The optimal plane for measurement of the right ventricular (RV) volumes by real-time three-dimensional echocardiography (RT3DE) was determined and the feasibility and accuracy of RT3DE in studying RV systolic function...The optimal plane for measurement of the right ventricular (RV) volumes by real-time three-dimensional echocardiography (RT3DE) was determined and the feasibility and accuracy of RT3DE in studying RV systolic function was assessed. RV “Full volume” images were acquired by RT3DE in 22 healthy subjects. RV end-diastolic volumes (RVEDV) and end-systolic volumes (RVESV) were outlined using apical biplane, 4-plane, 8-plane, 16-plane offline separately. RVSV and RVEF were calculated. Meanwhile tricuspid annual systolic excursion (TASE) was measured by M-mode echo. LVSV was outlined by 2-D echo according to the biplane Simpson's rule. The results showed: (1) There was a good correlation between RVSV measured from series planes and LVSV from 2-D echo (r=0.73; r=0.69; r=0.63; r=0.66, P<0.25—0.0025); (2) There were significant differences between RVEDV in biplane and those in 4-, 8-, 16-plane (P<0.001). There was also difference between RV volume in 4-plane and that in 8-plane (P<0.05), but there was no significant difference between RV volume in 8-plane and that in 16-plane (P>0.05); (3) Inter-observers and intro-observers variability analysis showed that there were close agreements and relations for RV volumes (r=0.986, P<0.001; r=0.93, P<0.001); (4) There was a significantly positive correlation of TASE to RVSV and RVEF from RT3DE (r=0.83; r=0.90). So RV volume measures with RT3DE are rapid, accurate and reproducible. In view of RV's complex shape, apical 8-plane method is better in clinical use. It may allow early detection of RV systolic function.展开更多
BACKGROUND HeartModel(HM)is a fully automated adaptive quantification software that can quickly quantify left heart volume and left ventricular function.This study used HM to quantify the left ventricular end-diastoli...BACKGROUND HeartModel(HM)is a fully automated adaptive quantification software that can quickly quantify left heart volume and left ventricular function.This study used HM to quantify the left ventricular end-diastolic(LVEDV)and end-systolic volumes(LVESV)of patients with dilated cardiomyopathy(DCM),coronary artery heart disease with segmental wall motion abnormality,and hypertrophic cardiomyopathy(HCM)to determine whether there were differences in the feasibility,accuracy,and repeatability of measuring the LVEDV,LVESV,LV ejection fraction(LVEF)and left atrial end-systolic volume(LAESV)and to compare these measurements with those obtained with traditional twodimensional(2D)and three-dimensional(3D)methods.AIM To evaluate the application value of HM in quantifying left heart chamber volume and LVEF in clinical patients.METHODS A total of 150 subjects who underwent 2D and 3D echocardiography were divided into 4 groups:(1)42 patients with normal heart shape and function(control group,Group A);(2)35 patients with DCM(Group B);(3)41 patients with LV remodeling after acute myocardial infarction(Group C);and(4)32 patients with HCM(Group D).The LVEDV,LVESV,LVEF and LAESV obtained by HM with(HM-RE)and without regional endocardial border editing(HM-NE)were compared with those measured by traditional 2D/3D echocardiographic methods to assess the correlation,consistency,and repeatability of all methods.RESULTS(1)The parameters measured by HM were significantly different among the groups(P<0.05 for all).Compared with Groups A,C,and D,Group B had higher LVEDV and LVESV(P<0.05 for all)and lower LVEF(P<0.05 for all);(2)HM-NE overestimated LVEDV,LVESV,and LAESV with wide biases and underestimated LVEF with a small bias;contour adjustment reduced the biases and limits of agreement(bias:LVEDV,28.17 mL,LVESV,14.92 mL,LAESV,8.18 mL,LVEF,-0.04%).The correlations between HM-RE and advanced cardiac 3D quantification(3DQA)(r_(s)=0.91-0.95,P<0.05 for all)were higher than those between HM-NE(r_(s)=0.85-0.93,P<0.05 for all)and the traditional 2D methods.The correlations between HM-RE and 3DQA were good for Groups A,B,and C but remained weak for Group D(LVEDV and LVESV,r_(s)=0.48-0.54,P<0.05 for all);and(3)The intraobserver and interobserver variability for the HM-RE measurements were low.CONCLUSION HM can be used to quantify the LV volume and LVEF in patients with common heart diseases and sufficient image quality.HM with contour editing is highly reproducible and accurate and may be recommended for clinical practice.展开更多
Previous studies have reported decreased cerebral volume as a result of smoking. However, little is known about accompanying changes in ventricular volume for healthy subjects who smoke, although ventricular volume is...Previous studies have reported decreased cerebral volume as a result of smoking. However, little is known about accompanying changes in ventricular volume for healthy subjects who smoke, although ventricular volume is increased in patients with multiple sclerosis who smoke. The present study analyzed whether cerebral volume decreased with smoking through the use of magnetic resonance imaging. In addition, accompanying changes in ventricular volume that resulted from decreased cerebral volume and smoking were analyzed in healthy subjects. When multivariate analysis of covariance was performed by integrating the 2 age groups, aged 20-28 years and 40-49 years, with statistical significance, results showed that cerebral volume of smokers was smaller and ventricular volume was greater compared with the non-smokers. These findings suggest that ventricular volume changes could be utilized to characterize the effects of smoking.展开更多
Left ventricular ejection fraction(LVEF)is an impor-tant predictor of cardiac outcome and helps in makingimportant diagnostic and therapeutic decisions suchas the treatment of different types of congestive heartfailur...Left ventricular ejection fraction(LVEF)is an impor-tant predictor of cardiac outcome and helps in makingimportant diagnostic and therapeutic decisions suchas the treatment of different types of congestive heartfailure or implantation of devices like cardiac resynchro-nization therapy-defibrillator.LVEF can be measuredby various techniques such as transthoracic echo-cardiography,contrast ventriculography,radionuclidetechniques,cardiac magnetic resonance imaging andcardiac computed tomographic angiography(CTA).Thedevelopment of cardiac CTA using multi-detector rowCT(MDCT)has seen a very rapid improvement in thetechnology for identifying coronary artery stenosis andcoronary artery disease in the last decade.During theacquisition,processing and analysis of data to studycoronary anatomy,MDCT provides a unique opportunityto measure left ventricular volumes and LVEF simulta-neously with the same data set without the need foradditional contrast or radiation exposure.The develop-ment of semi-automated and automated software to measure LVEF has now added uniformity,efficiency and reproducibility of practical value in clinical practice rather than just being a research tool.This article will address the feasibility,the accuracy and the limitations of MDCT in measuring LVEF.展开更多
BACKGROUND Heart defects are the most common congenital malformations in fetuses.Fetal cardiac structure and function abnormalities lead to changes in ventricular volume.As ventricular volume is an important index for...BACKGROUND Heart defects are the most common congenital malformations in fetuses.Fetal cardiac structure and function abnormalities lead to changes in ventricular volume.As ventricular volume is an important index for evaluating fetal cardiovascular development,an effective and reliable method for measuring fetal ventricular volume and cardiac function is necessary for accurate ultrasonic diagnosis and effective clinical treatment.The new intelligent spatiotemporal image correlation(iSTIC)technology acquires high-resolution volumetric images.In this study,the iSTIC technique was used to measure right ventricular volume and to evaluate right ventricular systolic function to provide a more accurate and convenient evaluation of fetal heart function.AIM To investigate the value of iSTIC in evaluating right ventricular volume and systolic function in normal fetuses.METHODS Between October 2014 and September 2015,a total of 123 pregnant women received prenatal ultrasound examinations in our hospital.iSTIC technology was used to acquire the entire fetal cardiac volume with off-line analysis using QLAB software.Cardiac systolic and diastolic phases were defined by opening of the atrioventricular valve and the subsequent closure of the atrioventricular valve.The volumetric data of the two phases were measured by manual tracking and summation of multiple slices and recording of the right ventricular end-systolic volume and the right ventricular end-diastolic volume.The data were used to calculate the right stroke volume,the right cardiac output,and the right ejection fraction.The correlations of changes between the above-mentioned indices and gestational age were analyzed.The right ventricular volumes of 30 randomly selected cases were measured twice by the same sonographer,and the intraobserver agreement measurements were calculated.RESULTS Among the 123 normal fetuses,the mean right ventricular end-diastolic volume increased from 0.99±0.34 mL at 22 wk gestation to 3.69±0.36 mL at 35+6 wk gestation.The mean right ventricular end-systolic volume increased from 0.43±0.18 mL at 22 wk gestation to 1.36±0.22 mL at 35+6 wk gestation.The mean right stroke volume increased from 0.62±0.29 mL at 22 wk gestation to 2.33±0.18 mL at 35+6 wk gestation.The mean right cardiac output increased from 92.23±40.67 mL/min at 22 wk gestation to 335.83±32.75 mL/min at 35+6 wk gestation.Right ventricular end-diastolic volume,right ventricular end-systolic volume,right stroke volume,and right cardiac output all increased with gestational age and the correlations were linear(P<0.01).Right ejection fraction had no apparent correlation with gestational age(P>0.05).CONCLUSION Fetal right ventricular volume can be quantitatively measured using iSTIC technology with relative ease and high repeatability.iSTIC technology is expected to provide a new method for clinical evaluation of fetal cardiac function.展开更多
Background: Real-time three-dimensional echocardiography (RT-3DE) could obtain ventricular volume andejection fraction rapidly and non-invasively without relying on ventricular morphology. This study aims to useRT-3DE...Background: Real-time three-dimensional echocardiography (RT-3DE) could obtain ventricular volume andejection fraction rapidly and non-invasively without relying on ventricular morphology. This study aims to useRT-3DE to evaluate the changes in biventricular volume and systolic function in children with ventricular septaldefect (VSD) and moderate to severe pulmonary hypertension (PH) before surgery. Methods: In this study18 children with VSD and moderate to severe PH (VSD + PH Group) and 18 healthy children of the sameage (Control Group) were recruited. Biventricular volume and systolic function were evaluated by RT-3DE.The measurements included: left and right ventricular volume indexed to body surface area (BSA), stroke volume(SV) indexed to BSA, and ejection fraction (EF). Results: The results showed left and right ventricular volumeindexed to BSA and SV indexed to BSA were significantly increased in VSD + PH Group (VSD + PH Groupvs. Control Group), LVEDV/BSA (ml/m2): 48.67 ± 21.46 vs. 25.59 ± 6.96, RVEDV/BSA (ml/m2): 55.98 ±15.35 vs. 27.69 ± 4.37, LVSV/BSA (ml/m2): 24.08 ± 9.30 vs. 15.14 ± 4.29, RVSV/BSA (ml/m2): 26.02 ± 8.87 vs.14.11 ± 2.89, (P < 0.05). While for EF in VSD + PH Group decreased (VSD + PH Group vs. Control Group),LVEF: 50.93 ± 7.50% vs. 59.38 ± 7.24%, RVEF: 45.84 ± 7.71% vs. 51.05 ± 6.90% (P < 0.05). Conclusion: Inchildren with VSD and moderate to severe PH, increased biventricular volume and decreased systolic functionwere observed with RT-3DE, but biventricular systolic function remained within acceptable limits. The childrenin this study recovered well after surgery without serious perioperative complications, suggesting that biventricularsystolic function may help facilitate the surgical decision-making process in children with VSD and moderate-toseverePH.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
Background Assessment of the left ventricular (LV) and the right ventricular (RV) volumes and their functions is important for prognostic prediction and clinical decision making. We compared the accuracy for quantify...Background Assessment of the left ventricular (LV) and the right ventricular (RV) volumes and their functions is important for prognostic prediction and clinical decision making. We compared the accuracy for quantifying the LV and the RV volumes in vitro between conventional two-dimensional echocardiography (2DE) and real-time three-dimensional echocardiography (RT3DE) Methods The volumes of 37 rubber-models (10 regularly shaped to simulate normal LV, 7 shaped to simulate LV with symmetric aneurysm, 8 shaped to simulate LV with asymmetric aneurysm, and 12 irregularly shaped to simulate normal RV) and 10 excised canine hearts were measured by RT3DE and 2DE On RT3DE 'full volume' imaging, the inner-surfaces of the rubber-models and canine LV and RV were outlined and the volumes were measured using 2-, 4-, 8- and 16-plane methods with the RT3DE analysis software On 2DE imaging, the volumes were measured by the Simpson method The LV and RV volumes measured by drained water were served as reference values, with which we compared RT3DE and 2DE data Results In rubber models mimicking normal LV and LV with symmetric aneurysms, RT3DE results were strongly correlated with reference values ( r =0 795-0 998) and there was a good correlation between 2DE estimates and reference values ( r =0 715-0 729) There were no significant differences between RT3DE estimates, 2DE results and reference values ( P >0 05) In rubber models mimicking the RV and LV with asymmetric aneurysm, RT3DE strongly correlated with reference values ( r =0 765-0 988), but 2DE weakly correlated with reference values ( r =0 518-0 592) There were no differences between RT3DE and reference values ( P >0 05), but a significant difference between 2DE and reference values occurred ( P <0 05) For excised canine hearts, there was a strong correlation between RT3DE and reference values ( r =0 728-0 914), while 2DE showed a less obvious correlation ( r =0 502-0 615) Again, there were no significant differences between RT3DE and reference values ( P >0 05), but there was a significant difference between 2DE and reference values ( P <0 05) Conclusions RT3DE can accurately quantify LV and RV volumes and provides a new tool to evaluate LV and RV function For LV and RV measurements by RT3DE, 8-plane strategy is the optimum choice for accuracy and convenience展开更多
Background Multislice helical computed tomography (MSCT) has been used to depict coronary anatomy noninvasively, and proved useful for evaluating ventricular function. The aim of our study was to assess the accuracy...Background Multislice helical computed tomography (MSCT) has been used to depict coronary anatomy noninvasively, and proved useful for evaluating ventricular function. The aim of our study was to assess the accuracy of ventricular volume as measured by MSCT.Methods Fourteen human left ventricular (LV) and 15 right ventricular (RV) casts were scanned by MSCT. A series of LV and RV short-axis images were reconstructed later with slice thickness of 2.0 mm, 3.5 mm, 5.0 mm, 7.0 mm, and 10.0 mm. Ventricular volume was calculated by the multislice tomographic Simpson’s method. True LV and RV cast volumes were determined by water displacement. Results Both calculated LV and RV volumes correlated highly with the corresponding true volumes (all r>0.95, P<0.01). But with slice thickness from 2.0 mm to 10.0 mm, MSCT scanning overestimated the corresponding true volume by (3.21±5.95) ml to (12.58±8.56) ml for LV and (10.22±8.45) ml to (23.91±12.24) ml for RV (all P<0.01). There was a very high correlation between the overestimation and the selected slice thickness for both LV and RV volume measurements (r=0.998 and 0.996, P<0.01, respectively). However, when slice thickness was reduced to 5.0 mm, the overestimation for both LV and RV volume measurements became nonsignificant for slice thickness from 2.0 mm to 5.0 mm. Conclusions Both LV and RV volumes can be accurately estimated by MSCT. Thinner slice has more accurate calculated volume. However, 5.0 mm slice thickness is thin enough for an accurate measurement of LV or RV volume.展开更多
The effect of sublingual administration and intravenous drip of nitroglycerin (SLNTG and IVNTG) on left ventricular volumes (LVVs) were studied and systolic function was quantitatively assessed with two-dimensional ec...The effect of sublingual administration and intravenous drip of nitroglycerin (SLNTG and IVNTG) on left ventricular volumes (LVVs) were studied and systolic function was quantitatively assessed with two-dimensional echocardiography (2DE) in 28 patients with myocardial infarction (MI), including 13 cases without heart failure (MI-NHF) in one group and 15 with heart failure (MI-HF) in another. The results showed that after SLNTG and IVNTG in both groups the heart rate (HR) increased significantly (P< 0.05-0.001); the systolic blood pressure (SBP) decreased significantly (P< 0.05-0.001); the diastolic blood pressure (DBP) was not significantly changed (all P>0.05); the left ventricular end-diastolic and end-systolic volumes (EDV and ESV) both significantly reduced [EDV: decreased by 5.8-11.6% (-13.2-19.0 ml), P< 0.05-0.001; ESV: decreased by 9.6-16.6% (-8.6-17.3 ml), P< 0.05-0.001)1; the left ventricular ejection fraction (LVEF) all significantly elevated (increased by 6.6%-9.4% (3.2%-3.4%), P < 0.05-0.001] except in MI-NHF group after IVNTG; the segmental EF of normal and hypokinetic segments also significantly increased (P<0.05-0.001). The results suggest that NTG could beneficially reduce left ventricular EDV and ESV; and improve or strengthen its global and segmental systolic function in MI patients, particularly noticeable in patients with heart failure.展开更多
Background Left atrial enlargement has been suggested as a more robust marker of diastolic dysfunction. We hypothesize that the ratio of left atrial volume to left ventricular volume （LAV/LVV） may be more reasonable...Background Left atrial enlargement has been suggested as a more robust marker of diastolic dysfunction. We hypothesize that the ratio of left atrial volume to left ventricular volume （LAV/LVV） may be more reasonable to reflect left atrial enlargement in the patients with hypertension, because hypertensive patients have a characteristic of concentric remodeling of the left ventricle which is often accompanied with diastolic dysfunction. The aim of this study was to determine if the LAV/LVV can be used as a new parameter to assess left atrial size in hypertensive patients and the relationship between the LAV/LVV and diastolic dysfunction. Methods Ninety-one patients with hypertension and forty-three normal controls were studied. The hypertensive patients were assigned to the normal wall （NW） and hypertrophic wall （HW） groups. The left atrial diameter （LAD）, LAV, left atrial volume index （LAVi）, LVV and LAV/LVV were measured and calculated by 2-dimensional echocardiography and real time 3-dimensional echocardiography. All of the above parameters were used to evaluate the size of the left atrium. The ratio of peak E velocity of mitral valve inflow to peak E＇ velocity of lateral mitral annulus （E/E＇） was measured by pulse Doppler and tissue Doppler. This parameter was used to evaluate diastolic function. Results The LAD, LAV, LAVi, LAV/LVV and E/E＇ in hypertensive groups were significantly higher than those in the normal group （P 〈0.05 or 0.01）, and those in the HW group were significantly higher than those in the NW group （P 〈0.05 or 0.01）. The E/E＇ had a positive correlation with LAV, LAVi and LAV/LVV. The correlation coefficient between E/E＇ and LAV/LVV was relatively higher than that between E/E＇ and LAD or LAVi. Conclusion LAV/LVV may be used as a new index to evaluate left atrial size in hypertensive patients with diastolic dysfunction.展开更多
Background: The aim of this study was to determine the relation of left atrial (LA) volume and LA volume index with left ventricular function and to determine the association of duration of symptoms and left atrial vo...Background: The aim of this study was to determine the relation of left atrial (LA) volume and LA volume index with left ventricular function and to determine the association of duration of symptoms and left atrial volume index in patients with dilated cardiomyopathy. Materials and Methods: This was an observational, single centre study conducted in India. A total of 50 patients who were admitted to department of cardiology from July, 2008 to February, 2009 with diagnosis of dilated cardiomyopathy and an ejection fraction of <40% were included. Results: Of the 50 patients, 34 (68%) were males. 27 (54%) patients were in NYHA class II and 23 (46%) patients were in NYHA class III. LA volume was found to be ≥40 ml in all patients. LV function and LA volume were found to be correlated (r = -0.789, p < 0.01). Similarly, there was a correlation between LV function and LA volume index (r = -0.826, p < 0.01). There was no correlation between LA volume index and duration of symptoms (r = 0.04). Conclusion: It can be concluded that there is a strong inverse correlation between LA volume and left ventricular function and also between LA volume index and left ventricular function. The patients with NYHA class III were having larger left atrial volume than those with NYHA class II. Moreover, the duration of symptoms has no correlation with left atrial volume index.展开更多
The volume-time curve change in patients with normal left ventricular （LV） diastolic function and diastolic dysfunction was evaluated by real-time three-dimensional echocardiography （RT3DE）. LV diastolic dysfuncti...The volume-time curve change in patients with normal left ventricular （LV） diastolic function and diastolic dysfunction was evaluated by real-time three-dimensional echocardiography （RT3DE）. LV diastolic dysfunction was defined by E＇〈A＇ in pulse-wave tissue Doppler for inter-ventricular septal （IVS） of mitral annulus. In 24 patients with LV diastolic dysfunction, including 12 patients with delayed relaxation （delayed relaxation group） and 12 patients with pseudo-normal function （pseudo-normal group） and 24 normal volunteers （control group）, data of full-volume image were acquired by real-time three-dimensional echocardiography and subjected to volume-time curve analysis. EDV （end-diastolic volume）, ESV （end-systolic volume）, LVEF （left ventricular ejection fraction）, PER （peak ejection rate）, PFR （peak filling rate） from RT3DE were examined in the three groups. Compared to the control group, PFR （diastolic filling index of RT3DE） was significantly reduced in the delayed relaxation group and pseudo-normal group （P〈0.05）. There were no significant differences in EDV, ESV, LVEE PER （P〉0.05）. It is concluded that PFR, as a diastolic filling index of RT3DE, can reflect the early diastolic function and serve as a new non-invasive, quick and accurate tool for clinical assessment of LV diastolic function.展开更多
background To investigate the accuracy and feasibility of CT in quantification of ventricular volume based on semiautomatic three-dimensional(3D)threshold-based segmentation in porcine heart and children with tetralog...background To investigate the accuracy and feasibility of CT in quantification of ventricular volume based on semiautomatic three-dimensional(3D)threshold-based segmentation in porcine heart and children with tetralogy of Fallot(TOF).Methods Eight porcine hearts were used in the study.The atria were resected and both ventricles of the eight porcine hearts were filled with solidifiable silica gel and performed CT scanning.The water displacement volume of silica gel casting mould was referred as gold standard of ventricular volume.Results of left and right ventricular volumes measured by CT were compared with reference standard.Twenty-three children diagnosed with TOF were retrospectively included.The ventricular volumetric parameters were assessed by cardiac CT before and 6 months after surgery.results Left ventricular and right ventricular volumes of porcine hearts measured by CT were highly correlated to casting mould(r=0.845,p=0.008;r=0.933,p=0.001),and there were no statistically significant differences(t=−1.059,p=0.325;t=−1.121,p=0.299).In children with TOF,right ventricular end-systole volumes 6 months after operation were higher than that before surgery,21.93±4.44 vs 19.80±4.52 mL/m^(2),p=0.001.Right ventricular ejection fractions 6 months after surgery were lower compared with that before surgery 59.79%±4.26%vs 63.05%±5.04%,p=0.000.Conclusions CT is able to accurately assess ventricular volumetric parameters based on semiautomatic 3D threshold-based segmentation.Both of the right and left ventricular volumetric parameters could be evaluated by CT in children with TOF.展开更多
Objective: Ischemic conditioning (IC) limits myocyte necrosis after acute myocardial ischemia-reperfusion;however, controversy persists regarding its potential to attenuate LV contractile dysfunction. Pressure-volume ...Objective: Ischemic conditioning (IC) limits myocyte necrosis after acute myocardial ischemia-reperfusion;however, controversy persists regarding its potential to attenuate LV contractile dysfunction. Pressure-volume (P-V) loop analysis, via the load-insensitive conductance catheter method, was used to evaluate LV contractility, diastolic function, and ventriculo-arterial coupling. The goal of this study was to evaluate the ability of IC to improve post-ischemic recovery of LV contractile function. Methods: Twelve anesthetized dogs were randomly distributed to either the IC or the non-IC group;all dogs were subject to 60-min acute coronary occlusion followed by 180-min reperfusion. IC consisted of 4 repeated cycles of 5-min occlusion and 5-min reperfusion of the left main coronary artery. LV P-V relations were constructed under steady-state conditions (by inferior vena cava occlusion) at the beginning and end of the experiments;P-V loops were acquired at different time points before and during ischemia-reperfusion. Results: During ischemia and reperfusion, dP/dt<sub>max</sub> decreased significantly compared to baseline in both groups;dP/dt<sub>min</sub>, an indicator of the rate of LV relaxation rate was not affected for either group. Significant changes in several parameters of LV function including LVEF, SW, tPFR, ESV, and EDV caused by ischemia were also identified;none of these negative effects were resorbed, even in part, during reperfusion. Conclusions: Diminished LV contractile efficiency during systole and diastole produced by ischemia-reperfusion did not improve with IC pre-treatment despite significant endogenous protection against tissue necrosis.展开更多
Arrhythmogenic right ventricular cardiomyopathy(ARVC)is a progressive disease characterized by adipose and fibrous replacement of the myocardium.While elevated testosterone levels have been implicated in the pathologi...Arrhythmogenic right ventricular cardiomyopathy(ARVC)is a progressive disease characterized by adipose and fibrous replacement of the myocardium.While elevated testosterone levels have been implicated in the pathological process of ARVC,its exact contribution to cardiac fibrosis in ARVC remains unclear.In this study,we analyzed the potential contribution of gender-based differences on the distribution of the low-voltage area in an ARVC cohort undergoing an electrophysiological study,which was indicated by feature selection.Additionally,we established engineered cardiac spheroid models in vitro using patient-specific induced pluripotent stem cell(iPSC)-derived cardiomyocytes(iPSC-CMs)and iPSC-derived cardiac fibroblasts(icFBs).We elucidated the pathogenicity of abnormal splicing in the plakophilin-2(PKP2)gene caused by an intronic mutation.Additionally,pathogenic validation of the desmoglein-2(DSG2)point mutation further confirms the reliability of the models.Moreover,testosterone exacerbated the DNA damage in the mutated cardiomyocytes and further activated myofibroblasts in a chain reaction.In conclusion,we designed and constructed an in vitro three-dimensionally-engineered cardiac spheroid model of ARVC based on clinical findings and provided direct evidence of the fibrotic role of testosterone in ARVC.展开更多
Diabetic cardiomyopathy(DCM)has long been considered as a left ventricular(LV)disease with diastolic dysfunction preceding systolic dysfunction in diabetes.However,it is increasingly recognized that the right ventricl...Diabetic cardiomyopathy(DCM)has long been considered as a left ventricular(LV)disease with diastolic dysfunction preceding systolic dysfunction in diabetes.However,it is increasingly recognized that the right ventricle(RV)is also affected by diabetes and may be independently responsible for adverse outcomes in diabetic patients with or without LV failure.Yu et al conducted a 30-week longitudinal evaluation of biventricular function and pathology in OVE26 diabetic mice and revealed early diastolic dysfunction preceding systolic decline,suggesting that early LV diastolic impairment precedes the later onset of systolic dysfunction.With age,the animals developed fibrosis,hypertrophy,and pulmonary arterial hypertension in the RV.The purpose of this editorial is to contextualize these findings within the existing literature by highlighting the interplay between cardiac chambers and the vasculature.We also seek to reiterate that DCM is a condition extending beyond left ventricular dysfunction.As the authors note,the right side of the heart may remain"the forgotten ventricle"in diabetic patients.We hope that the mechanisms discussed in this paper will help researchers to understand the pathogenesis of cardiovascular disease in this context and encourage clinicians to be more attentive to the associated clinical symptoms.展开更多
This review comprehensively examines acute myocardial infarction with ventricular septal rupture(VSR),a rare yet lethal complication.We analyze its epidemiological,pathophysiological,clinical,and therapeutic aspects,e...This review comprehensively examines acute myocardial infarction with ventricular septal rupture(VSR),a rare yet lethal complication.We analyze its epidemiological,pathophysiological,clinical,and therapeutic aspects,emphasizing innovative strategies like bioabsorbable occluders and tissue engineering to reduce complications and improve prognosis.The integration of artificial intelligence and big data analytics for treatment decision-making and personalized surgical timing models is highlighted as transformative.Our analysis underscores the need for early diagnosis and tailored interventions,proposing future research directions in molecular mechanisms,multidisciplinary collaboration,and technology integration.These innovations promise to enhance VSR management and extend to other cardiovascular diseases,heralding a new era of precision and regenerative cardiovascular medicine.展开更多
Right ventricular(RV)failure accounts for significant morbidity and mortality in critically ill patients.The RV is particularly vulnerable in conditions characterized by elevated pulmonary vascular afterload,which are...Right ventricular(RV)failure accounts for significant morbidity and mortality in critically ill patients.The RV is particularly vulnerable in conditions characterized by elevated pulmonary vascular afterload,which are commonly encountered in the intensive care unit(ICU).Conditions such as acute respiratory distress syndrome,pulmonary embolism,and decompensated pulmonary arterial hypertension are associated with acute and acute-on-chronic RV failure.In the ICU,RV failure may develop or worsen in patients with parenchymal pulmonary disease who acutely experience fluctuations in preload,excessive afterload,and/or insufficient myocardial contractility,often in addition to mechanical ventilation and circulatory compromise.This dynamic clinical scenario demands early recognition and intervention tailored to an individual patient’s physiology.Distinguishing between acute and chronic RV failure in critical illness informs diagnostic workup,hemodynamic monitoring,and resuscitative efforts.This narrative review will provide an overview of common conditions associated with RV failure in critical illness,highlighting a practical,physiology-oriented approach to diagnosis and optimization of ventilator support,fluid resuscitation,vasopressor and inotrope use,and mechanical circulatory support.RV failure due to RV infarction or severe LV failure and decompensated congenital heart disease are distinct pathophysiologic entities.These conditions require distinct treatment approaches and are beyond the scope of this review.展开更多
文摘The optimal plane for measurement of the right ventricular (RV) volumes by real-time three-dimensional echocardiography (RT3DE) was determined and the feasibility and accuracy of RT3DE in studying RV systolic function was assessed. RV “Full volume” images were acquired by RT3DE in 22 healthy subjects. RV end-diastolic volumes (RVEDV) and end-systolic volumes (RVESV) were outlined using apical biplane, 4-plane, 8-plane, 16-plane offline separately. RVSV and RVEF were calculated. Meanwhile tricuspid annual systolic excursion (TASE) was measured by M-mode echo. LVSV was outlined by 2-D echo according to the biplane Simpson's rule. The results showed: (1) There was a good correlation between RVSV measured from series planes and LVSV from 2-D echo (r=0.73; r=0.69; r=0.63; r=0.66, P<0.25—0.0025); (2) There were significant differences between RVEDV in biplane and those in 4-, 8-, 16-plane (P<0.001). There was also difference between RV volume in 4-plane and that in 8-plane (P<0.05), but there was no significant difference between RV volume in 8-plane and that in 16-plane (P>0.05); (3) Inter-observers and intro-observers variability analysis showed that there were close agreements and relations for RV volumes (r=0.986, P<0.001; r=0.93, P<0.001); (4) There was a significantly positive correlation of TASE to RVSV and RVEF from RT3DE (r=0.83; r=0.90). So RV volume measures with RT3DE are rapid, accurate and reproducible. In view of RV's complex shape, apical 8-plane method is better in clinical use. It may allow early detection of RV systolic function.
文摘BACKGROUND HeartModel(HM)is a fully automated adaptive quantification software that can quickly quantify left heart volume and left ventricular function.This study used HM to quantify the left ventricular end-diastolic(LVEDV)and end-systolic volumes(LVESV)of patients with dilated cardiomyopathy(DCM),coronary artery heart disease with segmental wall motion abnormality,and hypertrophic cardiomyopathy(HCM)to determine whether there were differences in the feasibility,accuracy,and repeatability of measuring the LVEDV,LVESV,LV ejection fraction(LVEF)and left atrial end-systolic volume(LAESV)and to compare these measurements with those obtained with traditional twodimensional(2D)and three-dimensional(3D)methods.AIM To evaluate the application value of HM in quantifying left heart chamber volume and LVEF in clinical patients.METHODS A total of 150 subjects who underwent 2D and 3D echocardiography were divided into 4 groups:(1)42 patients with normal heart shape and function(control group,Group A);(2)35 patients with DCM(Group B);(3)41 patients with LV remodeling after acute myocardial infarction(Group C);and(4)32 patients with HCM(Group D).The LVEDV,LVESV,LVEF and LAESV obtained by HM with(HM-RE)and without regional endocardial border editing(HM-NE)were compared with those measured by traditional 2D/3D echocardiographic methods to assess the correlation,consistency,and repeatability of all methods.RESULTS(1)The parameters measured by HM were significantly different among the groups(P<0.05 for all).Compared with Groups A,C,and D,Group B had higher LVEDV and LVESV(P<0.05 for all)and lower LVEF(P<0.05 for all);(2)HM-NE overestimated LVEDV,LVESV,and LAESV with wide biases and underestimated LVEF with a small bias;contour adjustment reduced the biases and limits of agreement(bias:LVEDV,28.17 mL,LVESV,14.92 mL,LAESV,8.18 mL,LVEF,-0.04%).The correlations between HM-RE and advanced cardiac 3D quantification(3DQA)(r_(s)=0.91-0.95,P<0.05 for all)were higher than those between HM-NE(r_(s)=0.85-0.93,P<0.05 for all)and the traditional 2D methods.The correlations between HM-RE and 3DQA were good for Groups A,B,and C but remained weak for Group D(LVEDV and LVESV,r_(s)=0.48-0.54,P<0.05 for all);and(3)The intraobserver and interobserver variability for the HM-RE measurements were low.CONCLUSION HM can be used to quantify the LV volume and LVEF in patients with common heart diseases and sufficient image quality.HM with contour editing is highly reproducible and accurate and may be recommended for clinical practice.
文摘Previous studies have reported decreased cerebral volume as a result of smoking. However, little is known about accompanying changes in ventricular volume for healthy subjects who smoke, although ventricular volume is increased in patients with multiple sclerosis who smoke. The present study analyzed whether cerebral volume decreased with smoking through the use of magnetic resonance imaging. In addition, accompanying changes in ventricular volume that resulted from decreased cerebral volume and smoking were analyzed in healthy subjects. When multivariate analysis of covariance was performed by integrating the 2 age groups, aged 20-28 years and 40-49 years, with statistical significance, results showed that cerebral volume of smokers was smaller and ventricular volume was greater compared with the non-smokers. These findings suggest that ventricular volume changes could be utilized to characterize the effects of smoking.
文摘Left ventricular ejection fraction(LVEF)is an impor-tant predictor of cardiac outcome and helps in makingimportant diagnostic and therapeutic decisions suchas the treatment of different types of congestive heartfailure or implantation of devices like cardiac resynchro-nization therapy-defibrillator.LVEF can be measuredby various techniques such as transthoracic echo-cardiography,contrast ventriculography,radionuclidetechniques,cardiac magnetic resonance imaging andcardiac computed tomographic angiography(CTA).Thedevelopment of cardiac CTA using multi-detector rowCT(MDCT)has seen a very rapid improvement in thetechnology for identifying coronary artery stenosis andcoronary artery disease in the last decade.During theacquisition,processing and analysis of data to studycoronary anatomy,MDCT provides a unique opportunityto measure left ventricular volumes and LVEF simulta-neously with the same data set without the need foradditional contrast or radiation exposure.The develop-ment of semi-automated and automated software to measure LVEF has now added uniformity,efficiency and reproducibility of practical value in clinical practice rather than just being a research tool.This article will address the feasibility,the accuracy and the limitations of MDCT in measuring LVEF.
文摘BACKGROUND Heart defects are the most common congenital malformations in fetuses.Fetal cardiac structure and function abnormalities lead to changes in ventricular volume.As ventricular volume is an important index for evaluating fetal cardiovascular development,an effective and reliable method for measuring fetal ventricular volume and cardiac function is necessary for accurate ultrasonic diagnosis and effective clinical treatment.The new intelligent spatiotemporal image correlation(iSTIC)technology acquires high-resolution volumetric images.In this study,the iSTIC technique was used to measure right ventricular volume and to evaluate right ventricular systolic function to provide a more accurate and convenient evaluation of fetal heart function.AIM To investigate the value of iSTIC in evaluating right ventricular volume and systolic function in normal fetuses.METHODS Between October 2014 and September 2015,a total of 123 pregnant women received prenatal ultrasound examinations in our hospital.iSTIC technology was used to acquire the entire fetal cardiac volume with off-line analysis using QLAB software.Cardiac systolic and diastolic phases were defined by opening of the atrioventricular valve and the subsequent closure of the atrioventricular valve.The volumetric data of the two phases were measured by manual tracking and summation of multiple slices and recording of the right ventricular end-systolic volume and the right ventricular end-diastolic volume.The data were used to calculate the right stroke volume,the right cardiac output,and the right ejection fraction.The correlations of changes between the above-mentioned indices and gestational age were analyzed.The right ventricular volumes of 30 randomly selected cases were measured twice by the same sonographer,and the intraobserver agreement measurements were calculated.RESULTS Among the 123 normal fetuses,the mean right ventricular end-diastolic volume increased from 0.99±0.34 mL at 22 wk gestation to 3.69±0.36 mL at 35+6 wk gestation.The mean right ventricular end-systolic volume increased from 0.43±0.18 mL at 22 wk gestation to 1.36±0.22 mL at 35+6 wk gestation.The mean right stroke volume increased from 0.62±0.29 mL at 22 wk gestation to 2.33±0.18 mL at 35+6 wk gestation.The mean right cardiac output increased from 92.23±40.67 mL/min at 22 wk gestation to 335.83±32.75 mL/min at 35+6 wk gestation.Right ventricular end-diastolic volume,right ventricular end-systolic volume,right stroke volume,and right cardiac output all increased with gestational age and the correlations were linear(P<0.01).Right ejection fraction had no apparent correlation with gestational age(P>0.05).CONCLUSION Fetal right ventricular volume can be quantitatively measured using iSTIC technology with relative ease and high repeatability.iSTIC technology is expected to provide a new method for clinical evaluation of fetal cardiac function.
基金Wuhan Health and Family Planning Commission Grant/Award(WX16D18).
文摘Background: Real-time three-dimensional echocardiography (RT-3DE) could obtain ventricular volume andejection fraction rapidly and non-invasively without relying on ventricular morphology. This study aims to useRT-3DE to evaluate the changes in biventricular volume and systolic function in children with ventricular septaldefect (VSD) and moderate to severe pulmonary hypertension (PH) before surgery. Methods: In this study18 children with VSD and moderate to severe PH (VSD + PH Group) and 18 healthy children of the sameage (Control Group) were recruited. Biventricular volume and systolic function were evaluated by RT-3DE.The measurements included: left and right ventricular volume indexed to body surface area (BSA), stroke volume(SV) indexed to BSA, and ejection fraction (EF). Results: The results showed left and right ventricular volumeindexed to BSA and SV indexed to BSA were significantly increased in VSD + PH Group (VSD + PH Groupvs. Control Group), LVEDV/BSA (ml/m2): 48.67 ± 21.46 vs. 25.59 ± 6.96, RVEDV/BSA (ml/m2): 55.98 ±15.35 vs. 27.69 ± 4.37, LVSV/BSA (ml/m2): 24.08 ± 9.30 vs. 15.14 ± 4.29, RVSV/BSA (ml/m2): 26.02 ± 8.87 vs.14.11 ± 2.89, (P < 0.05). While for EF in VSD + PH Group decreased (VSD + PH Group vs. Control Group),LVEF: 50.93 ± 7.50% vs. 59.38 ± 7.24%, RVEF: 45.84 ± 7.71% vs. 51.05 ± 6.90% (P < 0.05). Conclusion: Inchildren with VSD and moderate to severe PH, increased biventricular volume and decreased systolic functionwere observed with RT-3DE, but biventricular systolic function remained within acceptable limits. The childrenin this study recovered well after surgery without serious perioperative complications, suggesting that biventricularsystolic function may help facilitate the surgical decision-making process in children with VSD and moderate-toseverePH.
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Background Assessment of the left ventricular (LV) and the right ventricular (RV) volumes and their functions is important for prognostic prediction and clinical decision making. We compared the accuracy for quantifying the LV and the RV volumes in vitro between conventional two-dimensional echocardiography (2DE) and real-time three-dimensional echocardiography (RT3DE) Methods The volumes of 37 rubber-models (10 regularly shaped to simulate normal LV, 7 shaped to simulate LV with symmetric aneurysm, 8 shaped to simulate LV with asymmetric aneurysm, and 12 irregularly shaped to simulate normal RV) and 10 excised canine hearts were measured by RT3DE and 2DE On RT3DE 'full volume' imaging, the inner-surfaces of the rubber-models and canine LV and RV were outlined and the volumes were measured using 2-, 4-, 8- and 16-plane methods with the RT3DE analysis software On 2DE imaging, the volumes were measured by the Simpson method The LV and RV volumes measured by drained water were served as reference values, with which we compared RT3DE and 2DE data Results In rubber models mimicking normal LV and LV with symmetric aneurysms, RT3DE results were strongly correlated with reference values ( r =0 795-0 998) and there was a good correlation between 2DE estimates and reference values ( r =0 715-0 729) There were no significant differences between RT3DE estimates, 2DE results and reference values ( P >0 05) In rubber models mimicking the RV and LV with asymmetric aneurysm, RT3DE strongly correlated with reference values ( r =0 765-0 988), but 2DE weakly correlated with reference values ( r =0 518-0 592) There were no differences between RT3DE and reference values ( P >0 05), but a significant difference between 2DE and reference values occurred ( P <0 05) For excised canine hearts, there was a strong correlation between RT3DE and reference values ( r =0 728-0 914), while 2DE showed a less obvious correlation ( r =0 502-0 615) Again, there were no significant differences between RT3DE and reference values ( P >0 05), but there was a significant difference between 2DE and reference values ( P <0 05) Conclusions RT3DE can accurately quantify LV and RV volumes and provides a new tool to evaluate LV and RV function For LV and RV measurements by RT3DE, 8-plane strategy is the optimum choice for accuracy and convenience
基金This study was supported in partbyagrant from the Doctor Foundation of ScienceandTechnologyBureauofHebeiProvince (No .0 0 5 42 0 0D -15 ) .
文摘Background Multislice helical computed tomography (MSCT) has been used to depict coronary anatomy noninvasively, and proved useful for evaluating ventricular function. The aim of our study was to assess the accuracy of ventricular volume as measured by MSCT.Methods Fourteen human left ventricular (LV) and 15 right ventricular (RV) casts were scanned by MSCT. A series of LV and RV short-axis images were reconstructed later with slice thickness of 2.0 mm, 3.5 mm, 5.0 mm, 7.0 mm, and 10.0 mm. Ventricular volume was calculated by the multislice tomographic Simpson’s method. True LV and RV cast volumes were determined by water displacement. Results Both calculated LV and RV volumes correlated highly with the corresponding true volumes (all r>0.95, P<0.01). But with slice thickness from 2.0 mm to 10.0 mm, MSCT scanning overestimated the corresponding true volume by (3.21±5.95) ml to (12.58±8.56) ml for LV and (10.22±8.45) ml to (23.91±12.24) ml for RV (all P<0.01). There was a very high correlation between the overestimation and the selected slice thickness for both LV and RV volume measurements (r=0.998 and 0.996, P<0.01, respectively). However, when slice thickness was reduced to 5.0 mm, the overestimation for both LV and RV volume measurements became nonsignificant for slice thickness from 2.0 mm to 5.0 mm. Conclusions Both LV and RV volumes can be accurately estimated by MSCT. Thinner slice has more accurate calculated volume. However, 5.0 mm slice thickness is thin enough for an accurate measurement of LV or RV volume.
文摘The effect of sublingual administration and intravenous drip of nitroglycerin (SLNTG and IVNTG) on left ventricular volumes (LVVs) were studied and systolic function was quantitatively assessed with two-dimensional echocardiography (2DE) in 28 patients with myocardial infarction (MI), including 13 cases without heart failure (MI-NHF) in one group and 15 with heart failure (MI-HF) in another. The results showed that after SLNTG and IVNTG in both groups the heart rate (HR) increased significantly (P< 0.05-0.001); the systolic blood pressure (SBP) decreased significantly (P< 0.05-0.001); the diastolic blood pressure (DBP) was not significantly changed (all P>0.05); the left ventricular end-diastolic and end-systolic volumes (EDV and ESV) both significantly reduced [EDV: decreased by 5.8-11.6% (-13.2-19.0 ml), P< 0.05-0.001; ESV: decreased by 9.6-16.6% (-8.6-17.3 ml), P< 0.05-0.001)1; the left ventricular ejection fraction (LVEF) all significantly elevated (increased by 6.6%-9.4% (3.2%-3.4%), P < 0.05-0.001] except in MI-NHF group after IVNTG; the segmental EF of normal and hypokinetic segments also significantly increased (P<0.05-0.001). The results suggest that NTG could beneficially reduce left ventricular EDV and ESV; and improve or strengthen its global and segmental systolic function in MI patients, particularly noticeable in patients with heart failure.
文摘Background Left atrial enlargement has been suggested as a more robust marker of diastolic dysfunction. We hypothesize that the ratio of left atrial volume to left ventricular volume （LAV/LVV） may be more reasonable to reflect left atrial enlargement in the patients with hypertension, because hypertensive patients have a characteristic of concentric remodeling of the left ventricle which is often accompanied with diastolic dysfunction. The aim of this study was to determine if the LAV/LVV can be used as a new parameter to assess left atrial size in hypertensive patients and the relationship between the LAV/LVV and diastolic dysfunction. Methods Ninety-one patients with hypertension and forty-three normal controls were studied. The hypertensive patients were assigned to the normal wall （NW） and hypertrophic wall （HW） groups. The left atrial diameter （LAD）, LAV, left atrial volume index （LAVi）, LVV and LAV/LVV were measured and calculated by 2-dimensional echocardiography and real time 3-dimensional echocardiography. All of the above parameters were used to evaluate the size of the left atrium. The ratio of peak E velocity of mitral valve inflow to peak E＇ velocity of lateral mitral annulus （E/E＇） was measured by pulse Doppler and tissue Doppler. This parameter was used to evaluate diastolic function. Results The LAD, LAV, LAVi, LAV/LVV and E/E＇ in hypertensive groups were significantly higher than those in the normal group （P 〈0.05 or 0.01）, and those in the HW group were significantly higher than those in the NW group （P 〈0.05 or 0.01）. The E/E＇ had a positive correlation with LAV, LAVi and LAV/LVV. The correlation coefficient between E/E＇ and LAV/LVV was relatively higher than that between E/E＇ and LAD or LAVi. Conclusion LAV/LVV may be used as a new index to evaluate left atrial size in hypertensive patients with diastolic dysfunction.
文摘Background: The aim of this study was to determine the relation of left atrial (LA) volume and LA volume index with left ventricular function and to determine the association of duration of symptoms and left atrial volume index in patients with dilated cardiomyopathy. Materials and Methods: This was an observational, single centre study conducted in India. A total of 50 patients who were admitted to department of cardiology from July, 2008 to February, 2009 with diagnosis of dilated cardiomyopathy and an ejection fraction of <40% were included. Results: Of the 50 patients, 34 (68%) were males. 27 (54%) patients were in NYHA class II and 23 (46%) patients were in NYHA class III. LA volume was found to be ≥40 ml in all patients. LV function and LA volume were found to be correlated (r = -0.789, p < 0.01). Similarly, there was a correlation between LV function and LA volume index (r = -0.826, p < 0.01). There was no correlation between LA volume index and duration of symptoms (r = 0.04). Conclusion: It can be concluded that there is a strong inverse correlation between LA volume and left ventricular function and also between LA volume index and left ventricular function. The patients with NYHA class III were having larger left atrial volume than those with NYHA class II. Moreover, the duration of symptoms has no correlation with left atrial volume index.
基金This project was supported by a grant from Guangdong Provincial Natural Sciences Foundation (No 05300738)
文摘The volume-time curve change in patients with normal left ventricular （LV） diastolic function and diastolic dysfunction was evaluated by real-time three-dimensional echocardiography （RT3DE）. LV diastolic dysfunction was defined by E＇〈A＇ in pulse-wave tissue Doppler for inter-ventricular septal （IVS） of mitral annulus. In 24 patients with LV diastolic dysfunction, including 12 patients with delayed relaxation （delayed relaxation group） and 12 patients with pseudo-normal function （pseudo-normal group） and 24 normal volunteers （control group）, data of full-volume image were acquired by real-time three-dimensional echocardiography and subjected to volume-time curve analysis. EDV （end-diastolic volume）, ESV （end-systolic volume）, LVEF （left ventricular ejection fraction）, PER （peak ejection rate）, PFR （peak filling rate） from RT3DE were examined in the three groups. Compared to the control group, PFR （diastolic filling index of RT3DE） was significantly reduced in the delayed relaxation group and pseudo-normal group （P〈0.05）. There were no significant differences in EDV, ESV, LVEE PER （P〉0.05）. It is concluded that PFR, as a diastolic filling index of RT3DE, can reflect the early diastolic function and serve as a new non-invasive, quick and accurate tool for clinical assessment of LV diastolic function.
基金This study was funded by Science Technology Department of Zhejiang Province of China(grant number:2016C54006).
文摘background To investigate the accuracy and feasibility of CT in quantification of ventricular volume based on semiautomatic three-dimensional(3D)threshold-based segmentation in porcine heart and children with tetralogy of Fallot(TOF).Methods Eight porcine hearts were used in the study.The atria were resected and both ventricles of the eight porcine hearts were filled with solidifiable silica gel and performed CT scanning.The water displacement volume of silica gel casting mould was referred as gold standard of ventricular volume.Results of left and right ventricular volumes measured by CT were compared with reference standard.Twenty-three children diagnosed with TOF were retrospectively included.The ventricular volumetric parameters were assessed by cardiac CT before and 6 months after surgery.results Left ventricular and right ventricular volumes of porcine hearts measured by CT were highly correlated to casting mould(r=0.845,p=0.008;r=0.933,p=0.001),and there were no statistically significant differences(t=−1.059,p=0.325;t=−1.121,p=0.299).In children with TOF,right ventricular end-systole volumes 6 months after operation were higher than that before surgery,21.93±4.44 vs 19.80±4.52 mL/m^(2),p=0.001.Right ventricular ejection fractions 6 months after surgery were lower compared with that before surgery 59.79%±4.26%vs 63.05%±5.04%,p=0.000.Conclusions CT is able to accurately assess ventricular volumetric parameters based on semiautomatic 3D threshold-based segmentation.Both of the right and left ventricular volumetric parameters could be evaluated by CT in children with TOF.
文摘Objective: Ischemic conditioning (IC) limits myocyte necrosis after acute myocardial ischemia-reperfusion;however, controversy persists regarding its potential to attenuate LV contractile dysfunction. Pressure-volume (P-V) loop analysis, via the load-insensitive conductance catheter method, was used to evaluate LV contractility, diastolic function, and ventriculo-arterial coupling. The goal of this study was to evaluate the ability of IC to improve post-ischemic recovery of LV contractile function. Methods: Twelve anesthetized dogs were randomly distributed to either the IC or the non-IC group;all dogs were subject to 60-min acute coronary occlusion followed by 180-min reperfusion. IC consisted of 4 repeated cycles of 5-min occlusion and 5-min reperfusion of the left main coronary artery. LV P-V relations were constructed under steady-state conditions (by inferior vena cava occlusion) at the beginning and end of the experiments;P-V loops were acquired at different time points before and during ischemia-reperfusion. Results: During ischemia and reperfusion, dP/dt<sub>max</sub> decreased significantly compared to baseline in both groups;dP/dt<sub>min</sub>, an indicator of the rate of LV relaxation rate was not affected for either group. Significant changes in several parameters of LV function including LVEF, SW, tPFR, ESV, and EDV caused by ischemia were also identified;none of these negative effects were resorbed, even in part, during reperfusion. Conclusions: Diminished LV contractile efficiency during systole and diastole produced by ischemia-reperfusion did not improve with IC pre-treatment despite significant endogenous protection against tissue necrosis.
基金supported by the National Natural Science Foundation of China(Nos.82370322 to CC,82200352 to FZ,82300352 to YZ,22275034 to HX,and 82070343 to MLC)the Natural Science Foundation of Jiangsu Province of China(Nos.BK20220710 to FZ and BK20230733 to YZ)Postgraduate Research&Practice Innovation Program of Jiangsu Province(No.JX13414086 to HYC).
文摘Arrhythmogenic right ventricular cardiomyopathy(ARVC)is a progressive disease characterized by adipose and fibrous replacement of the myocardium.While elevated testosterone levels have been implicated in the pathological process of ARVC,its exact contribution to cardiac fibrosis in ARVC remains unclear.In this study,we analyzed the potential contribution of gender-based differences on the distribution of the low-voltage area in an ARVC cohort undergoing an electrophysiological study,which was indicated by feature selection.Additionally,we established engineered cardiac spheroid models in vitro using patient-specific induced pluripotent stem cell(iPSC)-derived cardiomyocytes(iPSC-CMs)and iPSC-derived cardiac fibroblasts(icFBs).We elucidated the pathogenicity of abnormal splicing in the plakophilin-2(PKP2)gene caused by an intronic mutation.Additionally,pathogenic validation of the desmoglein-2(DSG2)point mutation further confirms the reliability of the models.Moreover,testosterone exacerbated the DNA damage in the mutated cardiomyocytes and further activated myofibroblasts in a chain reaction.In conclusion,we designed and constructed an in vitro three-dimensionally-engineered cardiac spheroid model of ARVC based on clinical findings and provided direct evidence of the fibrotic role of testosterone in ARVC.
文摘Diabetic cardiomyopathy(DCM)has long been considered as a left ventricular(LV)disease with diastolic dysfunction preceding systolic dysfunction in diabetes.However,it is increasingly recognized that the right ventricle(RV)is also affected by diabetes and may be independently responsible for adverse outcomes in diabetic patients with or without LV failure.Yu et al conducted a 30-week longitudinal evaluation of biventricular function and pathology in OVE26 diabetic mice and revealed early diastolic dysfunction preceding systolic decline,suggesting that early LV diastolic impairment precedes the later onset of systolic dysfunction.With age,the animals developed fibrosis,hypertrophy,and pulmonary arterial hypertension in the RV.The purpose of this editorial is to contextualize these findings within the existing literature by highlighting the interplay between cardiac chambers and the vasculature.We also seek to reiterate that DCM is a condition extending beyond left ventricular dysfunction.As the authors note,the right side of the heart may remain"the forgotten ventricle"in diabetic patients.We hope that the mechanisms discussed in this paper will help researchers to understand the pathogenesis of cardiovascular disease in this context and encourage clinicians to be more attentive to the associated clinical symptoms.
基金Supported by Science and Technology Department of Yunnan Province-Kunming Medical University,Kunming Medical Joint Special Project-Surface Project,China,No.202401AY070001-164Yunnan Provincial Department of Science and Technology Science and Technology Plan Project—Major Science and Technology Special Projects,No.202405AJ310003.
文摘This review comprehensively examines acute myocardial infarction with ventricular septal rupture(VSR),a rare yet lethal complication.We analyze its epidemiological,pathophysiological,clinical,and therapeutic aspects,emphasizing innovative strategies like bioabsorbable occluders and tissue engineering to reduce complications and improve prognosis.The integration of artificial intelligence and big data analytics for treatment decision-making and personalized surgical timing models is highlighted as transformative.Our analysis underscores the need for early diagnosis and tailored interventions,proposing future research directions in molecular mechanisms,multidisciplinary collaboration,and technology integration.These innovations promise to enhance VSR management and extend to other cardiovascular diseases,heralding a new era of precision and regenerative cardiovascular medicine.
文摘Right ventricular(RV)failure accounts for significant morbidity and mortality in critically ill patients.The RV is particularly vulnerable in conditions characterized by elevated pulmonary vascular afterload,which are commonly encountered in the intensive care unit(ICU).Conditions such as acute respiratory distress syndrome,pulmonary embolism,and decompensated pulmonary arterial hypertension are associated with acute and acute-on-chronic RV failure.In the ICU,RV failure may develop or worsen in patients with parenchymal pulmonary disease who acutely experience fluctuations in preload,excessive afterload,and/or insufficient myocardial contractility,often in addition to mechanical ventilation and circulatory compromise.This dynamic clinical scenario demands early recognition and intervention tailored to an individual patient’s physiology.Distinguishing between acute and chronic RV failure in critical illness informs diagnostic workup,hemodynamic monitoring,and resuscitative efforts.This narrative review will provide an overview of common conditions associated with RV failure in critical illness,highlighting a practical,physiology-oriented approach to diagnosis and optimization of ventilator support,fluid resuscitation,vasopressor and inotrope use,and mechanical circulatory support.RV failure due to RV infarction or severe LV failure and decompensated congenital heart disease are distinct pathophysiologic entities.These conditions require distinct treatment approaches and are beyond the scope of this review.
