated by early reperfusion:208 ST-elevation myocardial infarction(STEMI)patients(in which reperfusion was successfully obtained within 6 h of symptoms in 94%of cases)and 118 non-ST-elevation myocardial infarction(NSTEMI)patients(percutaneous coronary intervention was performed within 24 h and successful in 73%of cases).Follow-up of the patients was performed via telephone interviews a median of 25 mo after the index event(95%CI of the mean 23.3-28.0).Primary end-point was occurrence of all-cause or cardiac death;secondary end-point was occurrence of major clinical events(MCE,defined as mortality or readmission for new MI,new revascularization,episodes of heart failure or stroke).Possible correlations between HRV parameters(mainly the standard deviation of all normal RR intervals,SDNN),clinical features(age,sex,type of MI,history of diabetes,left ventricle ejection fraction),angiographic characteristics(number of coronary arteries with critical stenoses,success and completeness of revascularization)and long-term outcomes were analysed.RESULTSMarkedly depressed HRV parameters were present in a relatively small percentage of patients:SDNN<70 ms was found in 16%and SDNN<50 ms in 4%of cases.No significant differences were present between STEMI and NSTEMI cases as regards to their distribution among quartiles of SDNN(χ<sup>2</sup>=1.536,P=0.674).Female sex and history of diabetes maintained a significant correlation with lower values of SDNN at multivariate Cox regression analysis(respectively:P=0.008 and P=0.008),while no correlation was found between depressed SDNN and history of previous MI(P=0.999)or number of diseased coronary arteries(P=0.428)or unsuccessful percutaneous coronary intervention(PCI)(P=0.691).Patients with left ventricle ejection fraction(LVEF)<40%presented more often SDNN values in the lowest quartile(P<0.001).After>2 years from infarction,a total of 10 patients(3.1%)were lost to follow-up.Overall incidence of MCE at follow-up was similar between STEMI and NSTEMI(P=0.141),although all-cause and cardiac mortality were higher among NSTEMI cases(respectively:14%vs 2%,P=0.001;and 10%vs 1.5%,P=0.001).The Kaplan-Meier survival curves for all-cause mortality and for cardiac deaths did not reveal significant differences between patients with SDNN in the lowest quartile and other quartiles of SDNN(respectively:P=0.137 and P=0.527).Also the MCE-free survival curves were similar between the group of patients with SDNN in the lowest quartile vs the patients of the other SDNN quartiles(P=0.540),with no difference for STEMI(P=0.180)or NSTEMI patients(P=0.541).By the contrary,events-free survival was worse if patients presented with LVEF<40%(P=0.001).CONCLUSIONIn our group of patients with a recent complicated MI,abnormal autonomic parameters have been found with a prevalence that was similar for STEMI and NSTEMI cases,and substantially unchanged in comparison to what reported in the pre-primary-PCI era.Long-term outcomes did not correlate with level of depression of HRV parameters recorded in the subacute phase of the disease,both in STEMI and in NSTEMI patients.These results support lack of prognostic significance of traditional HRV parameters when immediate coronary reperfusion is utilised.
文摘A 72-year-old elderly male smoker with a known history of hypertension presented with a six day history of chest pain. His blood pressure at presentation was 110/70 mmHg and there was no audible murmur. ECG showed Q waves in the inferior leads （Figure IA） and troponin level was elevated （14 /.tg/L）.
