Objective A novel index based on fi-equency-domain analysis of heart rate variability （HRV） was tested on patients with reduced left ventricular systolic function. This index, namely VHFI, was defined as the very hi...Objective A novel index based on fi-equency-domain analysis of heart rate variability （HRV） was tested on patients with reduced left ventricular systolic function. This index, namely VHFI, was defined as the very high frequency （VHF） component of the power spectrum normalized to represent its relative value in proportion to the total power minus the very low frequency component. Methods Patients （n = 130） were divided into a study group, consisting 66 patients with decreased left ventricular systolic function, and a control group, consisting 64 patients with normal heart structure and function and without severe coronary artery stenosis （〈 50%）. Results VHFI in the study group was significantly higher than that in the control group （19.17 ± 13.35 vs 11.37 ± 10.77, P 〈 0.001）. Cardiac events occurred in 18 patients during follow-up （33.34 i 3.26 months）. Defining the positive test as VHFI =15 and negative test as VHFI 〈15, achieved a sensitivity of 57.58% and a specificity of78.13% for predicting decreased left ventricular systolic function, and achieved a sensitivity of 66.67% and a specificity of 64.29% for predicting cardiac events. Univariate Cox regression analysis showed that positive VHFI test was an independent variable in predictive cardiac events. Conclusions The results suggest that VHFI is a useful tool for quick evaluation of left ventricular systolic function and prediction of prognosis展开更多
Objectives To detect and compare the systolic strain rate (SR) and strain in the infarct and ischemic myocardium by strain rate imaging (SRI), in order to explore the clinical value of SRI in evaluating regional left ...Objectives To detect and compare the systolic strain rate (SR) and strain in the infarct and ischemic myocardium by strain rate imaging (SRI), in order to explore the clinical value of SRI in evaluating regional left ventricular systolic dysfunction. Methods Patients with coronary artery disease were divided into angina pectoris (11 cases) and myocardial infarction (21 cases) groups. Twenty age-matched normal subjects served as the control group. Septal, lateral, anterior, inferior, anteroseptal and posterior walls of the left ventricle were respectively scanned using color tissue Doppler imaging (TDI). Then SR and strain curves were derived from TDI for basal, middle and apical segments of each wall. SRI parameters were: Systolic SR (SRsys), systolic strain (εsys) and maximum strain (εmax). Results Compared with normal segments, SRsys, εsys and εmax decreased significantly in the infarct and ischemic segments (P<0.01). Compared with ischemic segments, SRsys, εsys and εmax decreased significantly in the infarct segments (P<0.05). Conclusions SRsys, εsys and εmax measured by SRI can be used to quantitatively analyze regional left ventricular systolic dysfunction in patients with coronary artery disease, and aid in differentiating infarct from ischemic myocardium.展开更多
The left ventricular regional systolic functions in patients with hypertrophic cardiomyopathy （HCM） were assessed by using quantitative tissue velocity imaging （QTVI）. Left ventricular （LV） regional myocardial v...The left ventricular regional systolic functions in patients with hypertrophic cardiomyopathy （HCM） were assessed by using quantitative tissue velocity imaging （QTVI）. Left ventricular （LV） regional myocardial velocity along long- and short-axis in 31 HCM patients and 20 healthy subjects were analyzed by QTVI, and the regional myocardial systolic peak velocities （MVS） were measured. Mean MVS at each level including mitral annular, basal, middle and apical segments were calculated. The ratio of MVS along long-axis to that along short-axis （Ri） at basal and middle segments of the LV posterior wall and ventricular septum were calculated. The results showed that mean MVS was slower at each level including mitral annular, basal, middle and apical segments in the HCM patients than that in the healthy subjects （P〈0.01）. There were no significant differences in mean MVS between obstructive and non-obstructive groups in HCM patients. MVS of all regional myocardial segments along long-axis in the HCM patients were significantly slower than that in the healthy subjects （P〈0.05）, but there was no significant difference in MVS of all regional myocardial segments along long-axis between hypertrophied and non-hypertrophied group in the HCM patients. Ri was significantly lower in the HCM patients than that in the healthy subjects. The LV regional myocardial contractility along long-axis was impaired not only in the hypertrophied wall but also in the non-hypertrophied one in patients with HCM, suggesting that QTVI can assess accurately LV regional systolic function in patient with HCM and provides a novel means for an early diagnosis before and independent of hypertrophy.展开更多
The effect of sublingual administration and intravenous drip of nitroglycerin (SLNTG and IVNTG) on left ventricular volumes (LVVs) were studied and systolic function was quantitatively assessed with two-dimensional ec...The effect of sublingual administration and intravenous drip of nitroglycerin (SLNTG and IVNTG) on left ventricular volumes (LVVs) were studied and systolic function was quantitatively assessed with two-dimensional echocardiography (2DE) in 28 patients with myocardial infarction (MI), including 13 cases without heart failure (MI-NHF) in one group and 15 with heart failure (MI-HF) in another. The results showed that after SLNTG and IVNTG in both groups the heart rate (HR) increased significantly (P< 0.05-0.001); the systolic blood pressure (SBP) decreased significantly (P< 0.05-0.001); the diastolic blood pressure (DBP) was not significantly changed (all P>0.05); the left ventricular end-diastolic and end-systolic volumes (EDV and ESV) both significantly reduced [EDV: decreased by 5.8-11.6% (-13.2-19.0 ml), P< 0.05-0.001; ESV: decreased by 9.6-16.6% (-8.6-17.3 ml), P< 0.05-0.001)1; the left ventricular ejection fraction (LVEF) all significantly elevated (increased by 6.6%-9.4% (3.2%-3.4%), P < 0.05-0.001] except in MI-NHF group after IVNTG; the segmental EF of normal and hypokinetic segments also significantly increased (P<0.05-0.001). The results suggest that NTG could beneficially reduce left ventricular EDV and ESV; and improve or strengthen its global and segmental systolic function in MI patients, particularly noticeable in patients with heart failure.展开更多
The current study aimed to compare the effects between remimazolam and propofol on hemodynamic stability during the induction of general anesthesia in elderly patients.We used propofol at a rate of 60 mg/(kg·h)in...The current study aimed to compare the effects between remimazolam and propofol on hemodynamic stability during the induction of general anesthesia in elderly patients.We used propofol at a rate of 60 mg/(kg·h)in the propofol group(group P)or remimazolam at a rate of 6 mg/(kg·h)in the remimazolam group(group R)for the induction.A processed electroencephalogram was used to determine whether the induction was successful and when to stop the infusion of the study drug.We measured when patients entered the operating room(T_(0)),when the induction was successful(T_(1)),and when before(T_(2))and 5 min after successful endotracheal intubation(T_(3)).We found that mean arterial pressure(MAP)was lower at T_(1–3),compared with T_(0) in both groups,but higher at T_(2) in the group R,whileΔMAP_(T0–T2) andΔMAP_(max) were smaller in the group R(ΔMAP_(T0–T2):the difference between MAP at time point T_(0) and T_(2),ΔMAP_(max):the difference between MAP at time point T_(0) and the lowest value from T_(0) to T_(3)).Cardiac index and stroke volume index did not differ between groups,whereas systemic vascular resistance index was higher at T_(1–3) in the group R.These findings show that remimazolam,compared with propofol,better maintains hemodynamic stability during the induction,which may be attributed to its ability to better maintain systemic vascular resistance levels.展开更多
Objective Shengmai Recipe （SMR） is a Chinese patent medicine used for the treatment of chronic heart disease. In order to further assess the renal-protective effect against ischemia lesion of SMR, the cardioprotecti...Objective Shengmai Recipe （SMR） is a Chinese patent medicine used for the treatment of chronic heart disease. In order to further assess the renal-protective effect against ischemia lesion of SMR, the cardioprotective effect of SMR on pressure overload-induced left ventricular （LV） systolic dysfunction and the potential mechanism on alleviating myocardial damage, myocardial fibrosis, and renal ischemia lesion in chronic heart failure （CHF） rats were investigated. Methods Rats with partially ligated abdominal aorta were randomly divided into model, Sham, and SMR groups. One week after recovery from surgery, animals were preventively ig administered with SMR at the dose of 810 mg/kg once daily for 8 weeks. Cardiac function and structure, endogenous biomarkers （CK-MB and LDH）, myocardial fibrosis, and organ pathological change were estimated by echocardiography, immunodepression and velocity method, hematoxylin- eosin staining, and masson＇s trichrome staining, respectively. Results The administration of SMR significantly decreased serum CK-MB and LDH levels and reduced myocardial fibrosis. Interestingly, SMR not only improved cardiac function but also ameliorated kidney injury induced by ischemia in CHF rats. Conclusion SMR could enhance the LV contractile function, reduce myocardial necrosis, and reverse LV remodeling in CHF rats, and most importantly, SMR could be used to treat the renal ischemia injury in pressure overload rats.展开更多
Background:Hypothermia therapy has been suggested to attenuate myocardial necrosis;however,the clinical implementation as a valid therapeutic strategy has failed,and new approaches are needed to translate into clinica...Background:Hypothermia therapy has been suggested to attenuate myocardial necrosis;however,the clinical implementation as a valid therapeutic strategy has failed,and new approaches are needed to translate into clinical applications.This study aimed to assess the feasibility,safety,and efficacy of a novel selective intracoronary hypothermia(SICH)device in mitigating myocardial reperfusion injury.Methods:This study comprised two phases.The first phase of the SICH was performed in a normal porcine model for 30 minutes(n=5)to evaluate its feasibility.The second phase was conducted in a porcine myocardial infarction(MI)model of myocardial ischemia/reperfusion which was performed by balloon occlusion of the left anterior descending coronary artery for 60 minutes and maintained for 42 days.Pigs in the hypothermia group(n=8)received hypothermia intervention onset reperfusion for 30 minutes and controls(n=8)received no intervention.All animals were followed for 42 days.Cardiac magnetic resonance analysis(five and 42 days post-MI)and a series of biomarkers/histological studies were performed.Results:The average time to lower temperatures to a steady state was 4.8±0.8 s.SICH had no impact on blood pressure or heart rate and was safely performed without complications by using a 3.9 F catheter.Interleukin-6(IL-6),tumor necrosis factor-α,C-reactive protein(CRP),and brain natriuretic peptide(BNP)were lower at 60 min post perfusion in pigs that underwent SICH as compared with the control group.On day 5 post MI/R,edema,intramyocardial hemorrhage,and microvascular obstruction were reduced in the hypothermia group.On day 42 post MI/R,the infarct size,IL-6,CRP,BNP,and matrix metalloproteinase-9 were reduced,and the ejection fraction was improved in pigs that underwent SICH.Conclusions:The SICH device safely and effectively reduced the infarct size and improved heart function in a pig model of MI/R.These beneficial effects indicate the clinical potential of SICH for treatment of myocardial reperfusion injury.展开更多
文摘Objective A novel index based on fi-equency-domain analysis of heart rate variability （HRV） was tested on patients with reduced left ventricular systolic function. This index, namely VHFI, was defined as the very high frequency （VHF） component of the power spectrum normalized to represent its relative value in proportion to the total power minus the very low frequency component. Methods Patients （n = 130） were divided into a study group, consisting 66 patients with decreased left ventricular systolic function, and a control group, consisting 64 patients with normal heart structure and function and without severe coronary artery stenosis （〈 50%）. Results VHFI in the study group was significantly higher than that in the control group （19.17 ± 13.35 vs 11.37 ± 10.77, P 〈 0.001）. Cardiac events occurred in 18 patients during follow-up （33.34 i 3.26 months）. Defining the positive test as VHFI =15 and negative test as VHFI 〈15, achieved a sensitivity of 57.58% and a specificity of78.13% for predicting decreased left ventricular systolic function, and achieved a sensitivity of 66.67% and a specificity of 64.29% for predicting cardiac events. Univariate Cox regression analysis showed that positive VHFI test was an independent variable in predictive cardiac events. Conclusions The results suggest that VHFI is a useful tool for quick evaluation of left ventricular systolic function and prediction of prognosis
文摘Objectives To detect and compare the systolic strain rate (SR) and strain in the infarct and ischemic myocardium by strain rate imaging (SRI), in order to explore the clinical value of SRI in evaluating regional left ventricular systolic dysfunction. Methods Patients with coronary artery disease were divided into angina pectoris (11 cases) and myocardial infarction (21 cases) groups. Twenty age-matched normal subjects served as the control group. Septal, lateral, anterior, inferior, anteroseptal and posterior walls of the left ventricle were respectively scanned using color tissue Doppler imaging (TDI). Then SR and strain curves were derived from TDI for basal, middle and apical segments of each wall. SRI parameters were: Systolic SR (SRsys), systolic strain (εsys) and maximum strain (εmax). Results Compared with normal segments, SRsys, εsys and εmax decreased significantly in the infarct and ischemic segments (P<0.01). Compared with ischemic segments, SRsys, εsys and εmax decreased significantly in the infarct segments (P<0.05). Conclusions SRsys, εsys and εmax measured by SRI can be used to quantitatively analyze regional left ventricular systolic dysfunction in patients with coronary artery disease, and aid in differentiating infarct from ischemic myocardium.
文摘The left ventricular regional systolic functions in patients with hypertrophic cardiomyopathy （HCM） were assessed by using quantitative tissue velocity imaging （QTVI）. Left ventricular （LV） regional myocardial velocity along long- and short-axis in 31 HCM patients and 20 healthy subjects were analyzed by QTVI, and the regional myocardial systolic peak velocities （MVS） were measured. Mean MVS at each level including mitral annular, basal, middle and apical segments were calculated. The ratio of MVS along long-axis to that along short-axis （Ri） at basal and middle segments of the LV posterior wall and ventricular septum were calculated. The results showed that mean MVS was slower at each level including mitral annular, basal, middle and apical segments in the HCM patients than that in the healthy subjects （P〈0.01）. There were no significant differences in mean MVS between obstructive and non-obstructive groups in HCM patients. MVS of all regional myocardial segments along long-axis in the HCM patients were significantly slower than that in the healthy subjects （P〈0.05）, but there was no significant difference in MVS of all regional myocardial segments along long-axis between hypertrophied and non-hypertrophied group in the HCM patients. Ri was significantly lower in the HCM patients than that in the healthy subjects. The LV regional myocardial contractility along long-axis was impaired not only in the hypertrophied wall but also in the non-hypertrophied one in patients with HCM, suggesting that QTVI can assess accurately LV regional systolic function in patient with HCM and provides a novel means for an early diagnosis before and independent of hypertrophy.
文摘The effect of sublingual administration and intravenous drip of nitroglycerin (SLNTG and IVNTG) on left ventricular volumes (LVVs) were studied and systolic function was quantitatively assessed with two-dimensional echocardiography (2DE) in 28 patients with myocardial infarction (MI), including 13 cases without heart failure (MI-NHF) in one group and 15 with heart failure (MI-HF) in another. The results showed that after SLNTG and IVNTG in both groups the heart rate (HR) increased significantly (P< 0.05-0.001); the systolic blood pressure (SBP) decreased significantly (P< 0.05-0.001); the diastolic blood pressure (DBP) was not significantly changed (all P>0.05); the left ventricular end-diastolic and end-systolic volumes (EDV and ESV) both significantly reduced [EDV: decreased by 5.8-11.6% (-13.2-19.0 ml), P< 0.05-0.001; ESV: decreased by 9.6-16.6% (-8.6-17.3 ml), P< 0.05-0.001)1; the left ventricular ejection fraction (LVEF) all significantly elevated (increased by 6.6%-9.4% (3.2%-3.4%), P < 0.05-0.001] except in MI-NHF group after IVNTG; the segmental EF of normal and hypokinetic segments also significantly increased (P<0.05-0.001). The results suggest that NTG could beneficially reduce left ventricular EDV and ESV; and improve or strengthen its global and segmental systolic function in MI patients, particularly noticeable in patients with heart failure.
文摘The current study aimed to compare the effects between remimazolam and propofol on hemodynamic stability during the induction of general anesthesia in elderly patients.We used propofol at a rate of 60 mg/(kg·h)in the propofol group(group P)or remimazolam at a rate of 6 mg/(kg·h)in the remimazolam group(group R)for the induction.A processed electroencephalogram was used to determine whether the induction was successful and when to stop the infusion of the study drug.We measured when patients entered the operating room(T_(0)),when the induction was successful(T_(1)),and when before(T_(2))and 5 min after successful endotracheal intubation(T_(3)).We found that mean arterial pressure(MAP)was lower at T_(1–3),compared with T_(0) in both groups,but higher at T_(2) in the group R,whileΔMAP_(T0–T2) andΔMAP_(max) were smaller in the group R(ΔMAP_(T0–T2):the difference between MAP at time point T_(0) and T_(2),ΔMAP_(max):the difference between MAP at time point T_(0) and the lowest value from T_(0) to T_(3)).Cardiac index and stroke volume index did not differ between groups,whereas systemic vascular resistance index was higher at T_(1–3) in the group R.These findings show that remimazolam,compared with propofol,better maintains hemodynamic stability during the induction,which may be attributed to its ability to better maintain systemic vascular resistance levels.
基金National Basic Research Program of China (973 Program) (2011CB505300,2011CB505302)Tianjin City High School Science & Technology Fund Planning Project (20110206)
文摘Objective Shengmai Recipe （SMR） is a Chinese patent medicine used for the treatment of chronic heart disease. In order to further assess the renal-protective effect against ischemia lesion of SMR, the cardioprotective effect of SMR on pressure overload-induced left ventricular （LV） systolic dysfunction and the potential mechanism on alleviating myocardial damage, myocardial fibrosis, and renal ischemia lesion in chronic heart failure （CHF） rats were investigated. Methods Rats with partially ligated abdominal aorta were randomly divided into model, Sham, and SMR groups. One week after recovery from surgery, animals were preventively ig administered with SMR at the dose of 810 mg/kg once daily for 8 weeks. Cardiac function and structure, endogenous biomarkers （CK-MB and LDH）, myocardial fibrosis, and organ pathological change were estimated by echocardiography, immunodepression and velocity method, hematoxylin- eosin staining, and masson＇s trichrome staining, respectively. Results The administration of SMR significantly decreased serum CK-MB and LDH levels and reduced myocardial fibrosis. Interestingly, SMR not only improved cardiac function but also ameliorated kidney injury induced by ischemia in CHF rats. Conclusion SMR could enhance the LV contractile function, reduce myocardial necrosis, and reverse LV remodeling in CHF rats, and most importantly, SMR could be used to treat the renal ischemia injury in pressure overload rats.
基金supported by grants from the National Natural Science Foundation of China(No.82170342)Shanghai Engineering Research Center of Interventional Medicine(No.19DZ2250300)+4 种基金National Key R&D Program of China(No.2021YFA1201300)Chinese Academy of Medical Sciences(Nos.2019-I2M-5-060 and 2020-JKCS-0154020)the Fellowship of the China National Postdoctoral Program for Innovative Talents(No.BX20220094)China Postdoctoral Science Foundation(No.2022M710776)Shanghai Shenkang Hospital Development Center(No.SHDC2020CR3023B).
文摘Background:Hypothermia therapy has been suggested to attenuate myocardial necrosis;however,the clinical implementation as a valid therapeutic strategy has failed,and new approaches are needed to translate into clinical applications.This study aimed to assess the feasibility,safety,and efficacy of a novel selective intracoronary hypothermia(SICH)device in mitigating myocardial reperfusion injury.Methods:This study comprised two phases.The first phase of the SICH was performed in a normal porcine model for 30 minutes(n=5)to evaluate its feasibility.The second phase was conducted in a porcine myocardial infarction(MI)model of myocardial ischemia/reperfusion which was performed by balloon occlusion of the left anterior descending coronary artery for 60 minutes and maintained for 42 days.Pigs in the hypothermia group(n=8)received hypothermia intervention onset reperfusion for 30 minutes and controls(n=8)received no intervention.All animals were followed for 42 days.Cardiac magnetic resonance analysis(five and 42 days post-MI)and a series of biomarkers/histological studies were performed.Results:The average time to lower temperatures to a steady state was 4.8±0.8 s.SICH had no impact on blood pressure or heart rate and was safely performed without complications by using a 3.9 F catheter.Interleukin-6(IL-6),tumor necrosis factor-α,C-reactive protein(CRP),and brain natriuretic peptide(BNP)were lower at 60 min post perfusion in pigs that underwent SICH as compared with the control group.On day 5 post MI/R,edema,intramyocardial hemorrhage,and microvascular obstruction were reduced in the hypothermia group.On day 42 post MI/R,the infarct size,IL-6,CRP,BNP,and matrix metalloproteinase-9 were reduced,and the ejection fraction was improved in pigs that underwent SICH.Conclusions:The SICH device safely and effectively reduced the infarct size and improved heart function in a pig model of MI/R.These beneficial effects indicate the clinical potential of SICH for treatment of myocardial reperfusion injury.
