BACKGROUND Although transcatheter aortic valve implantation(TAVI)is a safe and effective treatment for aortic stenosis,it still carries some risks,such as valve leaks,stroke,and even death.The left ventricular global ...BACKGROUND Although transcatheter aortic valve implantation(TAVI)is a safe and effective treatment for aortic stenosis,it still carries some risks,such as valve leaks,stroke,and even death.The left ventricular global longitudinal strain(LVGLS)measurement may be useful for the prediction of adverse events during this operation.AIM To explore the change of LVGLS during TAVI procedure and the relationship between LVGLS and perioperative adverse events.METHODS In this study,61 patients who had undergone percutaneous transfemoral TAVI were evaluated by transthoracic echocardiography.Before surgery,data on left ventricular ejection fraction(LVEF)and LVGLS were collected separately following balloon expansion and stent implantation.Difference in values of LVGLS and LVEF during preoperative balloon expansion(pre-ex),preoperative stent implantation(pre-im)and balloon expansion-stent implantation(ex-im)were also examined.Adverse events were defined as perioperative death,cardiac rupture,heart arrest,moderate or severe perivalvular leakage,significant mitral regurgitation during TAVI,perioperative moderate or severe mitral regurgitation,perioperative left ventricular outflow tract obstruction,reoperation,and acute heart failure.RESULTS The occurrence of perioperative adverse events was associated with differences in pre-ex LVGLS,but not with difference in pre-ex LVEF.There were significant differences between pre-LVGLS and ex-LVGLS,and between pre-LVGLS and im-LVGLS(P=0.037 and P=0.020,respectively).However,differences in LVEF were not significant(P=0.358,P=0.254);however differences in pre-ex LVGLS were associated with pre-LVGLS(P=0.045).Compared to LVEF,LVGLS is more sensitive as a measure of left heart function during TAVI and the perioperative period.Moreover,the differences in LVGLS were associated with the occurrence of perioperative adverse events,and changes in LVGLS were apparent in patients with undesirable LVGLS before the surgery.Furthermore,LVGLS is useful to predict changes in cardiac function during TAVI.CONCLUSION Greater attention should be paid to the patients who plan to undergo TAVI with normal LVEF but poor LVGLS.展开更多
BackgroundCardiovascular 疾病和维生素 D 的不够的层次是为不利外科的结果的风险因素，并且他们是在经历整形外科的外科的更老的成年人之中通常在场的两个。给维生素 D 的心血管的效果， hypovitaminosis D 的外科手术前的诊断将是为...BackgroundCardiovascular 疾病和维生素 D 的不够的层次是为不利外科的结果的风险因素，并且他们是在经历整形外科的外科的更老的成年人之中通常在场的两个。给维生素 D 的心血管的效果， hypovitaminosis D 的外科手术前的诊断将是为补充协议的实现的珍贵的步。如果，我们调查了浆液 25 的正规化[哦] D 能改善受不了心血管的 diseases.MethodsWe 的更老的成年人的心脏的性能注册了为主要整形外科的外科安排的 47 个更老的成年人并且受不了 hypovitaminosis D。病人们与开始的剂量经历了 6 月的 calcifediol 补充 50 湩琠敨攠敶瑮的起初手术后的白天吗？展开更多
BACKGROUND The estimation of left ventricular ejection fraction(LVEF)by 2D echocardiography(2D-ECHO)is the most used tool to assess LV systolic function(LVSF).Global longitudinal strain(GLS)has recently been suggested...BACKGROUND The estimation of left ventricular ejection fraction(LVEF)by 2D echocardiography(2D-ECHO)is the most used tool to assess LV systolic function(LVSF).Global longitudinal strain(GLS)has recently been suggested as a superior method for several evaluations.This study explored the association and prevalence of LV systolic dysfunction(LVSD)by using these methods in patients with end-stage renal disease(ESRD)and severe hyperparathyroidism(SHPTH);both associated with cardiovascular events(CEs).AIM To evaluate the myocardial function in patients with ESRD and SHPTH by using the GLS and LVEF measured through conventional 2D-ECHO.METHODS In 62 patients with ESRD and SHPTH,asymptomatic,and without a history of CEs,LVSF was evaluated by 2D-ECHO,obtaining the EF,by the Simpson biplane method,and GLS by speckle tracking.RESULTS The total patients with ESRD had a preserved LVEF(>50%)but abnormal GLS(<13.55%).Additionally,multivariate analysis showed an independent association of GLS and serum parathyroid hormone(PTH),LV mass index,and hemoglobin.Also,PTH was independently associated with lateral e'wave and tricuspid regurgitation velocity.CONCLUSION In patients with SHPTH linked to ESRD,the use of GLS by 2D-ECHO is a more sensitive tool than LVEF for detecting LVSD.展开更多
Background: Cardiac toxicity is currently defined as a symptomatic decrease in Left Ventricular Ejection Fraction (LVEF) of more than 5% or an asymptomatic decrease of at least 10% to a value of under 50% in repeated ...Background: Cardiac toxicity is currently defined as a symptomatic decrease in Left Ventricular Ejection Fraction (LVEF) of more than 5% or an asymptomatic decrease of at least 10% to a value of under 50% in repeated evaluations on conventional transthoracic echocardiogram (TTE), as well as a Global Longitudinal Strain (GLS) value Aims: To highlight using GLS rather than modified Simpson 2D-LVEF for the evaluation of long-term cardiotoxicity. Case Presentation: The case concerns a 73-year-old female patient with a history of breast cancer chemotherapy and anthracyclines-based therapy who presented symptoms of late cardiac toxicity related to the chemotherapeutic treatment. In the following years, the patient remained asymptomatic with a 2D-LVEF of 48%, dilation of the left atrium was found, and the reservoir phase strain was severely decreased. Conclusion: The preferred method for evaluating cardiovascular complications associated with chemotherapy is the TTE, which is performed prior to the start of treatment, during therapy, and in the follow-up. Myocardial deformation as a predictor of cardiotoxicity allows the identification of subclinical heart failure.展开更多
目的本研究旨在采用二维斑点示踪技术(2D-STE)评估2型糖尿病(T2DM)患者左心室应变功能,比较体重控制良好和体重控制不佳的糖尿病患者的左室功能差异以及与健康对照组的差异。方法选择2022年8月—2023年3月在本院内分泌科住院的98例2型...目的本研究旨在采用二维斑点示踪技术(2D-STE)评估2型糖尿病(T2DM)患者左心室应变功能,比较体重控制良好和体重控制不佳的糖尿病患者的左室功能差异以及与健康对照组的差异。方法选择2022年8月—2023年3月在本院内分泌科住院的98例2型糖尿病患者及39名体检正常的健康人作为研究对象,将98例T2DM患者按体重指数(BMI)分为A组(BMI≥24 kg m^(-2),50例)和B组(BMI<24 kg m^(-2),48例)两组,同时将39名健康正常人作为健康对照组记为C组(其左室射血分数LVEF≥55%)。采用常规超声心动图测量常规心脏数据同时采用二维斑点示踪技术(2D-STE)获得左室心尖四腔、三腔、两腔二维动态图像,统计出左室基底段、中间段、心尖段各节段纵向应变值及左室整体纵向应变值和左室前间壁、前壁、前侧壁、下侧壁、下壁、下间壁各侧壁纵向应变值,并比较这些数据在三组之间的差异性。分析左室整体纵向应变值与BMI之间的相关性。任意选取16例患者重新检查检验观察者内与观察者间的可重复性。结果三组患者的LAd、LVd、LVPW S'、E/e'值比较,差异无统计学意义(P>0.05);A组和B组患者的LVEF、IVS S'值比C组明显降低,且A组患者的LVEF、IVS S'值低于B组,差异具有统计学意义(P<0.05);A组和B组患者的左室基底段、中间段、心尖段及整体纵向应变值比C组明显降低,且A组患者的左室基底段、中间段、心尖段及整体纵向应变值低于B组,差异具有统计学意义(P<0.05);A组和B组患者的左室前间壁、前壁、前侧壁、下侧壁、下壁、下间壁纵向应变值比C组明显降低,且A组患者的左室前间壁、前壁、前侧壁、下侧壁、下壁、下间壁纵向应变值低于B组,差异具有统计学意义(P<0.05)。Pearson相关性分析表明,左室整体纵向应变值与BMI呈显著负相关,差异具有统计学意义。Bland-Altman分析显示,随机选取的16例患者左室基底段、中间段、心尖段纵向应变值测量散点值绝大多数处于95%一致性界限范围内,提示在观察者内与观察者间表现出较好的重复性。结论本研究表明体重控制不佳糖尿病组左室整体纵向应变值较体重控制良好糖尿病组及健康对照组改变明显,提示临床医生有必要对2型糖尿病患者的体重进行监管,特别是那些体重控制不良的患者,应加强心脏功能的监测和管理,防止病程发展演变到糖尿病心脏病,并为临床治疗提供参考依据。展开更多
文摘BACKGROUND Although transcatheter aortic valve implantation(TAVI)is a safe and effective treatment for aortic stenosis,it still carries some risks,such as valve leaks,stroke,and even death.The left ventricular global longitudinal strain(LVGLS)measurement may be useful for the prediction of adverse events during this operation.AIM To explore the change of LVGLS during TAVI procedure and the relationship between LVGLS and perioperative adverse events.METHODS In this study,61 patients who had undergone percutaneous transfemoral TAVI were evaluated by transthoracic echocardiography.Before surgery,data on left ventricular ejection fraction(LVEF)and LVGLS were collected separately following balloon expansion and stent implantation.Difference in values of LVGLS and LVEF during preoperative balloon expansion(pre-ex),preoperative stent implantation(pre-im)and balloon expansion-stent implantation(ex-im)were also examined.Adverse events were defined as perioperative death,cardiac rupture,heart arrest,moderate or severe perivalvular leakage,significant mitral regurgitation during TAVI,perioperative moderate or severe mitral regurgitation,perioperative left ventricular outflow tract obstruction,reoperation,and acute heart failure.RESULTS The occurrence of perioperative adverse events was associated with differences in pre-ex LVGLS,but not with difference in pre-ex LVEF.There were significant differences between pre-LVGLS and ex-LVGLS,and between pre-LVGLS and im-LVGLS(P=0.037 and P=0.020,respectively).However,differences in LVEF were not significant(P=0.358,P=0.254);however differences in pre-ex LVGLS were associated with pre-LVGLS(P=0.045).Compared to LVEF,LVGLS is more sensitive as a measure of left heart function during TAVI and the perioperative period.Moreover,the differences in LVGLS were associated with the occurrence of perioperative adverse events,and changes in LVGLS were apparent in patients with undesirable LVGLS before the surgery.Furthermore,LVGLS is useful to predict changes in cardiac function during TAVI.CONCLUSION Greater attention should be paid to the patients who plan to undergo TAVI with normal LVEF but poor LVGLS.
基金Supported by the Secretaría de Investigación y Posgrado of the Instituto Politécnico Nacionalthe Comisión de Operación y Fomento de Actividades Académicas of the Instituto Politécnico Nacionalthe Consejo Nacional de Ciencia y Tecnología
文摘BACKGROUND The estimation of left ventricular ejection fraction(LVEF)by 2D echocardiography(2D-ECHO)is the most used tool to assess LV systolic function(LVSF).Global longitudinal strain(GLS)has recently been suggested as a superior method for several evaluations.This study explored the association and prevalence of LV systolic dysfunction(LVSD)by using these methods in patients with end-stage renal disease(ESRD)and severe hyperparathyroidism(SHPTH);both associated with cardiovascular events(CEs).AIM To evaluate the myocardial function in patients with ESRD and SHPTH by using the GLS and LVEF measured through conventional 2D-ECHO.METHODS In 62 patients with ESRD and SHPTH,asymptomatic,and without a history of CEs,LVSF was evaluated by 2D-ECHO,obtaining the EF,by the Simpson biplane method,and GLS by speckle tracking.RESULTS The total patients with ESRD had a preserved LVEF(>50%)but abnormal GLS(<13.55%).Additionally,multivariate analysis showed an independent association of GLS and serum parathyroid hormone(PTH),LV mass index,and hemoglobin.Also,PTH was independently associated with lateral e'wave and tricuspid regurgitation velocity.CONCLUSION In patients with SHPTH linked to ESRD,the use of GLS by 2D-ECHO is a more sensitive tool than LVEF for detecting LVSD.
文摘Background: Cardiac toxicity is currently defined as a symptomatic decrease in Left Ventricular Ejection Fraction (LVEF) of more than 5% or an asymptomatic decrease of at least 10% to a value of under 50% in repeated evaluations on conventional transthoracic echocardiogram (TTE), as well as a Global Longitudinal Strain (GLS) value Aims: To highlight using GLS rather than modified Simpson 2D-LVEF for the evaluation of long-term cardiotoxicity. Case Presentation: The case concerns a 73-year-old female patient with a history of breast cancer chemotherapy and anthracyclines-based therapy who presented symptoms of late cardiac toxicity related to the chemotherapeutic treatment. In the following years, the patient remained asymptomatic with a 2D-LVEF of 48%, dilation of the left atrium was found, and the reservoir phase strain was severely decreased. Conclusion: The preferred method for evaluating cardiovascular complications associated with chemotherapy is the TTE, which is performed prior to the start of treatment, during therapy, and in the follow-up. Myocardial deformation as a predictor of cardiotoxicity allows the identification of subclinical heart failure.
文摘目的本研究旨在采用二维斑点示踪技术(2D-STE)评估2型糖尿病(T2DM)患者左心室应变功能,比较体重控制良好和体重控制不佳的糖尿病患者的左室功能差异以及与健康对照组的差异。方法选择2022年8月—2023年3月在本院内分泌科住院的98例2型糖尿病患者及39名体检正常的健康人作为研究对象,将98例T2DM患者按体重指数(BMI)分为A组(BMI≥24 kg m^(-2),50例)和B组(BMI<24 kg m^(-2),48例)两组,同时将39名健康正常人作为健康对照组记为C组(其左室射血分数LVEF≥55%)。采用常规超声心动图测量常规心脏数据同时采用二维斑点示踪技术(2D-STE)获得左室心尖四腔、三腔、两腔二维动态图像,统计出左室基底段、中间段、心尖段各节段纵向应变值及左室整体纵向应变值和左室前间壁、前壁、前侧壁、下侧壁、下壁、下间壁各侧壁纵向应变值,并比较这些数据在三组之间的差异性。分析左室整体纵向应变值与BMI之间的相关性。任意选取16例患者重新检查检验观察者内与观察者间的可重复性。结果三组患者的LAd、LVd、LVPW S'、E/e'值比较,差异无统计学意义(P>0.05);A组和B组患者的LVEF、IVS S'值比C组明显降低,且A组患者的LVEF、IVS S'值低于B组,差异具有统计学意义(P<0.05);A组和B组患者的左室基底段、中间段、心尖段及整体纵向应变值比C组明显降低,且A组患者的左室基底段、中间段、心尖段及整体纵向应变值低于B组,差异具有统计学意义(P<0.05);A组和B组患者的左室前间壁、前壁、前侧壁、下侧壁、下壁、下间壁纵向应变值比C组明显降低,且A组患者的左室前间壁、前壁、前侧壁、下侧壁、下壁、下间壁纵向应变值低于B组,差异具有统计学意义(P<0.05)。Pearson相关性分析表明,左室整体纵向应变值与BMI呈显著负相关,差异具有统计学意义。Bland-Altman分析显示,随机选取的16例患者左室基底段、中间段、心尖段纵向应变值测量散点值绝大多数处于95%一致性界限范围内,提示在观察者内与观察者间表现出较好的重复性。结论本研究表明体重控制不佳糖尿病组左室整体纵向应变值较体重控制良好糖尿病组及健康对照组改变明显,提示临床医生有必要对2型糖尿病患者的体重进行监管,特别是那些体重控制不良的患者,应加强心脏功能的监测和管理,防止病程发展演变到糖尿病心脏病,并为临床治疗提供参考依据。
