Objective The cardiac synchronization therapy (CRT) was proven to have good treatment for the cardiacconduction disorders patients with serious heart failure. But many disadvantages were gradually be noticed,such as d...Objective The cardiac synchronization therapy (CRT) was proven to have good treatment for the cardiacconduction disorders patients with serious heart failure. But many disadvantages were gradually be noticed,such as difficulty of sinus electrode implantation,coronary sinus injury and bleeding,still one third展开更多
Cardiac hypertrophy is an independent risk factor for sudden cardiac death in clinical settings and the incidence of sudden cardiac death and ventricular arrhythmias are closely related.The aim of this study was to de...Cardiac hypertrophy is an independent risk factor for sudden cardiac death in clinical settings and the incidence of sudden cardiac death and ventricular arrhythmias are closely related.The aim of this study was to determine the effects of the calmodulin-dependent protein kinase(CaMK) Ⅱ inhibitor,KN-93,on L-type calcium current(I Ca,L) and early after-depolarizations(EADs) in hypertrophic cardiomyocytes.A rabbit model of myocardial hypertrophy was constructed through abdominal aortic coarctation(LVH group).The control group(sham group) received a sham operation,in which the abdominal aortic was dissected but not coarcted.Eight weeks later,the degree of left ventricular hypertrophy(LVH) was evaluated using echocardiography.Individual cardiomyocyte was isolated through collagenase digestion.Action potentials(APs) and I Ca,L were recorded using the perforated patch clamp technique.APs were recorded under current clamp conditions and I Ca,L was recorded under voltage clamp conditions.The incidence of EADs and I ca,L in the hypertrophic cardiomyocytes were observed under the conditions of low potassium(2 mmol/L),low magnesium(0.25 mmol/L) Tyrode’s solution perfusion,and slow frequency(0.25-0.5 Hz) electrical stimulation.The incidence of EADs and I ca,L in the hypertrophic cardiomyocytes were also evaluated after treatment with different concentrations of KN-92(KN-92 group) and KN-93(KN-93 group).Eight weeks later,the model was successfully established.Under the conditions of low potassium,low magnesium Tyrode’s solution perfusion,and slow frequency electrical stimulation,the incidence of EADs was 0/12,11/12,10/12,and 5/12 in sham group,LVH group,KN-92 group(0.5 μmol/L),and KN-93 group(0.5 μmol/L),respectively.When the drug concentration was increased to 1 μmol/L in KN-92 group and KN-93 group,the incidence of EADs was 10/12 and 2/12,respectively.At 0 mV,the current density was 6.7±1.0 and 6.3±0.7 PA·PF-1 in LVH group and sham group,respectively(P>0.05,n=12).When the drug concentration was 0.5 μmol/L in KN-92 and KN-93 groups,the peak I Ca,L at 0 mV was decreased by(9.4±2.8)% and(10.5±3.0)% in the hypertrophic cardiomyocytes of the two groups,respectively(P>0.05,n=12).When the drug concentration was increased to 1 μmol/L,the peak I Ca,L values were lowered by(13.4±3.7)% and(40±4.9)%,respectively(P<0.01,n=12).KN-93,a specific inhibitor of CaMKII,can effectively inhibit the occurrence of EADs in hypertrophic cardiomyocytes partially by suppressing I Ca,L,which may be the main action mechanism of KN-93 antagonizing the occurrence of ventricular arrhythmias in hypertrophic myocardium.展开更多
Sudden cardiac death threats ischaemic and dilated cardiomyopathy patients. Anti- arrhythmic protection may be provided to these patients with implanted cardiac defibrillators(ICD), after an efficient risk stratificat...Sudden cardiac death threats ischaemic and dilated cardiomyopathy patients. Anti- arrhythmic protection may be provided to these patients with implanted cardiac defibrillators(ICD), after an efficient risk stratification approach. The proposed risk stratifier of an impaired left ventricular ejection fraction has limited sensitivity meaning that a significant number of victims will remain undetectable by this risk stratification approach because they have a preserved left ventricular systolic function. Current risk stratification strategies focus on combinations of non invasive methods like T wave alternans, late potentials, heart rate turbulence, deceleration capacity and others, with invasive methods like the electrophysiologic study. In the presence of an electrically impaired substrate with formed post myocardial infarction fibrotic zones, programmed ventricular stimulation provides important prognostic information for the selection of the patients expected to benefit from an ICD implantation, while due to its high negative predictive value, patients at low risk level may also be detected. Clustering evidence from different research groups and electrophysiologic labs support an electrophysiologic testing guided risk stratification approach for sudden cardiac death.展开更多
Amyloidosis is an infiltrative disease caused by extracellular protein deposition that has accumulated a lot of scientific production in recent years.Different types of amyloidosis can affect the heart.Transthyretin a...Amyloidosis is an infiltrative disease caused by extracellular protein deposition that has accumulated a lot of scientific production in recent years.Different types of amyloidosis can affect the heart.Transthyretin amyloidosis and light chain amyloidosis are the two most common types of cardiac amyloidosis.These entities have a poor prognosis,so accurate diagnostic techniques are imperative for determining an early therapeutic approach.Recent advances in cardiac imaging and diagnostic strategies show that these tools are safe and can avoid the use of invasive diagnostic techniques to histological confirmation,such as endomyocardial biopsy.We performed a review on the diagnostic and prognostic implications of different cardiac imaging techniques in cardiac amyloidosis.We mainly focus on reviewing echocardiography,cardiac magnetic resonance,computed tomography and nuclear imaging techniques and the different safety measurements that can be done with each of them.展开更多
Despite optimal interventional and medical therapy, ischemic heart disease is still an important cause of morbidity and mortality worldwide. Although not included in standard of care rehabilitation, stem cell therapy(...Despite optimal interventional and medical therapy, ischemic heart disease is still an important cause of morbidity and mortality worldwide. Although not included in standard of care rehabilitation, stem cell therapy(SCT) could be a solution for prompting cardiac regeneration. Multiple studies have been published from the beginning of SCT until now, but overall no unanimous conclusion could be drawn in part due to the lack of appropriate endpoints. In order to appreciate the impact of SCT, multiple markers from different categories should be considered: Structural, biological, functional, physiological, but also major adverse cardiac events or quality of life. Imaging end-points are among the most used-especially left ventricle ejection fraction(LVEF) measured through different methods. Other imaging parameters are infarct size, myocardial viability and perfusion. The impact of SCT on all of the aforementioned end-points is controversial and debatable. 2 D-echocardiography is widely exploited, but new approaches such as tissue Doppler, strain/strain rate or 3 D-echocardiography are more accurate, especially since the latter one is comparable with the MRI gold standard estimation of LVEF. Apart from the objective parameters, there are also patient-centered evaluations to reveal the benefits of SCT, such as quality of life and performance status, the most valuable from the patient point of view. Emerging parameters investigating molecular pathways such as non-coding RNAs or inflammation cytokines have a high potential as prognostic factors. Due to the disadvantages of current techniques, new imaging methods with labelled cells tracked along their lifetime seem promising, but until now only pre-clinical trials have been conducted in humans. Overall, SCT is characterized by high heterogeneity not only in preparation, administration and type of cells, but also in quantification of therapy effects.展开更多
The increasing scope of interventions in the cardiac catheterization laboratory (CCL) and electrophysiological laboratory (EPL) has resulted in new challenges for the anaesthesia teams where they deal with different p...The increasing scope of interventions in the cardiac catheterization laboratory (CCL) and electrophysiological laboratory (EPL) has resulted in new challenges for the anaesthesia teams where they deal with different patient categories, complications and safety issues. Collaboration and planning between cardiologist and anaesthesiologist are required for both patient safety and procedural success. This review aims to discuss procedures performed in interventional cardiology and the importance of anaesthesiologists in managing such patients. Percutaneous interventions are being increasingly performed in adult as well as in pediatric patients. Procedures are usually done under mild to moderate sedation. General anaesthesia is required in certain conditions and also in pediatric patients. Knowledge of echocardiography, individual disease condition and fluoroscopy is important. Anaesthesiologists are assuming an increasingly important role in the multidisciplinary management of complex patients and interventions. A comprehensive understanding of procedures is essential to provide a high level of anaesthetic care and maintain patient safety.展开更多
Background: Recently faster cardiac magnetic resonance (CMR) cine sequences basing on k-t compressed sensing have been developed. Purpose: To compare two compressed sensing CMR sequences-one in breath-hold technique a...Background: Recently faster cardiac magnetic resonance (CMR) cine sequences basing on k-t compressed sensing have been developed. Purpose: To compare two compressed sensing CMR sequences-one in breath-hold technique and one during free breathing—with the standard SSFP sequence with respect to regional left ventricular function assessment. Material and Methods: Left ventricular short-axis stacks of two compressed sensing sequences in breath-hold technique (sparse_HB) and during free breathing (sparse_FB;both spatial resolution, 1.8 × 1.8 × 8 mm3) and a standard SSFP cine sequence (spatial resolution, 1.9 × 1.9 × 8 mm3) were acquired in 50 patients on a 1.5 T MR system. Regional wall motion abnormalities (RWMA) were rated qualitatively (normal/hypo-/a-/dyskinesia) by two experienced readers in consensus for all cardiac segments (American Heart Association’s segment model) and sequences. RWMA detection rates were compared between sequences by kappa statistic. Results: In 13 patients, RWMA were detected in at least one cardiac segment. The RWMA detection rates were similar between CMR sequences (hypokinesia, 7.2% to 7.9%;akinesia, 0.8% to 1.3%;dyskinesia 0.3% to 0.4%) and kappa statistics revealed an almost perfect agreement in RWMA detection between both sparse and the standard SSFP sequence (standard versus sparse_HB: kappa, 0.918, p value, p value, Conclusion: Compressed sensing cine CMR acquired during breath-hold or free-breathing allows reliable RWMA detection, thus, might alternatively be used in cine CMR for regional left ventricular function assessment.展开更多
BACKGROUND Subclavian vein stenosis or occlusion may be caused by a transvenous pacemaker,which makes the reimplantation of a new pacemaker lead difficult.Transvenous pacemaker lead implantation-related subclavian vei...BACKGROUND Subclavian vein stenosis or occlusion may be caused by a transvenous pacemaker,which makes the reimplantation of a new pacemaker lead difficult.Transvenous pacemaker lead implantation-related subclavian vein occlusion may present difficulty with regard to cardiac resynchronization therapy(CRT)upgrade.CASE SUMMARY We report the case of a 46-year-old man who was admitted with total subclavian vein occlusion caused by a permanent pacemaker that had been implanted 2 years previously.We successfully treated this patient with an upgrade to a CRT pacemaker by utilizing transferable interventional coronary and radiological techniques.The patient recovered uneventfully during the follow-up period.CONCLUSION CRT upgrade is still a viable technique for the treatment of subclavian vein obstruction caused by previous pacemaker implantation.展开更多
Percutaneous vertebroplasty(PVP) is an interventional radiological procedure involving the injection of bone cement(polymethylmethacrylate) into a fractured vertebral body to remodel the vertebral body and relieve lum...Percutaneous vertebroplasty(PVP) is an interventional radiological procedure involving the injection of bone cement(polymethylmethacrylate) into a fractured vertebral body to remodel the vertebral body and relieve lumbar pain.展开更多
The Luo Rudy models of mammalian ventricular cell were chosen in studying cardiac electrophysiology. Rush and Larsen’s algorithm and adaptive time step methods were used to solve the ordinary differential equations (...The Luo Rudy models of mammalian ventricular cell were chosen in studying cardiac electrophysiology. Rush and Larsen’s algorithm and adaptive time step methods were used to solve the ordinary differential equations (ODE’s). The operator splitting (or time splitting) and adaptive time step methods were used to solve the partial differential equations (PDE’s) in cardiac tissue conduction models. The alternating direction implicit (ADI) method was used to integrate the PDE. Using these methods we accomplished the simulation programs of single cardiomyocyte model, one dimensional cable model(1 D) and two dimensional(2 D) tissue model. The methods of initiating spiral waves were studied with these software. The data getting from 2 D simulation can be used for further study on isopotential contour lines, spiral wave tip trajectories, and pseudo ECG. The software for computer simulation have been successfully used in simulation studying of electrophysiology properties of single cardiomyocyte, conduction in one dimensional cable model(1 D) and two dimensional(2 D) tissue model.展开更多
Aims:Although the application of ultrasound-guided vascular puncture and Z-stitch hemostasis to manage femoral access has been widely utilized,there is limited data on this combined application in adult congenital hea...Aims:Although the application of ultrasound-guided vascular puncture and Z-stitch hemostasis to manage femoral access has been widely utilized,there is limited data on this combined application in adult congenital heart disease(ACHD)patients undergoing electrophysiological(EP)procedures.We sought to evaluate the safety and efficacy of ultrasound-guided puncture and postprocedural Z-stitch hemostasis for ACHD patients under-going EP procedures.Methods and Results:The population of ACHD patients undergoing transfemoral EP pro-cedures at the University of Zurich Heart Center between January 2019 and December 2022 was observed and analyzed.During the study period,femoral access(left/right,arterial/venous)was performed under real-time ultrasound guidance.At the end of the procedure,a single Z-stitch was performed at the puncture site.We eval-uated the incidence of in-hospital complications associated with femoral access puncture in this population.Among 101 patients who had a total of 147 previous ipsilateral vascular punctures(mean 1.5 per person),100 patients underwent successful femoral vascular access for EP procedures.The median age of the patients was 47±15 years and 34(34%)were male.Z-stitches were performed after the procedure in 100 patients with 303 femoral vascular accesses(mean 3 punctures per person).No patient developed vascular puncture relevant inguinal hematoma,pseudo aneurysm,arteriovenousfistula,venous or arterial thrombosis.Conclusion:In ACHD patients undergoing EP procedures,optimal femoral access management can be achieved with ultra-sound-guided puncture and postprocedural Z-stitch hemostasis.展开更多
Epilepsy can be defined as a dysfunction of the brain network,and each type of epilepsy involves different brain-network changes that are implicated diffe rently in the control and propagation of interictal or ictal d...Epilepsy can be defined as a dysfunction of the brain network,and each type of epilepsy involves different brain-network changes that are implicated diffe rently in the control and propagation of interictal or ictal discharges.Gaining more detailed information on brain network alterations can help us to further understand the mechanisms of epilepsy and pave the way for brain network-based precise therapeutic approaches in clinical practice.An increasing number of advanced neuroimaging techniques and electrophysiological techniques such as diffusion tensor imaging-based fiber tra ctography,diffusion kurtosis imaging-based fiber tractography,fiber ball imagingbased tra ctography,electroencephalography,functional magnetic resonance imaging,magnetoencephalography,positron emission tomography,molecular imaging,and functional ultrasound imaging have been extensively used to delineate epileptic networks.In this review,we summarize the relevant neuroimaging and neuroelectrophysiological techniques for assessing structural and functional brain networks in patients with epilepsy,and extensively analyze the imaging mechanisms,advantages,limitations,and clinical application ranges of each technique.A greater focus on emerging advanced technologies,new data analysis software,a combination of multiple techniques,and the construction of personalized virtual epilepsy models can provide a theoretical basis to better understand the brain network mechanisms of epilepsy and make surgical decisions.展开更多
With the support by the National Natural Science Foundation of China,the research team led by Professor Li Yigang(李毅刚)at Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine and Professor ...With the support by the National Natural Science Foundation of China,the research team led by Professor Li Yigang(李毅刚)at Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine and Professor Peng Huisheng(彭慧胜)at Fudan University presented a new type of展开更多
Objective To investigate the alterations of cardiac electrophysiological properties and substantial mechanism and find the stable arrhythmia mouse model in Kunming(KM) and C57BL6/J(C57) mice.Methods Electrocardiogram ...Objective To investigate the alterations of cardiac electrophysiological properties and substantial mechanism and find the stable arrhythmia mouse model in Kunming(KM) and C57BL6/J(C57) mice.Methods Electrocardiogram recordings were used to analyze the QT interval in vivo,and monophasic action potential of right and left ventricular epicardium was recorded to elicit changes of action potential duration(APD) in conventional and programmed electrical stimulation(PES).Transient outward potassium current(I to) was recorded via whole-cell patch-clamp technique in single right and left epicardial myocytes.Results QT interval was prolonged in KM mice relative to C57 mice(62.51±4.47 ms vs.52.59±4.85 ms,P<0.05).The APD at 50% repolarization of the left ventricular epicardium(18.60±0.91 ms vs.12.90±0.35 ms),and APDs at 50%(17.31±6.05 ms vs.12.00±3.24 ms) and 70% repolarization(36.13±5.32 ms vs.21.95±8.06 ms) of the right ventricular epicardium in KM mice were significantly prolonged compared with C57 mice,respectively(all P<0.05).KM mice were more sensitive to PES-induced ventricular tachycardia(25%,3 of 12 hearts),and especially to Burst-induced ventricular tachycardia(50%,6 of 12 hearts) compared with C57 mice,which were 20%(2 of 10 hearts) and 30%(3 of 10 hearts) respectively.I to densities both in the left and right ventricular epicardial myocytes from KM mice were significantly decreased compared with C57 mice,respectively(all P<0.01).Conclusion Our data showed that KM mice with the prolonged QT interval and APD are vulnerabilities to ventricular arrhythmia,which are attributed to lower I to densities in ventricular myocytes obtained from KM mice than that from C57 mice.展开更多
文摘Objective The cardiac synchronization therapy (CRT) was proven to have good treatment for the cardiacconduction disorders patients with serious heart failure. But many disadvantages were gradually be noticed,such as difficulty of sinus electrode implantation,coronary sinus injury and bleeding,still one third
基金supported by grants from the Fujian Provincial Natural Science Foundation of China (No. 2008J0075)the Fujian Provincial Science and Technology Project of China(No. 2010Y0011)
文摘Cardiac hypertrophy is an independent risk factor for sudden cardiac death in clinical settings and the incidence of sudden cardiac death and ventricular arrhythmias are closely related.The aim of this study was to determine the effects of the calmodulin-dependent protein kinase(CaMK) Ⅱ inhibitor,KN-93,on L-type calcium current(I Ca,L) and early after-depolarizations(EADs) in hypertrophic cardiomyocytes.A rabbit model of myocardial hypertrophy was constructed through abdominal aortic coarctation(LVH group).The control group(sham group) received a sham operation,in which the abdominal aortic was dissected but not coarcted.Eight weeks later,the degree of left ventricular hypertrophy(LVH) was evaluated using echocardiography.Individual cardiomyocyte was isolated through collagenase digestion.Action potentials(APs) and I Ca,L were recorded using the perforated patch clamp technique.APs were recorded under current clamp conditions and I Ca,L was recorded under voltage clamp conditions.The incidence of EADs and I ca,L in the hypertrophic cardiomyocytes were observed under the conditions of low potassium(2 mmol/L),low magnesium(0.25 mmol/L) Tyrode’s solution perfusion,and slow frequency(0.25-0.5 Hz) electrical stimulation.The incidence of EADs and I ca,L in the hypertrophic cardiomyocytes were also evaluated after treatment with different concentrations of KN-92(KN-92 group) and KN-93(KN-93 group).Eight weeks later,the model was successfully established.Under the conditions of low potassium,low magnesium Tyrode’s solution perfusion,and slow frequency electrical stimulation,the incidence of EADs was 0/12,11/12,10/12,and 5/12 in sham group,LVH group,KN-92 group(0.5 μmol/L),and KN-93 group(0.5 μmol/L),respectively.When the drug concentration was increased to 1 μmol/L in KN-92 group and KN-93 group,the incidence of EADs was 10/12 and 2/12,respectively.At 0 mV,the current density was 6.7±1.0 and 6.3±0.7 PA·PF-1 in LVH group and sham group,respectively(P>0.05,n=12).When the drug concentration was 0.5 μmol/L in KN-92 and KN-93 groups,the peak I Ca,L at 0 mV was decreased by(9.4±2.8)% and(10.5±3.0)% in the hypertrophic cardiomyocytes of the two groups,respectively(P>0.05,n=12).When the drug concentration was increased to 1 μmol/L,the peak I Ca,L values were lowered by(13.4±3.7)% and(40±4.9)%,respectively(P<0.01,n=12).KN-93,a specific inhibitor of CaMKII,can effectively inhibit the occurrence of EADs in hypertrophic cardiomyocytes partially by suppressing I Ca,L,which may be the main action mechanism of KN-93 antagonizing the occurrence of ventricular arrhythmias in hypertrophic myocardium.
文摘Sudden cardiac death threats ischaemic and dilated cardiomyopathy patients. Anti- arrhythmic protection may be provided to these patients with implanted cardiac defibrillators(ICD), after an efficient risk stratification approach. The proposed risk stratifier of an impaired left ventricular ejection fraction has limited sensitivity meaning that a significant number of victims will remain undetectable by this risk stratification approach because they have a preserved left ventricular systolic function. Current risk stratification strategies focus on combinations of non invasive methods like T wave alternans, late potentials, heart rate turbulence, deceleration capacity and others, with invasive methods like the electrophysiologic study. In the presence of an electrically impaired substrate with formed post myocardial infarction fibrotic zones, programmed ventricular stimulation provides important prognostic information for the selection of the patients expected to benefit from an ICD implantation, while due to its high negative predictive value, patients at low risk level may also be detected. Clustering evidence from different research groups and electrophysiologic labs support an electrophysiologic testing guided risk stratification approach for sudden cardiac death.
文摘Amyloidosis is an infiltrative disease caused by extracellular protein deposition that has accumulated a lot of scientific production in recent years.Different types of amyloidosis can affect the heart.Transthyretin amyloidosis and light chain amyloidosis are the two most common types of cardiac amyloidosis.These entities have a poor prognosis,so accurate diagnostic techniques are imperative for determining an early therapeutic approach.Recent advances in cardiac imaging and diagnostic strategies show that these tools are safe and can avoid the use of invasive diagnostic techniques to histological confirmation,such as endomyocardial biopsy.We performed a review on the diagnostic and prognostic implications of different cardiac imaging techniques in cardiac amyloidosis.We mainly focus on reviewing echocardiography,cardiac magnetic resonance,computed tomography and nuclear imaging techniques and the different safety measurements that can be done with each of them.
文摘Despite optimal interventional and medical therapy, ischemic heart disease is still an important cause of morbidity and mortality worldwide. Although not included in standard of care rehabilitation, stem cell therapy(SCT) could be a solution for prompting cardiac regeneration. Multiple studies have been published from the beginning of SCT until now, but overall no unanimous conclusion could be drawn in part due to the lack of appropriate endpoints. In order to appreciate the impact of SCT, multiple markers from different categories should be considered: Structural, biological, functional, physiological, but also major adverse cardiac events or quality of life. Imaging end-points are among the most used-especially left ventricle ejection fraction(LVEF) measured through different methods. Other imaging parameters are infarct size, myocardial viability and perfusion. The impact of SCT on all of the aforementioned end-points is controversial and debatable. 2 D-echocardiography is widely exploited, but new approaches such as tissue Doppler, strain/strain rate or 3 D-echocardiography are more accurate, especially since the latter one is comparable with the MRI gold standard estimation of LVEF. Apart from the objective parameters, there are also patient-centered evaluations to reveal the benefits of SCT, such as quality of life and performance status, the most valuable from the patient point of view. Emerging parameters investigating molecular pathways such as non-coding RNAs or inflammation cytokines have a high potential as prognostic factors. Due to the disadvantages of current techniques, new imaging methods with labelled cells tracked along their lifetime seem promising, but until now only pre-clinical trials have been conducted in humans. Overall, SCT is characterized by high heterogeneity not only in preparation, administration and type of cells, but also in quantification of therapy effects.
文摘The increasing scope of interventions in the cardiac catheterization laboratory (CCL) and electrophysiological laboratory (EPL) has resulted in new challenges for the anaesthesia teams where they deal with different patient categories, complications and safety issues. Collaboration and planning between cardiologist and anaesthesiologist are required for both patient safety and procedural success. This review aims to discuss procedures performed in interventional cardiology and the importance of anaesthesiologists in managing such patients. Percutaneous interventions are being increasingly performed in adult as well as in pediatric patients. Procedures are usually done under mild to moderate sedation. General anaesthesia is required in certain conditions and also in pediatric patients. Knowledge of echocardiography, individual disease condition and fluoroscopy is important. Anaesthesiologists are assuming an increasingly important role in the multidisciplinary management of complex patients and interventions. A comprehensive understanding of procedures is essential to provide a high level of anaesthetic care and maintain patient safety.
文摘Background: Recently faster cardiac magnetic resonance (CMR) cine sequences basing on k-t compressed sensing have been developed. Purpose: To compare two compressed sensing CMR sequences-one in breath-hold technique and one during free breathing—with the standard SSFP sequence with respect to regional left ventricular function assessment. Material and Methods: Left ventricular short-axis stacks of two compressed sensing sequences in breath-hold technique (sparse_HB) and during free breathing (sparse_FB;both spatial resolution, 1.8 × 1.8 × 8 mm3) and a standard SSFP cine sequence (spatial resolution, 1.9 × 1.9 × 8 mm3) were acquired in 50 patients on a 1.5 T MR system. Regional wall motion abnormalities (RWMA) were rated qualitatively (normal/hypo-/a-/dyskinesia) by two experienced readers in consensus for all cardiac segments (American Heart Association’s segment model) and sequences. RWMA detection rates were compared between sequences by kappa statistic. Results: In 13 patients, RWMA were detected in at least one cardiac segment. The RWMA detection rates were similar between CMR sequences (hypokinesia, 7.2% to 7.9%;akinesia, 0.8% to 1.3%;dyskinesia 0.3% to 0.4%) and kappa statistics revealed an almost perfect agreement in RWMA detection between both sparse and the standard SSFP sequence (standard versus sparse_HB: kappa, 0.918, p value, p value, Conclusion: Compressed sensing cine CMR acquired during breath-hold or free-breathing allows reliable RWMA detection, thus, might alternatively be used in cine CMR for regional left ventricular function assessment.
基金The Ningbo Natural Science Foundation of China,No.2019A610342the Ningbo Health Branding Subject Fund,No.PPXK2018-01.
文摘BACKGROUND Subclavian vein stenosis or occlusion may be caused by a transvenous pacemaker,which makes the reimplantation of a new pacemaker lead difficult.Transvenous pacemaker lead implantation-related subclavian vein occlusion may present difficulty with regard to cardiac resynchronization therapy(CRT)upgrade.CASE SUMMARY We report the case of a 46-year-old man who was admitted with total subclavian vein occlusion caused by a permanent pacemaker that had been implanted 2 years previously.We successfully treated this patient with an upgrade to a CRT pacemaker by utilizing transferable interventional coronary and radiological techniques.The patient recovered uneventfully during the follow-up period.CONCLUSION CRT upgrade is still a viable technique for the treatment of subclavian vein obstruction caused by previous pacemaker implantation.
文摘Percutaneous vertebroplasty(PVP) is an interventional radiological procedure involving the injection of bone cement(polymethylmethacrylate) into a fractured vertebral body to remodel the vertebral body and relieve lumbar pain.
基金Project Supported by National Natural Science Foundation of China(No.3 0 10 0 0 67)
文摘The Luo Rudy models of mammalian ventricular cell were chosen in studying cardiac electrophysiology. Rush and Larsen’s algorithm and adaptive time step methods were used to solve the ordinary differential equations (ODE’s). The operator splitting (or time splitting) and adaptive time step methods were used to solve the partial differential equations (PDE’s) in cardiac tissue conduction models. The alternating direction implicit (ADI) method was used to integrate the PDE. Using these methods we accomplished the simulation programs of single cardiomyocyte model, one dimensional cable model(1 D) and two dimensional(2 D) tissue model. The methods of initiating spiral waves were studied with these software. The data getting from 2 D simulation can be used for further study on isopotential contour lines, spiral wave tip trajectories, and pseudo ECG. The software for computer simulation have been successfully used in simulation studying of electrophysiology properties of single cardiomyocyte, conduction in one dimensional cable model(1 D) and two dimensional(2 D) tissue model.
基金This study complied with the Declaration of Helsinki and was approved by the local Ethics Committee(Cantonal Ethics Committee Zurich,Nr.2016-00116).All patients signed informed consent for the procedure and the use of clinical data for scientific study.
文摘Aims:Although the application of ultrasound-guided vascular puncture and Z-stitch hemostasis to manage femoral access has been widely utilized,there is limited data on this combined application in adult congenital heart disease(ACHD)patients undergoing electrophysiological(EP)procedures.We sought to evaluate the safety and efficacy of ultrasound-guided puncture and postprocedural Z-stitch hemostasis for ACHD patients under-going EP procedures.Methods and Results:The population of ACHD patients undergoing transfemoral EP pro-cedures at the University of Zurich Heart Center between January 2019 and December 2022 was observed and analyzed.During the study period,femoral access(left/right,arterial/venous)was performed under real-time ultrasound guidance.At the end of the procedure,a single Z-stitch was performed at the puncture site.We eval-uated the incidence of in-hospital complications associated with femoral access puncture in this population.Among 101 patients who had a total of 147 previous ipsilateral vascular punctures(mean 1.5 per person),100 patients underwent successful femoral vascular access for EP procedures.The median age of the patients was 47±15 years and 34(34%)were male.Z-stitches were performed after the procedure in 100 patients with 303 femoral vascular accesses(mean 3 punctures per person).No patient developed vascular puncture relevant inguinal hematoma,pseudo aneurysm,arteriovenousfistula,venous or arterial thrombosis.Conclusion:In ACHD patients undergoing EP procedures,optimal femoral access management can be achieved with ultra-sound-guided puncture and postprocedural Z-stitch hemostasis.
基金supported by the Natural Science Foundation of Sichuan Province of China,Nos.2022NSFSC1545 (to YG),2022NSFSC1387 (to ZF)the Natural Science Foundation of Chongqing of China,Nos.CSTB2022NSCQ-LZX0038,cstc2021ycjh-bgzxm0035 (both to XT)+3 种基金the National Natural Science Foundation of China,No.82001378 (to XT)the Joint Project of Chongqing Health Commission and Science and Technology Bureau,No.2023QNXM009 (to XT)the Science and Technology Research Program of Chongqing Education Commission of China,No.KJQN202200435 (to XT)the Chongqing Talents:Exceptional Young Talents Project,No.CQYC202005014 (to XT)。
文摘Epilepsy can be defined as a dysfunction of the brain network,and each type of epilepsy involves different brain-network changes that are implicated diffe rently in the control and propagation of interictal or ictal discharges.Gaining more detailed information on brain network alterations can help us to further understand the mechanisms of epilepsy and pave the way for brain network-based precise therapeutic approaches in clinical practice.An increasing number of advanced neuroimaging techniques and electrophysiological techniques such as diffusion tensor imaging-based fiber tra ctography,diffusion kurtosis imaging-based fiber tractography,fiber ball imagingbased tra ctography,electroencephalography,functional magnetic resonance imaging,magnetoencephalography,positron emission tomography,molecular imaging,and functional ultrasound imaging have been extensively used to delineate epileptic networks.In this review,we summarize the relevant neuroimaging and neuroelectrophysiological techniques for assessing structural and functional brain networks in patients with epilepsy,and extensively analyze the imaging mechanisms,advantages,limitations,and clinical application ranges of each technique.A greater focus on emerging advanced technologies,new data analysis software,a combination of multiple techniques,and the construction of personalized virtual epilepsy models can provide a theoretical basis to better understand the brain network mechanisms of epilepsy and make surgical decisions.
文摘With the support by the National Natural Science Foundation of China,the research team led by Professor Li Yigang(李毅刚)at Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine and Professor Peng Huisheng(彭慧胜)at Fudan University presented a new type of
基金Supported by the National Natural Science Foundation of China(81070142)Natural Science Foundation of Hubei Province (2011CDB504)
文摘Objective To investigate the alterations of cardiac electrophysiological properties and substantial mechanism and find the stable arrhythmia mouse model in Kunming(KM) and C57BL6/J(C57) mice.Methods Electrocardiogram recordings were used to analyze the QT interval in vivo,and monophasic action potential of right and left ventricular epicardium was recorded to elicit changes of action potential duration(APD) in conventional and programmed electrical stimulation(PES).Transient outward potassium current(I to) was recorded via whole-cell patch-clamp technique in single right and left epicardial myocytes.Results QT interval was prolonged in KM mice relative to C57 mice(62.51±4.47 ms vs.52.59±4.85 ms,P<0.05).The APD at 50% repolarization of the left ventricular epicardium(18.60±0.91 ms vs.12.90±0.35 ms),and APDs at 50%(17.31±6.05 ms vs.12.00±3.24 ms) and 70% repolarization(36.13±5.32 ms vs.21.95±8.06 ms) of the right ventricular epicardium in KM mice were significantly prolonged compared with C57 mice,respectively(all P<0.05).KM mice were more sensitive to PES-induced ventricular tachycardia(25%,3 of 12 hearts),and especially to Burst-induced ventricular tachycardia(50%,6 of 12 hearts) compared with C57 mice,which were 20%(2 of 10 hearts) and 30%(3 of 10 hearts) respectively.I to densities both in the left and right ventricular epicardial myocytes from KM mice were significantly decreased compared with C57 mice,respectively(all P<0.01).Conclusion Our data showed that KM mice with the prolonged QT interval and APD are vulnerabilities to ventricular arrhythmia,which are attributed to lower I to densities in ventricular myocytes obtained from KM mice than that from C57 mice.