Electrocardiography ; Humans ; Hypertension ; diagnosis ; physiopathology ; Hypertrophy, Left Ventricular ; diagnosis ; physiopathology

To assess the left ventricular regional relaxation abnormalities in patients with hypertrophic cardiomyopathy (HCM) by quantitative tissue velocity imaging (QTVI), Doppler echocardiography and QTVI were performed in HCM (n=10) and healthy subjects (n=11) at apical long-axis, two-chamber and four-chamber views. Regional early diastolic velocity (rVe) and regional atrial contraction (rVa) were measured at each segment of ventricular middle, basal and annular levels. Mean rVe and mean rVa at three levels as well as mean rVe/rVa ratio were calculated. Our results showed that transmitral inflow peak velocities during early diastole (E) and atrial contraction (A) were also measured and E/A ratio was calculated. The rVe of all left ventricular segments in HCM were lower than those in healthy subjects (P<0.05), but compared with healthy subjects majority of rVa in HCM were not different except inferior wall and anterior wall. E between HCM and healthy subjects was different (P=0.036), while mean rVe between them was significantly different (P<0.0001). Mean rVa and mean rVe/rVa of three levels were lower in HCM than in healthy subjects (P<0.05), but there were no differences in A and E/A between them (P=0.22, P=0.101). Left ventricular regional myocardial relaxation is reduced in HCM. Transmitral inflow E and A are influenced by preload, relaxation of myocardium and atrial contraction, etc., while rVe and rVa reflect myocardial relaxation function independently. QTVI is more sensitive and more accurate than conventional Doppler imaging for characterizingregional diastolic properties in HCM.
Cardiomyopathy, Hypertrophic/*physiopathology ; Cardiomyopathy, Hypertrophic/*ultrasonography ; Diastole ; Echocardiography, Doppler, Color/methods ; Hypertrophy, Left Ventricular/*physiopathology ; Hypertrophy, Left Ventricular/ultrasonography ; Ventricular Function, Left

OBJECTIVETo determine the value of terminal force of P wave in V1 lead (Ptf-V1) in the diagnosis of coal-workers' pneumoconiosis with pulmonary heart disease complicated by left ventricular hypertrophy.

METHODSSelect the coal-worker with pneumoconiosis postmortem examination cases which were pathologically diagnosed as pulmonary heart disease complicated by left ventricular hypertrophy and can measure Ptf-V1. Select 14 cases with ECG left axis deviation, no deviation and right axis deviation. Measure and analyze the Ptf-V1 value, the thickness of left and right ventricular wall.

RESULTSThere's obvious discrepancy in ventricular wall thickness mean in ECG left axis deviation, no deviation and right axis deviation groups, the discrepancy have statistical significance (F1 = 32.18, P < 0.01, F2 = 8.02, P < 0.01). The left ventricular wall is thicker in ECG left axis deviation group [(1.81 +/- 0.18) cm] than in no deviation [(1.47 +/- 0.15) cm] and right axis deviation groups [(1.39 +/- 0.10) cm], the discrepancy have statistical significance with (P < 0.01). The right ventricular wall is thicker in ECG left axis deviation group [(0.79 +/- 0.14) cm] than in no deviation group [(0.58 +/- 0.14) cm], the discrepancy have statistical significance with (P < 0.01). The right ventricular wall is thicker in ECG right axis deviation group [(0.71 +/- 0.14) cm] than in no deviation group, the discrepancy have statistical significance with (P < 0.05). ECG left axis deviation Ptf-V1 relevance ratio 85.71% is higher than in no deviation (35.70%) and right axis deviation groups (28.57%), the discrepancy have statistical significance with (P < 0.01). The Ptf-V1 absolute value is positively related with left ventricular wall thickness in ECG left axis deviation and no deviation groups (r1 = 0.92, P < 0.01, r2 = 0.93, P < 0.01).

CONCLUSIONPft-V1 absolute value is the criterion index of left ventricular morphosis and function especially left atrium loading change. ECG Ptf-V1 combined with ECG left axis deviation is valuable to the diagnosis of coal-workers with pneumoconiosis complicated by left ventricular hypertrophy.

Aged ; Anthracosis ; complications ; physiopathology ; Electrocardiography ; Humans ; Hypertrophy, Left Ventricular ; complications ; diagnosis ; physiopathology ; Middle Aged ; Pulmonary Heart Disease ; complications ; diagnosis ; physiopathology

To assess the left ventricular regional relaxation abnormalities in patients with hypertrophic cardiomyopathy (HCM) by quantitative tissue velocity imaging (QTVI), Doppler echocardiography and QTVI were performed in HCM (n=10) and healthy subjects (n=11) at apical long-axis, two-chamber and four-chamber views. Regional early diastolic velocity (rVe) and regional atrial contraction (rVa) were measured at each segment of ventricular middle, basal and annular levels. Mean rVe and mean rVa at three levels as well as mean rVe/rVa ratio were calculated. Our results showed that transmitral inflow peak velocities during early diastole (E) and atrial contraction (A) were also measured and E/A ratio was calculated. The rVe of all left ventricular segments in HCM were lower than those in healthy subjects (P<0.05), but compared with healthy subjects majority of rVa in HCM were not different except inferior wall and anterior wall. E between HCM and healthy subjects was different (P=0.036), while mean rVe between them was significantly different (P<0.0001). Mean rVa and mean rVe/rVa of three levels were lower in HCM than in healthy subjects (P<0.05), but there were no differences in A and E/A between them (P=0.22, P=0.101). Left ventricular regional myocardial relaxation is reduced in HCM. Transmitral inflow E and A are influenced by preload, relaxation of myocardium and atrial contraction, etc., while rVe and rVa reflect myocardial relaxation function independently. QTVI is more sensitive and more accurate than conventional Doppler imaging for characterizingregional diastolic properties in HCM.
Adolescent ; Adult ; Aged ; Cardiomyopathy, Hypertrophic ; diagnostic imaging ; physiopathology ; Child ; Diastole ; Echocardiography, Doppler, Color ; methods ; Female ; Humans ; Hypertrophy, Left Ventricular ; diagnostic imaging ; physiopathology ; Male ; Middle Aged ; Ventricular Function, Left

AIMTo investigate the relations between left ventricular hypertrophy and systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), neuropeptide Y (NPY) during cardiac hypertrophy and regression.

METHODSBlood pressure and heart rate were recorded with polygraph channel biologic message system. NPY in plasma and myocardium were measured with Radioimmunoassay. Correlation coefficient were calculated with SPSS software.

RESULTSThere were positive correlations between SBP, DBP, MAP, NPY in the cardiac tissue and cardiac coefficient (LVW/BW). There was no correlations between cardiac coefficient and heart rate (HR), NPY in plasma.

CONCLUSIONHypertension is one of cardiac hypertrophy factors, SBP correlate better with LVW/ BW than DBP. SBP, DBP, MAP, NPY in cardiac tissue has correlative tendency with LVW/BW.

Animals ; Blood Pressure ; Heart Rate ; Hypertension ; metabolism ; physiopathology ; Hypertrophy, Left Ventricular ; metabolism ; physiopathology ; Male ; Neuropeptide Y ; metabolism ; Rats ; Rats, Wistar

The current study proposes a model of the cardiovascular system that couples heart cell mechanics with arterial hemodynamics to examine the physiological role of arterial blood pressure (BP) in left ventricular hypertrophy (LVH). We developed a comprehensive multiphysics and multiscale cardiovascular model of the cardiovascular system that simulates physiological events, from membrane excitation and the contraction of a cardiac cell to heart mechanics and arterial blood hemodynamics. Using this model, we delineated the relationship between arterial BP or pulse wave velocity and LVH. Computed results were compared with existing clinical and experimental observations. To investigate the relationship between arterial hemodynamics and LVH, we performed a parametric study based on arterial wall stiffness, which was obtained in the model. Peak cellular stress of the left ventricle and systolic blood pressure (SBP) in the brachial and central arteries also increased; however, further increases were limited for higher arterial stiffness values. Interestingly, when we doubled the value of arterial stiffness from the baseline value, the percentage increase of SBP in the central artery was about 6.7% whereas that of the brachial artery was about 3.4%. It is suggested that SBP in the central artery is more critical for predicting LVH as compared with other blood pressure measurements.
Aorta/physiology ; Arteries/*physiology ; Blood Pressure ; Cardiovascular System/*physiopathology ; Computer Simulation ; *Hemodynamics ; Humans ; Hypertrophy, Left Ventricular/physiopathology ; *Models, Biological ; Ventricular Function

OBJECTIVETo study the correlation between the expression levels of phagocytic NADPH oxidase p22phox subunit and left ventricular mass index (LVMI) in patients with non-valvular chronic heart failure and explore the role of oxidative stress caused by NADPH oxidase p22phox subunit in left ventricular remodeling.

METHODSSemi-quantitative RT-PCR was used to examine the expression levels of phagocytic NADPH oxidase p22phox in 59 patients with non-valvular chronic heart failure and 20 control subjects. All the subjects underwent ultrasonic cardiography to record their IVST, LVPWT, LVEDd, LVEDs, and EF. Based on the calculated LVMI, the patients were divided into heart failure without LV hypertrophy (LVH) group and heart failure with LVH group.

RESULTSThe patients with heart failure showed significantly higher expression of phagocytic NADPH oxidase p22phox than the control subjects (0.91∓0.37 vs 0.68∓0.33, P=0.039), and the patients with LVH had significantly higher p22phox expression than those without LVH (1.58∓0.20 vs 0.71∓0.24, P=0.026). LVMI showed a positive correlation with the expression of p22phox in these patients (r=0.508, P<0.05).

CONCLUSIONNADPH oxidase p22phox expression level is positively correlated with LVMI and can be indicative of the level of left ventricular remodeling in patients with non-valvular chronic heart failure.

Adult ; Aged ; Case-Control Studies ; Female ; Heart Failure ; metabolism ; physiopathology ; Humans ; Hypertrophy, Left Ventricular ; metabolism ; physiopathology ; Male ; Middle Aged ; NADPH Oxidases ; metabolism ; Ventricular Remodeling

OBJECTIVETo observe the association between positive autoantibodies against AT(1)-receptor and cardiac remodeling in primary hypertensive patients.

METHODSEchocardiography was performed and serum autoantibodies against AT(1)-receptor were detected by enzyme linked immunosorbent assay (ELISA) in 592 patients with primary hypertension. The differences on blood pressure level, course of hypertension, vasoactive substance and echocardiography parameters between the positive group and negative group were compared. Factors related to left ventricular enlargement were analyzed by multiple logistic regressions.

RESULTSThe positive percentage of autoantibodies against AT(1)-receptor was 38.0% (225/592). End-diastolic right atrial and left ventricular diameters in positive group were significantly larger than that in negative group (P = 0.049 and P = 0.044, respectively). Regression analysis demonstrated that positive autoantibodies against AT(1)-receptor, male gender, diastolic blood pressure and course of hypertension were related to left ventricular enlargement (all P < 0.05).

CONCLUSIONThe autoantibodies against AT(1)-receptor is associated with left ventricular and right atrial enlargement in hypertensive patients.

Adult ; Aged ; Autoantibodies ; blood ; Female ; Heart Ventricles ; physiopathology ; Humans ; Hypertension ; blood ; immunology ; physiopathology ; Hypertrophy, Left Ventricular ; Male ; Middle Aged ; Receptor, Angiotensin, Type 1 ; immunology ; Ventricular Remodeling

INTRODUCTIONAdults with obstructive sleep apnoea (OSA) are well documented to be at high risk for cardiovascular abnormalities. Growing evidence suggests that OSA is also associated with cardiovascular consequences in children. The purpose of this review is to examine the available data on this association in children.

METHODSPrimary studies were extracted from a MEDLINE search limited to those published between 1970 and 2008. The keywords used included child, sleep disordered breathing, sleep apnoea, snoring, blood pressure and hearts. The relevant articles were selected by consensus between 2 authors.

RESULTSThe results suggested that OSA was consistently associated with hypertension. Meta-analysis of risk of hypertension in those with high apnoea-hypopnoea index was undertaken. A combined odds ratio equal to 3.15 was found (95% confidence interval, 2.01 to 4.93). There was evidence for increased sympathetic activation, decreased arterial distensibility and ventricular hypertrophy in children with OSA.

CONCLUSIONChildhood OSA is associated with blood pressure dysregulation. The association of OSA with other cardiovascular morbidities requires further study in view of the limited data available currently.

Atherosclerosis ; physiopathology ; Blood Pressure ; physiology ; Cardiovascular System ; physiopathology ; Cerebral Arteries ; physiopathology ; Child ; Endothelium, Vascular ; physiopathology ; Heart Rate ; physiology ; Humans ; Hypertension ; physiopathology ; Hypertrophy, Left Ventricular ; physiopathology ; Pulmonary Heart Disease ; physiopathology ; Regional Blood Flow ; Sleep Apnea, Obstructive ; complications ; physiopathology ; Ventricular Function

OBJECTIVETo evaluate the cardiopulmonary exercise capacity in patients with essential hypertension (EH) complicating with or without left ventricular hypertrophy (LVH).

METHODSGraded maximal exercise test on the bicycle ergometer with respiratory gas analysis were performed in 30 gender and age matched normotensive controls, 40 EH patients without LVH and 30 EH patients with LVH (LVMI>125 g/m2 in males and > 120 g/m2 in females). Metabolic equivalents (METs), oxygen uptake (VO2), oxygen uptake to body mass ratio (VO2/kg) and oxygen uptake to heart beat ratio (VO2/HR) at time of reaching anaerobic threshold (AT) and at maximal oxygen uptake (VO2max) were measured and compared.

RESULTSMETs and VO2/kg were significantly reduced in EH patients with or without LVH compared with controls [at AT, METs: 3.57 +/- 0.8 and 4.34 +/- 1.47 vs. 5.21 +/- 1.45; VO2/kg: 12.38 +/- 2.85 and 14.42 +/- 4.33 vs. 18.48 +/- 4.52, all P < 0.01; at VO2max, METs: 4.94 +/- 1.24 and 5.90 +/- 1.51 vs. 6.96 +/- 1.85; VO(2)/kg: (17.20 +/- 4.34) mlxmin(-1)xkg(-1) and (20.41 +/- 4.59) mlxmin(-1)xkg(-1) vs. (24.04 +/- 5.21) mlxmin(-1)xkg(-1), all P < 0.01]. METs and VO2/kg at both time points were also significantly reduced in EH patients with LVH compared EH patients without LVH (all P < 0.05). The lower VO2/kg in hypertensive patients was significantly correlated to higher LVMI (P < 0.05).

CONCLUSIONSCardiopulmonary exercise capacity was reduced in hypertensive patients, especially in hypertensive patients with LVH.

Adult ; Aged ; Case-Control Studies ; Exercise Test ; Exercise Tolerance ; Female ; Heart ; physiopathology ; Humans ; Hypertension ; physiopathology ; Hypertrophy, Left Ventricular ; physiopathology ; Lung ; physiopathology ; Male ; Middle Aged ; Respiratory Function Tests