Evaluation of Ventricular-vascular Coupling in Patients with Type 2 Diabetes Mellitus Using 2-Dimensional Speckle Tracking Imaging

The elastic and functional coupling of heart and vessels makes the stroke work （SW） of the heart optimal. Speckle tracking imaging （STI） can evaluate the myocardial strain and function. We studied ventricular-vascular coupling in 80 diabetic patients with different systolic function using STI. The patients were divided into two groups according to ejection fraction （EF）： the diabetes mel- litus with normal EF （DMN） group and the diabetes mellitus with abnormal EF （DMA） group. Forty-two volunteers served as control group. The relative wall thickness （RWT）, left ventricular mass index （LVMI）, stroke volume （SV）, SW, rate-pressure product （RPP）, systemic vascular resis- tance index （SVRI）, left ventricular end-systolic elastance （Ees）, effective arterial elasticity （Ea） and ventricular-vascular coupling index （VVI） were measured and calculated by conventional echocardi- ography. The longitudinal strain （LS） at basement （LSBA）, papillary muscle （LSvM） and cardiac apex （LSAv） was assessed with STI. It was found： （A） compared with control group, in DMN and DMA groups, LSBA, LSvM and LSAp decreased, and they were lower in DMA group. （B） VVI, RPP and SVRI increased, and they were higher in DMN group; Ees decreased, and it was lower in DMA group. （C） LSBA, LSpM, and LSAv had negative correlation with VVI. LSAp, RWT, LVMI and SW were independent predictors for VVI. The area under the receiver operating characteristic （ROC） curves was used for identification of DMA and DMN with LSBA, LSpM, and LSAp, and the area under the ROC of LSAp was the largest. This study supports that myocardial LS could reflect the ventricu- lar-vascular coupling. Different segments had an order to “respond to” the state of the coupling, and the cardiac apex might be the earliest.

Clinical Observation on Acupuncture Plus Acupoint Sticking for Bronchial Asthma in Remissive State

Objective:To observe the clinical efficacy of acupuncture plus acupoint sticking for bronchial asthma in remissive state.Methods:A total of 210 cases with asthma at remissive state were randomly allocated into an acupuncture group of 100 cases and a comprehensive therapy group of 110 cases.Cases in the acupuncture group were treated with acupuncture alone,and cases in the comprehensive therapy group were treated with acupuncture plus acupoint sticking therapy.Then the therapeutic efficacies were compared using observation indexes including wheezing,cough and coughing up phlegm,peak expiratory flow(PEF)and forced expiratory volume in one second(FEV1).In addition,the overall therapeutic efficacies were also analyzed on different traditional Chinese medicine(TCM)patterns.Results:The comprehensive therapy obtained better effects than acupuncture alone in alleviating cough and coughing up phlegm and improving PEF and FEV1;the overall efficacies on asthma due to lung-qi deficiency and spleen-qi deficiency were better than those on asthma due to kidney-qi deficiency.Conclusion:Acupuncture plus acupoint sticking is a convenient and effective therapy for asthma at remissive state and therefore worthy of being popularized.

International Clinical Practice Guideline of Chinese Medicine-Age-related Macular Degeneration

Foreword Patent issues may be existed in this document, and the Word Federation of Chinese Medicine Societies declared that they are not to blame.The main drafting Committee of this docement:First People’s Hospital Affiliated to Shanghai Jiaotong University, Eye hospital,China academy of Chinese Medical Sciences, Beijing Tongren Hospital Affiliated to Capital Medical University, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, National Eye Institute/National Institute of Health.

Value of cardiovascular interaction by exercise echocardiography according to gender

Background The cardiovascular interaction is important for the heart to achieve maximal cardiac work.The cardiovascular stiffness contributes to exercise intolerance. However, the difference in cardiovascular stiff-ness between genders is seldom reported when the objects do exercise. This study was to evaluate the ventricu-lar and arterial stiffness at rest and exercise according to gender. Methods Forty healthy volunteers were studied. The left ventricular function, structure and blood flow were measured by echocardiograph at rest and exercise. The derived variables including left ventricular end-systolic and diastolic elastance（Ees and Ed）, arterial elastance（Ea）, ventricular-vascular coupling index（VVI） and total stiffness index（TSI） were calculated.Results During exercise, all of the Ed, Ees, Ea and TSI showed significant increase, but VVI was no difference compared with them at rest. Both at rest and exercise, Ed, VVI and TSI had significantly higher in women than in men. The area under the receiver operating characteristic curves showed the area of Ed, Ees, Ea and TSI was greater than that of VVI. There were significant differences in Ed, Ees, Ea and TSI（P 〈 0.05）, but no significant difference in VVI（P 〉 0.05） between rest and exercise. Only in women, the Ed, Ees and Ea were correlated with the TSI, rate pressure product, E/e and EF. Conclusions Exercise leads to synchronous increase in ventricular and arterial stiffness, and ventriculoarterial coupling is maintained for healthy objects. The exercise intolerance is lower in women than in men.