The present study investigated the application of echocardiography to evaluation of cardiac dyssynchrony in patients with congestive heart failure(CHF). A total of 348 consecutive CHF patients who were admitted for ...The present study investigated the application of echocardiography to evaluation of cardiac dyssynchrony in patients with congestive heart failure(CHF). A total of 348 consecutive CHF patients who were admitted for cardiac resynchronization(CRT) and presented with low ejection fraction(EF) and wide QRS duration were enrolled in this study, along with 388 healthy individuals. Dyssynchrony was assessed based on filling time ratio(FT/RR), left ventricular pre-ejection delay(PED), interventricular mechanical delay(IVMD), longitudinal opposing wall delay(LOWD) and radial septal to posterior wall delay(RSPWD). Response to CRT was defined as a ≥15% increase in EF. The results showed that FT/RR was decreased while PED, IVMD, LOWD and RSPWD were increased in the CHF group compared with the control group(P〈0.01). In the CHF group, FT/RR was negatively correlated with the QRS duration, LV end-diastolic diameter(LVESd), LV end-diastolic volume(LVEDV) and LV end-systolic volume(LVESV)(P〈0.01), but positively with the LVEF(P〈0.01). Additionally, PED, IVMD, LOWD and RSPWD were positively correlated with the QRS duration, LVESd, LVEDV and LVESV(P〈0.01), but negatively with the LVEF(P〈0.01). The CHF group was divided into three subgroups according to the varying degrees of LVEF. FT/RR decreased successively from the LVEF-1 group to the LVEF-2 group to the LVEF-3 group, while the PED, IVMD, LOWD and RSPWD successively increased in the same order(P〈0.01). The CHF group was divided into three subgroups according to the varying degrees of QRS duration, and FT/RR decreased successively in a sequence from the QRS-1 group to the QRS-2 group to the QRS-3 group, while the PED, IVMD, LOWD and RSPWD successively increased in the same order(P〈0.01). Speckle tracking radial dyssynchrony ≥130 ms was predictive of an EF response in patients in QRS-1 group(78% sensitivity, 83% specificity), those in QRS-2 group(83% sensitivity, 77% specificity) and in QRS-3 group(89% sensitivity, 79% specificity). In conclusion, echocardiography is a convenient and sensitive method for evaluating cardiac dyssynchrony in patients with CHF.展开更多
Objective: To investigate the intervention effect of Jianxin Decoction (健心汤, JXD) on the cytokine level in serum of patients with congestive heart failure (CHF). Methods; Sixty-six patients with CHF were randomly d...Objective: To investigate the intervention effect of Jianxin Decoction (健心汤, JXD) on the cytokine level in serum of patients with congestive heart failure (CHF). Methods; Sixty-six patients with CHF were randomly divided into the control group (n = 33) and the trial group (n = 33). The control group received conventional treatment, and the trial group was treated with conventional therapy plus JXD for 4 weeks. Before and after treatment, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and nitrogen monoxide (NO) in serum and cardiac function were determined. Results: After treatment, the levels of TNF-α, IL-6 and NO were significantly lower than those before treatment (P<0.05, or P<0.01) in the two groups, and the lowering degree of the indices in the trial group was more significantly reduced than that in the control group (P<0.05). And cardiac functions in both groups were improved significantly (P<0.05, or P< 0.01). Conclusion: JXD could prevent and reverse ventricular remodeling so as to ameliorate cardiac function through regulating the levels of cytokines.展开更多
Objective To explore the effects of thyroid hormone (TH) on cardiac function and peripheral lymphocyte β-adrenoceptors (β-ARs) of patients with chronic congestive heart failure (CHF).Methods Twenty-eight patients wi...Objective To explore the effects of thyroid hormone (TH) on cardiac function and peripheral lymphocyte β-adrenoceptors (β-ARs) of patients with chronic congestive heart failure (CHF).Methods Twenty-eight patients with class III or IV advanced CHF due to dilated cardiomyopathy (DCM) or ischemic cardiomyopathy (ICM) were randomly divided into groups A and B. L-thyroxine (L-T50) was administered to group B. Exercise tolerance, chest X-rays, and echocardiographic parameters were obtained before and after one month of treatment, Ficoll-hypaque solution was used to separate peripheral lymphocytes, and 125l-pindolol radioligand binding was used to measure β-AR levels in peripheral lymphocytes.Results L-T50 therapy improved cardiac output [CO, (2. 98±0. 31 )L/min vs (3. 24 ±0. 28) L/min, P<0. 01], left ventricular ejection fraction (LVEF, 26.21%±3.21% vs 37.93% ±9.01%, P< 0. 01), and decreased isovolumetric relaxation time (IVRT, 0.12 ±0. 04 vs 0.10 ±0. 02, P<0. 01). Serum TH levels and the maximal number of β-AR binding sites (βmax) in peripheral lymphocytes were lower in patients with CHF than in normal healthy people, but L-T50 administration induced a β-AR up-regulation on peripheral lymphocyte surfaces. L-T50 was well tolerated without episodes of ischemia or arrhythmia. There was no significant change in heart rate or metabolic rate.Conclusion TH administration improves cardiac function and β-AR expression in peripheral lymphocytes of patients with CHF.展开更多
文摘The present study investigated the application of echocardiography to evaluation of cardiac dyssynchrony in patients with congestive heart failure(CHF). A total of 348 consecutive CHF patients who were admitted for cardiac resynchronization(CRT) and presented with low ejection fraction(EF) and wide QRS duration were enrolled in this study, along with 388 healthy individuals. Dyssynchrony was assessed based on filling time ratio(FT/RR), left ventricular pre-ejection delay(PED), interventricular mechanical delay(IVMD), longitudinal opposing wall delay(LOWD) and radial septal to posterior wall delay(RSPWD). Response to CRT was defined as a ≥15% increase in EF. The results showed that FT/RR was decreased while PED, IVMD, LOWD and RSPWD were increased in the CHF group compared with the control group(P〈0.01). In the CHF group, FT/RR was negatively correlated with the QRS duration, LV end-diastolic diameter(LVESd), LV end-diastolic volume(LVEDV) and LV end-systolic volume(LVESV)(P〈0.01), but positively with the LVEF(P〈0.01). Additionally, PED, IVMD, LOWD and RSPWD were positively correlated with the QRS duration, LVESd, LVEDV and LVESV(P〈0.01), but negatively with the LVEF(P〈0.01). The CHF group was divided into three subgroups according to the varying degrees of LVEF. FT/RR decreased successively from the LVEF-1 group to the LVEF-2 group to the LVEF-3 group, while the PED, IVMD, LOWD and RSPWD successively increased in the same order(P〈0.01). The CHF group was divided into three subgroups according to the varying degrees of QRS duration, and FT/RR decreased successively in a sequence from the QRS-1 group to the QRS-2 group to the QRS-3 group, while the PED, IVMD, LOWD and RSPWD successively increased in the same order(P〈0.01). Speckle tracking radial dyssynchrony ≥130 ms was predictive of an EF response in patients in QRS-1 group(78% sensitivity, 83% specificity), those in QRS-2 group(83% sensitivity, 77% specificity) and in QRS-3 group(89% sensitivity, 79% specificity). In conclusion, echocardiography is a convenient and sensitive method for evaluating cardiac dyssynchrony in patients with CHF.
文摘Objective: To investigate the intervention effect of Jianxin Decoction (健心汤, JXD) on the cytokine level in serum of patients with congestive heart failure (CHF). Methods; Sixty-six patients with CHF were randomly divided into the control group (n = 33) and the trial group (n = 33). The control group received conventional treatment, and the trial group was treated with conventional therapy plus JXD for 4 weeks. Before and after treatment, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and nitrogen monoxide (NO) in serum and cardiac function were determined. Results: After treatment, the levels of TNF-α, IL-6 and NO were significantly lower than those before treatment (P<0.05, or P<0.01) in the two groups, and the lowering degree of the indices in the trial group was more significantly reduced than that in the control group (P<0.05). And cardiac functions in both groups were improved significantly (P<0.05, or P< 0.01). Conclusion: JXD could prevent and reverse ventricular remodeling so as to ameliorate cardiac function through regulating the levels of cytokines.
基金the Zhengzhou Railway Bureau Science Fund, China (99w33).
文摘Objective To explore the effects of thyroid hormone (TH) on cardiac function and peripheral lymphocyte β-adrenoceptors (β-ARs) of patients with chronic congestive heart failure (CHF).Methods Twenty-eight patients with class III or IV advanced CHF due to dilated cardiomyopathy (DCM) or ischemic cardiomyopathy (ICM) were randomly divided into groups A and B. L-thyroxine (L-T50) was administered to group B. Exercise tolerance, chest X-rays, and echocardiographic parameters were obtained before and after one month of treatment, Ficoll-hypaque solution was used to separate peripheral lymphocytes, and 125l-pindolol radioligand binding was used to measure β-AR levels in peripheral lymphocytes.Results L-T50 therapy improved cardiac output [CO, (2. 98±0. 31 )L/min vs (3. 24 ±0. 28) L/min, P<0. 01], left ventricular ejection fraction (LVEF, 26.21%±3.21% vs 37.93% ±9.01%, P< 0. 01), and decreased isovolumetric relaxation time (IVRT, 0.12 ±0. 04 vs 0.10 ±0. 02, P<0. 01). Serum TH levels and the maximal number of β-AR binding sites (βmax) in peripheral lymphocytes were lower in patients with CHF than in normal healthy people, but L-T50 administration induced a β-AR up-regulation on peripheral lymphocyte surfaces. L-T50 was well tolerated without episodes of ischemia or arrhythmia. There was no significant change in heart rate or metabolic rate.Conclusion TH administration improves cardiac function and β-AR expression in peripheral lymphocytes of patients with CHF.