AIM To explore regional systolic strain of midwall and endocardial segments using speckle tracking echocardiography in patients with apical hypertrophic cardiomyopathy(HCM).METHODS We prospectively assessed 20 patient...AIM To explore regional systolic strain of midwall and endocardial segments using speckle tracking echocardiography in patients with apical hypertrophic cardiomyopathy(HCM).METHODS We prospectively assessed 20 patients(mean age 53 ± 16 years,range:18-81 years,10 were male),with apical HCM. We measured global longitudinal peak systolic strain(GLPSS) in the midwall and endocardium of the left ventricle. RESULTS The diastolic thickness of the 4 apical segments was 16.25 ± 2.75 mm. All patients had a normal global systolicfunction with a fractional shortening of 50% ± 8%. In spite of supernormal left ventricular(LV) systolic function,midwall GLPSS was decreased in all patients,more in the apical(-7.3% ±-8.8%) than in basal segments(-15.5% ±-6.93%),while endocardial GLPPS was significantly greater and reached normal values(apical:-22.8% ±-7.8%,basal:-17.9% ±-7.5%). CONCLUSION This study shows that two-dimensional strain was decreased mainly confined to the mesocardium,while endocardium myocardial deformation was preserved in HCM and allowed to identify subclinical LV dysfunction. This transmural heterogeneity in systolic strain had not been previously described in HCM and could be explained by the distribution of myofibrillar disarray in deep myocardial areas. The clinical application of this novel finding may help further understanding of the pathophysiology of HCM.展开更多
Subjective: To observe the effect of electroacupuncture (EA) of acupoints of the Heart Meridian and Lung Meridian on ischemic cardiac systolic ability for analyzing the relative specific relationship between the Heart...Subjective: To observe the effect of electroacupuncture (EA) of acupoints of the Heart Meridian and Lung Meridian on ischemic cardiac systolic ability for analyzing the relative specific relationship between the Heart Meridian and the heart. Methods: Acute myocardial ischemia (AMI) was produced by intravenous infusion of pituitrin (40 u + 5% glucose injection 500 ml, 60 drips/min) in the rabbit. Left intraventricular pressure (LVP), maximal rising velocity of LVP (dp/dt max), isovolumetric pressure (IP) and end-diastolic pressure (EDP) of the left cardiac ventricle were used as the indexes. Three points of Heart Meridian [HM, from 'Shenmen' (HT 7) to 'Lingdao' (HT 4)] and the three points of Lung Meridian [LM, from 'Taiyuan' (LU 9) to 'Lieque' (LU 7)] were punctured with filiform needles and stimulated with hand-manipulation and electrically with ZY2-1 EA Therapeutic Apparatus. 30 rabbits anesthetized with urethane (1 g/kg) were randomly and evenly divided into control group, HM group and LM group. Result-s: The effects of EA of HM points were evidently superior to those of EA of LM points in promoting the recovery of both AMI-induced decrease of LVP and dp/dtmax, and AMI-induced increase of IP and EDP. Conclusion: Acupoints of Heart Meridian has a relatively specific connection with the heart in comparison with those of Lung Meridian; and the Heart Meridian is a functional whole.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
文摘AIM To explore regional systolic strain of midwall and endocardial segments using speckle tracking echocardiography in patients with apical hypertrophic cardiomyopathy(HCM).METHODS We prospectively assessed 20 patients(mean age 53 ± 16 years,range:18-81 years,10 were male),with apical HCM. We measured global longitudinal peak systolic strain(GLPSS) in the midwall and endocardium of the left ventricle. RESULTS The diastolic thickness of the 4 apical segments was 16.25 ± 2.75 mm. All patients had a normal global systolicfunction with a fractional shortening of 50% ± 8%. In spite of supernormal left ventricular(LV) systolic function,midwall GLPSS was decreased in all patients,more in the apical(-7.3% ±-8.8%) than in basal segments(-15.5% ±-6.93%),while endocardial GLPPS was significantly greater and reached normal values(apical:-22.8% ±-7.8%,basal:-17.9% ±-7.5%). CONCLUSION This study shows that two-dimensional strain was decreased mainly confined to the mesocardium,while endocardium myocardial deformation was preserved in HCM and allowed to identify subclinical LV dysfunction. This transmural heterogeneity in systolic strain had not been previously described in HCM and could be explained by the distribution of myofibrillar disarray in deep myocardial areas. The clinical application of this novel finding may help further understanding of the pathophysiology of HCM.
基金grants of State Scientific-technological Scale Project
文摘Subjective: To observe the effect of electroacupuncture (EA) of acupoints of the Heart Meridian and Lung Meridian on ischemic cardiac systolic ability for analyzing the relative specific relationship between the Heart Meridian and the heart. Methods: Acute myocardial ischemia (AMI) was produced by intravenous infusion of pituitrin (40 u + 5% glucose injection 500 ml, 60 drips/min) in the rabbit. Left intraventricular pressure (LVP), maximal rising velocity of LVP (dp/dt max), isovolumetric pressure (IP) and end-diastolic pressure (EDP) of the left cardiac ventricle were used as the indexes. Three points of Heart Meridian [HM, from 'Shenmen' (HT 7) to 'Lingdao' (HT 4)] and the three points of Lung Meridian [LM, from 'Taiyuan' (LU 9) to 'Lieque' (LU 7)] were punctured with filiform needles and stimulated with hand-manipulation and electrically with ZY2-1 EA Therapeutic Apparatus. 30 rabbits anesthetized with urethane (1 g/kg) were randomly and evenly divided into control group, HM group and LM group. Result-s: The effects of EA of HM points were evidently superior to those of EA of LM points in promoting the recovery of both AMI-induced decrease of LVP and dp/dtmax, and AMI-induced increase of IP and EDP. Conclusion: Acupoints of Heart Meridian has a relatively specific connection with the heart in comparison with those of Lung Meridian; and the Heart Meridian is a functional whole.
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.
