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Three hours continuous injection of adenosine improved left ventricular function and infarct size in patients with ST-segment elevation myocardial infarction

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Chinese Medical Journal 2012年第10期125卷 1713-1719页

作者： ZHANG Hang TIAN Nai-liang HU Zuo-ying WANG Feng CHEN Liang ZHANG Yao-jun CHEN Shao-liang Department of Cardiology Nanjing First HospitalNanjing Medical UniversityNanjingJiangsu 210006China

Background The definitive treatment for myocardial ischemia is reperfusion. However, reperfusion injury has the potential to cause additional reversible and irreversible damage to the myocardium. One likely candidate for a cardioprotection is adenosine. The present study aimed at investigating the effect of intravenous adenosine on clinical outcomes in patients with ST-segment elevation myocardial infarction （STEMI） undergoing primary percutaneous coronary intervention （PCI）. Methods Patients with STEMI within 12 hours from the onset of symptoms were randomized by 1：1：1 ratio to receive either adenosine 50μ***-1 （low-dose group, n=31）, or 70 μ***1 （high-dose group, n=32）, or saline 1 ml/min （control group, n=27） for three hours. Drugs were given to the patients immediately after the guide wire crossed the culprit lesion. Recurrence of no-reflow, TIMI flow grade （TFG） and TIMI myocardial perfusion grade （TMPG）, and collateral circulation were recorded. The postoperative and preoperative ST segment elevation sum of 18-lead electrocardiogram （ECG） and their ratio （STsum-post/STsum-pre） were recorded, as well as the peak time and peak value of CK-MB enzyme. Serial cardiac echo and myocardial perfusion imaging were performed at 24 hours and 6 months post-stenting. The primary endpoint was left ventricular function, and infarct size. The secondary end-point was the occurrence of cardiac and non-cardiac death, non-fatal myocardial infarction, and heart failure. Results A total of 90 STEMI patients were studied. No-reflow immediately after stent procedure was seen in 11 （35.5%） patients in the control group, significantly different from 6.3% in the low-dose group or 3.7% in the high-dose group （both P=0.001）. STsum-post/STsum-pre in the low-dose and high-dose groups was significantly different from the control group （low-dose group vs. control group, P=0.003 and high-dose group vs. control group, P=0.001）, without a dose-dependent pattern （P=0.238）. The peak v

关键词： acute myocardial infarction adenosine left ventricular function infarct size

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Effect of burden and origin sites of premature ventricular contractions on left ventricular function by 7-day Holter monitor

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The Journal of Biomedical Research 2015年第6期29卷 465-474页

作者： Wenhua Xu Mingfang Li Minglong Chen Bing Yang Daowu Wang Xiangqing Kong Hongwu Chen Weizhu Ju Kai Gu Kejiang Cao Hailei Liu Qi Jiang Jiaojiao Shi Yan Cui Hong Wang Department of Cardiology the First Affiliated Hospital of Nanjing Medical University Nursing College of Nanjing Medical University Department of Respiratory the First Affiliated Hospital of Nanjing Medical University

Recent studies have shown that premature ventricular contractions （PVCs） could enlarge the heart, but its risk factors are incompletely understood as a single 24-hour recording cannot reflect the true PVC burden due to day-to-day variability. Our purpose was to investigate the effect of burden and origin sites on left ventricular （LV） function in patients with PVCs by 7-day Holter electrocardiography （ECG）. From May 2012 to August 2013, 112 consecutive patients with PVCs were recruited from the authors＇ affiliated hospital. All patients received 2-dimensional transthoracic echocardiography, 12-lead routing ECG and 7-days Holter ECG. Serum N-terminal pro- brain natriuretic peptide （NT-proBNP） levels were measured. A total of 102 participants with PVCs were included in the final analysis. Origin of PVCs from the tricuspid annulus had the highest burden and NT-proBNP level. LV papillary muscle had a higher LV ejection fraction （EF） level and a lower LV end-systolic dimension （ESD） than other PVC foci （P〈0.05）. The high burden group had a higher LV end-diastolic dimension （EDD） and LVESD but lower LVEF than the other two groups （P〈0.05）. Female, older age, physical work, and history of PVCs had a significantly positive correlation with symptoms. Male, older age, physical work, and high burden were positive predictors of enlarged LVEDD, LVESD and higher serum NT-proBNP level, but lower LVEF. Seven-day dynamic ECG Holter monitor showed the true PVC burden on patients with PVCs. PVCs with a lower burden or origin from the LV papillary muscle and the fascicle were relatively benign, while PVCs with a higher burden or origin from the tricuspid annulus may lead to cardiac dysfunction.

关键词： premature ventricular contractions burden origin sites left ventricular function

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left ventricular function in rats measured by apical catheterization

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South China Journal of Cardiology 2021年第1期22卷 50-56页

作者：赖平薛进华廖永玲钟一鸣 Department of Cardiology The First Affiliated Hospital of Gannan Medical UniversityGanzhou 341000JiangxiChina Gannan Medical University Ganzhou 341000JiangxiChina

Background Evaluation of left ventricular function plays a vital role in the study of hemodynamics in the circulatory *** study investigated the feasibility of measuring left ventricular function in rats with catheterization at the apex of the *** left carotid catheterization was used to monitor artery pressure,then right carotid-ventricular catheterization and apical catheterization were orderly performed in 20 SD rats to observe the changes of left heart *** rate,carotid arterial pressure,left ventricular peak pressure,left ventricular end-diastolic pressure were recorded by the biological function experiment system,and differential calculations analyzed the systolic and diastolic rate of left ventricular *** The peak left ventricular pressure was statistically different between when measured by right carotid-ventricle catheterization and by catheterization at the apex of heart(120.7±14.46 mmHg vs.114.04±12.01 mmHg,Pleft ventricular function was measured by right carotid-ventricular catheterization and by apical catheterization(115.6±11.24 mmHg vs.108.07±12.33 mmHg,Pleft ventricular pressure(6197.89±1123.28 mmHg/s vs.5985.92±1342.81 mmHg/s,P>0.05);30 min later,the left ventricular pressure and the maximum increase rate of left ventricular pressure were not significantly different between the first and second measurement measured by catheterization at the apex of heart(114.04±12.01 mmHg vs.112.06±11.26 mmHg,5985.92±1342.81 mmHg/s vs.5700.86±598.97 mmHg/s,P>0.05).However,the maximum decline rate of left ventricular pressure was slightly lower compared with the previous measurement(5231.14±1302.57 mmHg/s vs.4862.72±610.49 mmHg/s,Pfunction in rats by catheterization at the apex of heart,and it is sup

关键词： apical catheterization left ventricular function rat

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left Atrial Volume Index in Patients with Dilated Cardiomyopathy—Correlation with left ventricular function

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World Journal of Cardiovascular Diseases 2016年第9期6卷 312-319页

作者： Stanley George Department of Cardiology Pariyaram Medical College Kannur Kerala 670503 India

Background: The aim of this study was to determine the relation of left atrial (LA) volume and LA volume index with left ventricular function and to determine the association of duration of symptoms and left atrial volume index in patients with dilated cardiomyopathy. Materials and Methods: This was an observational, single centre study conducted in India. A total of 50 patients who were admitted to department of cardiology from July, 2008 to February, 2009 with diagnosis of dilated cardiomyopathy and an ejection fraction of function and LA volume were found to be correlated (r = -0.789, p function and LA volume index (r = -0.826, p left ventricular function and also between LA volume index and left ventricular function. The patients with NYHA class III were having larger left atrial volume than those with NYHA class II. Moreover, the duration of symptoms has no correlation with left atrial volume index.

关键词： Ejection Fraction Dilated Cardiomyopathy left Atrial Volume Index left ventricular function

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Effects of Late Reperfusion on left ventricular function and Its Relationship With Viable Myocardium After Acute Myocardial Infarction in Patients With or Without Diabetes

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South China Journal of Cardiology 2009年第4期10卷 196-203页

作者：马礼坤余华冯克福陈鸿武张晓红胡雪松余江涛 Department of Cardiology Anhui Provincial Hospital Heart Center Clinic of CardiologyBad Berka Center Hospital of Germany

Objectives To compare the different effects of late successful reperfusion with PCI on left ventricular function and its relationship with viable myocardium after acute anterior wall myocardial infarction in patients with or without diabetes. Methods A total of 125 consecutive subjects with acute anterior wall myocardial infarction were selected, and divided into diabetes mellitus （DM） group （ n = 43） and Non-DM group （ n = 82） according to WHO diabetes diagnosis criteria. All patients received successful PCI at 12 ± 8 days from onset. Ischemic viable myocardium was detected with low-dose dobutamine echocardiography, and left ventricular function and wall motion abnormality were also assessed with echocardiography before PCI. The data of clinical manifestations and angiograms before and after PCI were analyzed. Levels of creatinine kinase-MB （CK-MB）, and troponin T （TnT） before PCI, 6 hours and 24 hours after PCI were assessed. All patients received clinic and echocardiography follow-up for 6 months. Results Higher rate of TIMI 2 flow, and lower rate of TIMI 3 flow in DM group were demonstrated immediately after PCI, and the rate of serum CK-MB and/or TnT levels were higher in DM group, compared with Non-DM group（P 〈 0.05）. 63% of DM patients and 56% of non-DM patients had viable myocardium before PCI（ P 〉 0. 05）. There were no significant differences of left ventricular ejection fraction （LVEF）, left ventricular end diastolic volume index （LVEDVI）, left ventricular end systolic volume index （LVESVI）, and wall motion score （WMS） between two groups at baseline before PCI（P 〉 0.05）. After six months, WMS was decreased and LVEF was increased in Non-DM group, but the WMS and the LVEF did not changed, and the LVEDVI was increased in DM group compared with baseline; the LVEDVI, LVESVI, LVEF, and WMS were significantly different between two groups （P 〈 0.05 or P 〈 0. 01 ）. Conclusions Compared with non-diabetics, delayed successful revascularization with PCI in diabetics p

关键词： diabetes myocardial infarction left ventricular function viable myocardium percutaneous coronary intervention

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Changes of left ventricular Geometry Shape and left ventricular Regional function in Patients With Dilated Cardiomyopathy

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South China Journal of Cardiology 2009年第1期10卷 9-14页

作者：王良玉谢明星李庆波陈平蔡志雄朱稚丹 Department of Cardiology The Affiliated Shantou Hospital of Sun Yat-sen University

To assess the left ventricle regional systolic and diastolic function, left ventricle geometry and left venticle sphericity indexes in patients with dilated cardiomyopathy （DCM） by quantitative tissue velocity imaging （QTVI）. Methods Thirty normal subjects and 52 DCM patients underwent QTVI and colour Doppler flow imaging study in order to measure the left ventricular regional function along left ventricle apical long-axis view and the left ventricle geometry. Peak tissue velocities of left venticle regional muscular tissue during systole （ Vs）, systolic acceleration （ a）, early diastole（Ve） and left atrium contraction（Va） along left venticle apical long axis view were measured. The indexes of left ventricular regional systolic and diastolic function were mearsured at the same time. The left ventricle geometry shape was reflected from the systolic and diastolic sphericity index （Sis and Sid）, the left ventricular ejection fraction （LVEF） and D wave / A wave （PVd/PVa） of pulmonary veins flowing spectrum reflected the global left ventricular systolic and diastolic function. The Vs, Ve, Va, a, PVd/PVa ratio, LVEF, Sis, Sid and their correlations between normal subjects and patients with DCM were compared and analyzed. Results Vs, Ve, Va, a, PVd/PVa, Sis and Sid in patients with DCM were lower than those in normal persons. There were significant relations between Sis and a （ r = 0. 6142, P 〈 0. 05）, Ve/Va and Sid （ r = 0. 6271, P 〈 0. 05 ）. Conclusions QTVI offer a newer method which has a higher sensitivity and accuracy in evaluating the left venticle regional systolic and diastolic function in DCM patients. There was significant relation between regional cardiac function and left venticle sphericity. （ S Chin J Cardiol 2009; 10（1）： 9 -14）

关键词： quantitative tissue velocity imaging geometry shape dilated cardiomyopathy left ventricular function

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Effects of Surgical ventricular Restoration on left ventricular Shape, Size, and function for left ventricular Anterior Aneurysm

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Chinese Medical Journal 2017年第12期130卷 1429-1434页

作者： Yao Wang Chang-Qing Gao Gang Wang Yan-Song Shen Department of Cardiovascular Surgery Chinese People's Liberation Army General Hospital Beijing 100853 China

Background： Surgical ventricular restoration （SVR） has been performed to treat left ventricular （LV） aneurysm. However, there is limited analysis of changes in LV shape. This study aimed to evaluate the changes in LV shape induced by SVR and the effects of SVR on LV size and function for LV aneurysm. Methods： Between April 2006 and March 2015, 18 patients with dyskinetic （dyskinetic group） and 12 patients with akinetic （akinetic group） postinfarction LV anterior aneurysm receiving SVR with the Dor procedure at Chinese People＇s Liberation Army General Hospital were enrolled in this study. A retrospective analysis was carried out using data from the echocardiography database. LV shape was analyzed by calculating the apical conicity index （ACI）. LV end-diastolic volume index, end-systolic volume index, and ejection fraction （EF） were measured. One-way analysis of variance was used to compare means at different time points within each group. Results： Within one week after SVR, LV shape became more conical in the two groups （ACI decreased from 0.84 ± 0.13 to 0.69 ± 0.11 [t = 5.155, P = 0.000] in dyskinetic group and from 0.73 ± 0.07 to 0.60 ± 0.11 [t = 2.701, P = 0.026] in akinetic group; LV volumes were decreased significantly and became closer to normal values and EF was improved significantly in the two groups）. On follow-up at least one year, LV shape remained unchanged in dyskinetic group （ACI increased from 0.69 ± 0.11 to 0.74 ± 0.12, t = - 1.109, P = 0.294）, but became more spherical in akinetic group （ACI significantly increased from 0.60 ± 0.11 to 0.75 ±0.11, t = -I .880, P = 0.047）; LV volumes remained unchanged in dyskinetic group, but increased significantly in akinetic group and EF remained unchanged in the two groups. Conclusions： SVR could reshape LV to a more conical shape and a more normal size and improve LV function significantly early after the procedure in patients with dyskinetic or akinetic postinfarction LV anterior aneurysm. However, LV tends to

关键词： Cardiac Aneurysm Echocardiography left Ventricle Remodeling left ventricular function Surgery

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The Clinical Association of left Atrial function with left ventricular Ejection Fraction

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World Journal of Cardiovascular Surgery 2023年第3期13卷 45-54页

作者： Vignendra Ariyarajah Hiten Patel Atif Shaikh Khurram Liaqat Sirin Apiyasawat Department of Medicine Heart Care Consultants New York USA Division of Cardiology The Brooklyn Hospital Center New York USA Southeastern Cardiology and Cardiovascular Clinic Lumberton North Carolina USA Cardiology Consultants of Philadelphia Limerick Pennsylvania USA Comanche County Memorial Hospital Lawton Oklahoma USA Division of Cardiology Faculty of Medicine Ramathibodi Hospital Mahidol University Bangkok Thailand

The left atrium (LA) has been recognized as a morphophysiological barometer of left ventricular (LV) diastolic dysfunction. Because in the myocardial ischemia cascade where LV diastolic dysfunction often precedes LV systolic dysfunction, the LA which fashions as an early marker of diastolic anomaly, could equally reflect a declining LV function and/or be a good predictor of potential sequelae. We assessed this association of LA function with reduced LV systolic function among hospitalized patients. Among patients with reduced LV ejection fraction, LA passive ejection fraction was lower (0.172 ± 0.12 vs. 0.232 ± 0.14, p = 0.013) whereas LA kinetic energy was higher (6.48 ± 6.3 vs. 4.57 ± 3.5, p = 0.005). Echocardiographic assessment of LA function, therefore, appears correlated with LVEF and could be important when risk stratifying hospitalized patients.

关键词： left Atrial function left Atrial Kinetic Energy left ventricular function left ventricular Ejection Fraction Echocardiography

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Specific alterations of regional myocardial work in strength-trained athletes using anabolic androgenic steroids compared to athletes with genetic hypertrophic cardiomyopathy

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Journal of Sport and Health Science 2023年第4期12卷 477-485页

作者： Antoine Grandperrin Frédéric Schnell Erwan Donal Elena Galli Christophe Hedon Olivier Cazorla Stéphane Nottin Avignon University LaPEC UPR 4278Avignon F-84000France Rennes University CHU RennesInsermLTSI-UMR 1099Rennes F-35000France Montpellier University PhyMedExpINSERMCNRSPhysiology and Experimental Heart and Muscle MedicineMontpellier 34295France

Background:Strength-trained athletes using anabolic androgenic steroids(AAS)have left ventricular(LV)hypertrophy and myocardial fibrosis that can lead to sudden cardiac death.A similar feature was described in athletes with hypertrophic cardiomyopathy(HCM),which complicates the diagnosis for *** this context,we aimed to compare the LV function of the 2 populations by measuring global and regional strain and myocardial work using speckle-tracking ***:Twenty-four strength-trained asymptomatic athletes using AAS(AAS-Athletes),22 athletes diagnosed with HCM(HCM-Athletes),and 20 healthy control athletes(Ctrl-Athletes)underwent a resting echocardiography to assess LV *** evaluated LV global and regional strains and myocardial work,with an evaluation of the constructive work(CW),wasted work,and work efficiency(WE).Results:Compared to Ctrl-Athletes,both AAS-Athletes and HCM-Athletes had a thicker interventricular septum,with maj ored values in *** strain was reduced in AAS-Athletes and even more in ***,global WE was significantly diminished in both AAS and HCM-Athletes(93%±2%in Ctrl-Athletes,90%±4%in AAS-Athletes,and 90%±5%in HCM-Athletes(mean±SD);p<0.05).Constructive work and WE regional analysis showed specific alterations,with the basal septal segments preferentially affected in AAS-Athletes,and both septal and apical segments affected in ***:The regional evaluation of myocardial work reported specific alterations of the major LV hypertrophy induced by the regular use of AAS compared to the LV hypertrophy due to *** finding could help clinicians to differentiate between these 2 forms of pathological hypertrophy.

关键词： Anabolic androgenic steroids Hypertrophic cardiomyopathy left ventricular function Myocardial work Speckle-tracking echocardiography

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Autologous transplantation of bone marrow mononuclear cells improved heart function after myocardial infarction

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Acta Pharmacologica Sinica 2004年第7期25卷 30-40页

作者： Guo-sheng LIN1, Jing-jun Lü, Xue-jun JIANG, Xiao-yan LI, Geng-shan LI Department of Cardiology, Renmin Hospitalof Wuhan University, Wuhan 430060, China Department of Cardiology Renmin Hospital of Wuhan University Wuhan 430060

AIM: To investigate whether autologous transplantation of adult stem cells could improve post-infarcted heart function. METHODS: Bone marrow mononuclear cells (MNCs) were isolated from adult rabbits’ tibias after coronary ligation. These cells were exposed to 5-azacytidine 10 μmol/L for 24 h on the third day of culture. After being labeled with bromodeoxyuridine (BrdU), the cells were auto-transplanted into bordering zone of the infarcted area at 2 weeks after injury. The animals were killed at 3 days, 2 weeks, 1 month, and 2 months after transplantation, respectively. The left ventricular functions, capillary density, and cardiac nerve density were measured and the differentiation of the engrafted cells was determined by immunostaining. RESULTS: BrdU-labeled MNCs were well aligned with the host cardiomyocytes. Parts of them were incorporated into capillary and arteriolar vessel walls. In addition to inducing angiogenic ligands (basic fibroblast growth factor, vascular endothelial growth factor) and imflammation cytokines (interleukin 1-β) during the early period of MNCs implantation, MNCs induced 2.0-fold increase in capillary density as well. Moreover, GAP43-positive and TH-positive nerve density were markedly higher in the MNCs-treated groups than that in the non-treated hearts. left ventricular ejection fraction, LV+dp/dtmax, and LV-dp/dtmax were 47 %, 67 %, and 55 % in MNCs-treated heart respectively, which was higher than that of the control heart, whereas left ventricular end-diastolic volume, left ventricular end-diastolic diameter, and left ventricular end-diastolic pressure were 45 %, 22 %, and 50 % respectively in MNCs-treated heart, which was lower than that of the control heart at 2 months after cell transplantation. CONCLUSION: Autologous transplantation of MNCs induced angiogenesis and nerve sprouting and improved left ventricular diastolic function.

关键词： autologous transplantation bone marrow cells stem cell left ventricular function angiogenesis nerve regeneration myocardial infarction

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