慢性心功能不全合并室性心律失常应用胺碘酮和美托洛尔治疗的效果探讨

目的探讨慢性心功能不全合并室性心律失常应用胺碘酮和美托洛尔治疗的效果。方法整群选取该院于2012年12月—2014年12月诊治的102例慢性心功能不全合并室性心律失常患者进行回顾性分析,随机分为实验组和对照组各51例,对照组采用胺碘酮进行治疗,实验组在对照组的基础上加入美托洛尔进行治疗,观察两组患者的治疗效果。结果实验组的总有效率(98.0%)明显高于对照组(78.4%),差异具有统计学意义(P<0.05)。结论对慢性心功能不全合并室性心律失常患者进行胺碘酮和美托洛尔治疗可以有效的改善患者的症状,具有重要的临床意义。

胺碘酮、美托洛尔及两者合用治疗慢性心功能不全合并室性心律失常的临床疗效

目的:探讨胺碘酮、美托洛尔及两者合用治疗慢性心功能不全合并室性心律失常的临床疗效。方法:选取150例慢性心功能不全合并室性心律失常患者,按照随机方法将其分为治疗一组、治疗二组和治疗三组,治疗一组患者采用胺碘酮联合美托洛尔进行治疗,治疗二组仅采用胺碘酮治疗,治疗三组仅采用美托洛尔进行治疗,比较三组患者1年后的治疗效果。结果:治疗一组的心功能改善情况明显优于治疗二组和治疗三组,对比结果差异有统计学意义(P<0.05)。同时治疗二组和治疗三组的心功能改善情况结果对比,差异无统计学意义(P>0.05)。结论:采用胺碘酮联合美托洛尔治疗慢性心功能不全合并室性心律失常患者,疗效好,能够明显改善患者的心功能情况,不良反应情况发生少,值得在临床上推广应用。

Right heart modified myocardial performance index and ductus venosus spectrum parameters in pre-eclampsia fetuses for predicting adverse pregnancy outcomes

Objective To observe the values of changes of right heart modified myocardial performance index(Mod-MPI)and ductus venosus(DV)spectrum parameters in pre-eclampsia fetuses for predicting adverse pregnancy outcomes.Methods Eighty-one pregnant women diagnosed as pre-eclampsia were prospectively enrolled and divided into severe pre-eclampsia(SPE)group(n=39)and mild pre-eclampsia(MPE)group(n=42),while 85 healthy pregnant women were taken as controls(control group).Fetal right heart function parameters,including right ventricular isovolumetric relaxation time(IRT),isovolumetric contraction time(ICT),ejection time(ET),total spent time(TST),Mod-MPI,tricuspid valve peak flow velocity ratio in early and late diastole(TV-E/A),as well as blood flow velocities in each waveform of DV spectrum(S,V,D,and A wave)were obtained,and the pulsatility index(PI)and the ratio of blood flow velocities in each waveform of the DV(S/V,S/D,S/A,V/D,V/A,D/A)were calculated.Intrauterine fetal distress,preterm delivery,neonatal asphyxia and newborn with low weight were considered as adverse pregnancy outcomes.The correlations of right heart Mod-MPI and TV-E/A with DV parameters in pre-eclampsia fetuses were assessed,and their predictive efficacies for adverse pregnancy outcomes were evaluated for right heart Mod-MPI and DV using the receiver operating characteristics(ROC)and the area under the curves(AUC).Results Compared with control group and MPE group,fetal right heart IRT,ICT and Mod-MPI increased and ET decreased in SPE group(all P<0.05).No significant differences of right heart TST and TV-E/A among 3 groups(both P>0.05).Fetal DV A-wave velocity and V/D values progressively decreased but PI progressively increased in control,MPE and SPE groups(all P<0.05).Fetal right heart Mod-MPI in pre-eclampsia was moderately positively correlated with DV PI(r=0.637,P=0.016),while TV-E/A was weakly negatively correlated with DV V/D(r=-0.355,P=0.043).Adverse pregnancy outcomes were noticed in 59 pre-eclampsia cases.The AUC of fetal right heart Mod-MPI and DV PI for predicting adverse pregnancy outcomes in pre-eclampsia cases was 0.897 and 0.848,respectively,without significant difference(Z=0.460,P=0.400).Conclusion Changes of right heart Mod-MPI and DV spectrum parameters in pre-eclampsia fetuses had high value for predicting adverse pregnancy outcomes.

Deep learning echocardiographic intelligent model for evaluation on left ventricular regional wall motion abnormality

Objective To observe the value of deep learning echocardiographic intelligent model for evaluation on left ventricular(LV)regional wall motion abnormalities(RWMA).Methods Apical two-chamber,three-chamber and four-chamber views two-dimensional echocardiograms were obtained prospectively in 205 patients with coronary heart disease.The model for evaluating LV regional contractile function was constructed using a five-fold cross-validation method to automatically identify the presence of RWMA or not,and the performance of this model was assessed taken manual interpretation of RWMA as standards.Results Among 205 patients,RWMA was detected in totally 650 segments in 83 cases.LV myocardial segmentation model demonstrated good efficacy for delineation of LV myocardium.The average Dice similarity coefficient for LV myocardial segmentation results in the apical two-chamber,three-chamber and four-chamber views was 0.85,0.82 and 0.88,respectively.LV myocardial segmentation model accurately segmented LV myocardium in apical two-chamber,three-chamber and four-chamber views.The mean area under the curve(AUC)of RWMA identification model was 0.843±0.071,with sensitivity of(64.19±14.85)%,specificity of(89.44±7.31)%and accuracy of(85.22±4.37)%.Conclusion Deep learning echocardiographic intelligent model could be used to automatically evaluate LV regional contractile function,hence rapidly and accurately identifying RWMA.

动态心电图在病态窦房结综合征诊断中的应用价值

目的:观察诊断病态窦房结综合征应用动态心电图应用价值。方法:收集2016年5月—2017年12月在我院心功能室接受检查的43例病态窦房结综合征患者为研究组,并收集2016年5月—2017年12月在我院进行体格检查的43例健康受检人为对照组,两组均给予动态心电图检查,对比两组24h平均心率、最高心率、平均总心搏数及窦性心动过缓、心率失常、房颤发生率。结果:两组受检人24h平均心率、最高心率、平均总心搏数指标比较具有显著差异,对照组各项观察指标均优于研究组,差异显著P<0.05。研究组窦性心动过缓发生率为67.44%、心率失常86.04%、房颤11.62%;对照组窦性心动过缓发生率为4.65%、心率失常6.97%、房颤0例0.00%,研究组窦性心动过缓、心率失常、房颤发生率高于对照组P<0.05。结论:动态心电图操作简单检出率高,是诊断病态窦房结综合征的有效方式。