In order to evaluate the left ventricular remodeling in patients with myocardial infarction after revascularization with intravenous real-time myocardial contrast echocardiography （RT-MCE）, intravenous RT-MCE was pe...In order to evaluate the left ventricular remodeling in patients with myocardial infarction after revascularization with intravenous real-time myocardial contrast echocardiography （RT-MCE）, intravenous RT-MCE was performed on 20 patients with myocardial infarction before coronary revascularization. Follow-up echocardiography was performed 3 months after coronary revascularization. Segmental wall motion was assessed using 18-segment LV model and classified as normal, hypokinesis, akinesis and dyskinesis. Myocardial perfusion was assessed by visual interpretation and divided into 3 conditions： homogeneous opacification=l; partial or reduced opaciflcation or subendocardial contrast defect=2; constrast defect=3. Myocardial perfusion score index （MPSI） was calculated by dividing the total sum of contrast score by the total number of segments with abnormal wall motion. Twenty patients were classified into 2 groups according to the MPSI： MPSI≤I.5 as good myocardial perfusion, MPSI〉1.5 as poor myocardial perfusion. To assess the left ventricular remodeling, the following comparisons were carried out： （1） Comparisons of left ventricular ejection fraction （LVEF）, left ventricular end-systolic volume （LVESV） and left ventricular end-diastolic volume （LVEDV） before and 3 months after revascularization in two groups;（2） Comparisons of LVEF, LVESV and LVEDV pre-revascularization between two groups and comparisons of these 3 months post-revascularization between two groups; （3） Comparisons of the differences in LVEF, LVESV and LVEDV between 3 months post-and pre-revascularization （ALVEF, ALVESV and ALVEDV） between two groups; （4） The linear regression analysis between ALVEF, ALVESV, ALVEDV and MPSI. The results showed that the LVEF obtained 3 months after revascularization in patients with MPSI〉1.5 was obviously lower than that in those with MPSI〈1.5. The LVEDV obtained 3 months post-revascularization in patients with MPSI〉1.5 was obviously larger than that in those with MPSI≤1.5 （P=0.002 and 0.04）. The differences in ALVEF and ALVEDV between patients with MPSI〉I.5 and those with MPSI≤1.5 were significant （P=0.002 and 0.001, respectively）. Linear regression analysis revealed that MPSI had a negative correlation with ALVEF and a positive correlation with ALVESV, ALVEDV （P=0.004, 0.008, and 0.016, respectively）. It was concluded that RT-MCE could accurately evaluate the left ventricular remodeling in patients with myocardial infarction after revascularization.展开更多
Objectives The purpose ofthis study was to investigate the effects of long-termramipril on ventricular remodeling, cardiac functionand survival in rat congestive heart failure after my-ocardial infarction. Methods Myo...Objectives The purpose ofthis study was to investigate the effects of long-termramipril on ventricular remodeling, cardiac functionand survival in rat congestive heart failure after my-ocardial infarction. Methods Myocardial infarction(MI) was caused by ligation of the left anterior de-scending coronary artery in rats. 7 days after thesurgery, the surviving rats were randomly assigned tothe following treatment protocols: 1) MI ras with notherapy, 2) MI rats treated with ramipril 3 mg/kg perday, 3) Sham-operated control rats, and 4) Sham-op-erated rats treated with ramipril 3 mg/kg per day. At22 weeks, cardiac hemodynamic parameters such asMAP, LVSP, ±dP/dtmax and LVEDP were measured,and cardiac morphometric parameters such as HW,LVW and LVCA were measured, mRNA of cardiacmolecule genes, such as βMHC, BNP, collagen Ⅰ andⅢ, and TGF-β_1, were quantified, and survival rateswere calculated. Results Compared with sham-operated rats, MI rats without therapy showed significantincreases in cardiac morphological parameters as wellas in mRAN expressions of cardiac molecule genes(P<0.01); while their hemodynamic parameters weresignificantly impaired (P<0.01), and survival rateshortened (P<0.05). Compared with MI rats with notherapy, MI rats treated with ramipril showed signifi-cant attenuation of mRAN expressions of cardiacmolecule genes (P<0.01); while their hemodynamicparameters were significantly improved (P<0.05 or P<0.01), and survival rates prolonged (P<0.05). Con-clusions Treatment with long-term ramipril may im-prove LV remodeling, cardiac function and survival inrat congestive heart failure after MI.展开更多
文摘In order to evaluate the left ventricular remodeling in patients with myocardial infarction after revascularization with intravenous real-time myocardial contrast echocardiography （RT-MCE）, intravenous RT-MCE was performed on 20 patients with myocardial infarction before coronary revascularization. Follow-up echocardiography was performed 3 months after coronary revascularization. Segmental wall motion was assessed using 18-segment LV model and classified as normal, hypokinesis, akinesis and dyskinesis. Myocardial perfusion was assessed by visual interpretation and divided into 3 conditions： homogeneous opacification=l; partial or reduced opaciflcation or subendocardial contrast defect=2; constrast defect=3. Myocardial perfusion score index （MPSI） was calculated by dividing the total sum of contrast score by the total number of segments with abnormal wall motion. Twenty patients were classified into 2 groups according to the MPSI： MPSI≤I.5 as good myocardial perfusion, MPSI〉1.5 as poor myocardial perfusion. To assess the left ventricular remodeling, the following comparisons were carried out： （1） Comparisons of left ventricular ejection fraction （LVEF）, left ventricular end-systolic volume （LVESV） and left ventricular end-diastolic volume （LVEDV） before and 3 months after revascularization in two groups;（2） Comparisons of LVEF, LVESV and LVEDV pre-revascularization between two groups and comparisons of these 3 months post-revascularization between two groups; （3） Comparisons of the differences in LVEF, LVESV and LVEDV between 3 months post-and pre-revascularization （ALVEF, ALVESV and ALVEDV） between two groups; （4） The linear regression analysis between ALVEF, ALVESV, ALVEDV and MPSI. The results showed that the LVEF obtained 3 months after revascularization in patients with MPSI〉1.5 was obviously lower than that in those with MPSI〈1.5. The LVEDV obtained 3 months post-revascularization in patients with MPSI〉1.5 was obviously larger than that in those with MPSI≤1.5 （P=0.002 and 0.04）. The differences in ALVEF and ALVEDV between patients with MPSI〉I.5 and those with MPSI≤1.5 were significant （P=0.002 and 0.001, respectively）. Linear regression analysis revealed that MPSI had a negative correlation with ALVEF and a positive correlation with ALVESV, ALVEDV （P=0.004, 0.008, and 0.016, respectively）. It was concluded that RT-MCE could accurately evaluate the left ventricular remodeling in patients with myocardial infarction after revascularization.
文摘Objectives The purpose ofthis study was to investigate the effects of long-termramipril on ventricular remodeling, cardiac functionand survival in rat congestive heart failure after my-ocardial infarction. Methods Myocardial infarction(MI) was caused by ligation of the left anterior de-scending coronary artery in rats. 7 days after thesurgery, the surviving rats were randomly assigned tothe following treatment protocols: 1) MI ras with notherapy, 2) MI rats treated with ramipril 3 mg/kg perday, 3) Sham-operated control rats, and 4) Sham-op-erated rats treated with ramipril 3 mg/kg per day. At22 weeks, cardiac hemodynamic parameters such asMAP, LVSP, ±dP/dtmax and LVEDP were measured,and cardiac morphometric parameters such as HW,LVW and LVCA were measured, mRNA of cardiacmolecule genes, such as βMHC, BNP, collagen Ⅰ andⅢ, and TGF-β_1, were quantified, and survival rateswere calculated. Results Compared with sham-operated rats, MI rats without therapy showed significantincreases in cardiac morphological parameters as wellas in mRAN expressions of cardiac molecule genes(P<0.01); while their hemodynamic parameters weresignificantly impaired (P<0.01), and survival rateshortened (P<0.05). Compared with MI rats with notherapy, MI rats treated with ramipril showed signifi-cant attenuation of mRAN expressions of cardiacmolecule genes (P<0.01); while their hemodynamicparameters were significantly improved (P<0.05 or P<0.01), and survival rates prolonged (P<0.05). Con-clusions Treatment with long-term ramipril may im-prove LV remodeling, cardiac function and survival inrat congestive heart failure after MI.
