ObjectiveTo investigate the relationship between carotid intima-media thickness (IMT)and plaque extent of carotid artery with coronary heart disease (CHD).Methods 131 inpatients were divided into 3 groups,in which 54 cases of coronary heart disease group,46 cases of risk group with coronary heart disease,31 cases of control group.The carotid wall IMT,plaque length and thickness was measured by Color Doppler ultrasound.The obtained data using SPSS 17.0 software for statistical processing.ResultsCarotid intimal thickening and the incidence had no significant difference between the group of coronary heart disease and risk group with coronary heart disease risk( all P ＞ 0.05),carotid artery IMT and incidence rate between the above two groups and the control group had statistical differene( t =3.26,3.48,all P ＜ 0.05 ),and the three groups of carotid artery plaque score and plaque classification were statistically significant( F =4.28,P ＜ 0.05 ).ConclusionCarotid IMT and plaque formation was the independent risk factor of CHD,and it could predict the occurrence and development of CHD,especially in carotid artery plaque specificity is higher,in the primary hospital could be used as the auxiliary examination method of CHD.

Objective To evaluate left atrial systolic function and synchronization by two dimensional speckle tracking imaging(2D-STI) measuring the strain in healthy subjects.Methods Thirty-two healthy subjects were studied.The peak velocity(Vmax),the peak amplitude of longitudinal and radial strain (Am-LS and Am-RS),the peak time of both longitudinal and radial strain(T-LS and T-RS) were acquired in each left atrial wall(anterior,inferior,posterior,lateral and septal) at three levels (basal,middle and apical)during left atrial active contraction by 2D-STI.Results ① No significant differences were found at theVmax,Am-LS,Am-RS,T-LS and T-RS among all left atrial walls in the same level ( P ＞ 0.05).②The Vmax,Am-LS and Am-RS were decreased progressively from basal to apical,and there were significant differences( P ＜0.05) except the Am-RS at anterior,posterior and septal( P =0.218,0.258 and 0.238,separately).③Compared all levels in each left atrial wall,the T-LS and T-RS showed no significant differences( P ＞0.05),except the T-LS at posterior( P =0.002) and the T-RS at lateral( P =0.026).④The standard deviation of the T-LS,T-RS and T-globe were 37.38 ms,48.25 ms and 43.85 ms,respectively.There were no significant correlation between T-LS and T-RS in the same segment with r =0.014 and P =0.885.Conclusions There were some regularity during left atrial active contraction.On the whole,the peak velocity and the peak amplitude were decreased progressively from basal to apical in each atrial wall,and the peak time of strain showed no significant difference in the same level of each left atrial wall.The 2D-STI may paly important roles in the evaluation of left atrial systolic function and synchronization.

Objective To evaluate the function and synchronization of left atrial in patients with chronic heart failure(CHF) by real-time three dimensional echocardiography (RT-3DE).MethodsThirty healthy controls and thirty-two patients with CHF were studied.The CHF were divided into group CHF1 with the normal of left ventricular filling pressure and group CHF2 with the elevated of that.From the volume-time curve of RT-3DE workstation,the maximum volume (LAVmax),the minimum volume (LAVmin),the volume before contraction (LAVp) of left atrial were acquired.Accordingly,the total,passive and active ejection fraction could be calculated.The synchronization parameters derived from RT3DE were the dispersion and maximum difference of time to minimum volume for left atrial segments (Tmsv- 16-SD,Tmsv 12-SD,Tmsv-6-SD,Tmsv- 16-Dif,Tmsv 12-Dif,Tmsv-6 Dif).The index of volume and time were corrected by the body surface area and interval of R-R,respectively.The correlation were analysed in them.Results ① All the index of volume before and after correction were gradually increasing from control to CHF2 group,but the LATEF,LAPEF and LAAEF were just the reverse,with all parameters had significant difference among total groups( P ＜0.01 ).②The synchronization parameters were significantly higher from control to CHF2 group( P ＜0.01 ).Comparing between two groups,no significant difference of the synchronization parameters were found between CHF1 group and CHF2 group ( P ＞ 0.05),except Tmsv-16-SD％ and Tmsv-16-Dif％ ( P ＜0.01 ).③The Tmsv-16-SD％ and Tmsv-16-Dif％ had a positive correlation with the index of volume and a negative correlation with the ejection fraction.The most significantly correlation parameters was LAVmaxI,with r =0.75 and P ＜0.01.ConclusionsThe function of left atrium are reduced in patients of CHF,there are dyssynchronization.The higher of the filling pressure of left ventricle,the lager of the dyssynchronization of left atrium.RT-3DE may paly important roles in the evaluation of function and synchronization of left atrium.

Objective To evaluate the right ventricular function in patients with congestive heart failure (CHF) after cardiac resynchronization therapy (CRT) by 2-dimensional speckle imaging (2D-STI).Methods 46 patients with CHF were divided into responders to CRT and non-responders to CRT according the standard of a decline in LV end-systolic volume ≥ 10％.All the patients received echocardiography examination 1-3 days before CRT and 6 month after CRT.Tissue Doppler imaging (TDI) indices included SD of time to peak velocity in systole (Ts-SD) among 12 segments.Right ventricular diameters included RV basal transverse diameter (D1),RV middle transverse diameter (D2) and RV longitudinal diameter (D3) in apical four views.2D-STI indices included systolic strain (S) and stain rate (SR) of basal or middle segment of RV free wall.Results Compared with before CRT,LVEDd,LVEDV,LVESV and Ts-SD significantly decreased,LVEF significantly increased in responders 6 months after CRT.Before CRT,compared with nonresponders,there was no significant difference of D1,D2 and D3 in responders,while S and SR in basal or middle segment of RV free wall were higher than non-responders.Compared with before CRT,D1,D2 and D3 in responders decreased significantly,S and SR in basal or middle segment of RV free wall increased significantly,while there was no difference in non-responders.There were significant negative correlation between S and SR in basal or middle segment of RV free wall and Ts-SD in responders.Conclusions The remodeling and systolic function of RV are improved after CRT.It may help for improving the efficacy of CRT when takes RV function data into account before CRT.

Objective To evaluate blood flow structure and quantify the variation of the flow within left ventricle,assess the impact of chronic heart failure(CHF) by vector flow mapping(VFM).Methods Twenty-seven patients with chronic heart failure and thirty controls were involved.The flow vector images on the section plane of the flow within the left ventricle were acquired by VFM.Time-flow(T-F) curve and all other peak systolic and diastolic flow curve include normal velocity profile,parallel velocity profile,vector profile,flow profile were analyzed by DSA-RS1 program.Results Ventricular ejection peak S,rapid ventricular filling peak E and atrial systole peak A were relatively lower at basal and middle segments in CHF group than normal control group.Normal velocity profile,velocity profile,flow profile at peak S and E were lower at basal and middle segments in CHF group than normal control group.Conclusions VFM technology could provide quantitative and intuitive information to demonstrate the flow structure of the ventricle and evaluate the cardiac function in patients with CHF.

Objective To evaluate the diastolic function in patients with congestive heart failure (CHF) after cardiac resynchronization therapy (CRT) by conventional echocardiography or Doppler tissue imaging (TDI).Methods 31 patients with CHF were divided into responders to CRT (group R) and nonresponders to CRT (group N) according the standard of a decline in left ventricular(LV) end-systolic volume ≥10％.All the patients received echocardiography examination 1-3 days before CRT and 6 month after CRT.Color M-mode echocardiography indices included Vp,E/Vp.TDI indices included the peak velocity in early diastole (e) at 4 sites of mitral annulus,E/e,time to peak velocity in systole (Ts),Ts-SD and maximum difference of Ts (Ts-Dif) among 12 segments.Results Compared with before CRT,Ts-SD and Ts-Dif significantly shortened in group R;Vp increased significantly,E/e at each 4 site and mean value at 4 sites of mitral annulus,E/Vp decreased significantly; but there were no significant difference in group N.There were significant positive correlation between mean value at 4 sites of E/e,E/Vp and Ts-SD in group R.Conclusions The diastolic function in responders to CRT improved after CRT,which was associated with the decreased LV filling pressure and improved LV relaxation.

Objective To assess the left ventricular function of patients with acute myocardial infarction (AMI) treated by percutaneous coronary intervention (PCI) by speckle tracking imaging (STI).Methods 75 AMI patients who had AMI for the first time and have been treated by primary PCI were enrolled.Dynamic images were acquired before PCI,at 6 months after PCI and analyzed by STI.Dynamic images were analyzed for longitudinal peak systolic strain (LPSS),radial peak systolic strain (RPSS) and circumferential peak systolic strain (CPSS) values by STI.According to the comparison of left ventricular ejection fraction (LVEF) before PCI and 6 months after PCI,patients were divided into left ventricular function improved group (△LVEF≥5％) and not-improved group.Results Compared to non-improved group,LPSS (P ＜0.001),RPSS (P ＜0.05,P ＜0.001) and CPSS (P ＜0.001) of improved group were all higher before and 6 months after PCI.LPSS (r =-0.578,P ＜0.001) and CPSS (r =-0.817,P ＜0.001) before PCI were both closely related to △LVEF.In single parameter mode of ROC curve analysis,the area under the ROC curve (AUC) (0.867),sensitivity (94.7％) and specificity (74.4％) of CPSS are relatively higher than other STI parameters.In multiple parameters united mode of ROC curve analysis,AUC (0.897),sensitivity (94.7％) and specificity (74.4％) of LPSS,RPSS and CPSS united were the highest among all the combinations of all STI parameters.Conclusions Left ventricular function improvement of patients with AMI 6 months after PCI is accurately assessed and predicted by STI.CPSS is a strong predictor for left ventricular function improvement 6 months after PCI of AMI patients among all the STI parameters and is an effective indicator for the assessment of left ventricular function improvement of AMI patients.

Objective To explore the relationship between snoring and hypertension in the elderly.Methods A total of 375 subjects who were ≥40 years without stroke and myocardial infarction accepted questionnaire survey on snoring.Non conditional Logistic regression analysis was used to analyze the factors of hypertension.Results In 375 subjects,non-snore was in 169 subjects,occasionally snore was in 86 subjects and regular snore was in 120 subjects,the prevalence of hypertension in them were 33.7％(57/169),39.5％(34/86) and 49.2％ (59/120),respectively,there was significant difference among them.Non conditional Logistic regression analysis showed:after correcting other factors,regular snore was still risk factor of hypertension,the OR value was 2.124 (95％ CI 1.189-3.796).According to gender stratification,regular snore was still risk factor of hypertension in female,the OR value was 3.993 (95％ CI 1.259-12.663),rather than risk factor in male.Condusion Regular snore is relevant to the increased prevalence of hypertension,and it is a risk factor of hypertension.

Objective To analyze longitudinal layer‐specific strain in endocardial ,midcardial and epicardial layers of left ventricle (LV) by two‐dimensional speckle tracking imaging(2D‐STI) in patients with coronary heart disease (CHD) and to evaluate the regional or global systolic function of LV . Methods Seventy‐eight patients with suspected CHD were divided into CHD group (46 subjects) and control group (32 subjects) according to the results of selective coronary arteriography . According to the stenosis degree or number of coronary arteries ,the CHD group was divided into mild stenosis group ( corresponding blood‐supply vessel stenosis 50% -75% ) ,severe stenosis group ( corresponding blood‐supply vessel stenosis ≥75% ) or single‐vessel stenosis group ,multi‐vessel stenosis group . Two‐dimensional images with high frame rate were recorded in apical four‐chamber ,long‐axis ,two‐chamber of LV in all subjects . The strain parameters by EchoPAC analysis software included territorial longitudinal strain ( TLS ) of endocardial , midcardial and epicardial layers ( TLSendo ,TLSmid ,TLSepi) and global longitudinal strain ( GLS) of endocardial ,midcardial and epicardial layers ( GLSendo ,GLSmid ,GLSepi) . Results Regardless of with or without corresponding blood‐supply coronary artery stenosis and range of coronary artery stenosis , TLSendo ,TLSmid ,TLSepi and GLSendo ,GLSmid ,GLSepi all showed a gradient decrease( P < 0 .05) . Compared with the control group ,TLSendo ,TLSepi of mild stenosis group and severe stenosis group decreased significantly( P <0 .05) ,while there was no significant difference about TLSmid between the two groups( P > 0 .05) . Compared with the mild stenosis group ,TLSendo ,TLSepi of severe stenosis group decreased significantly( P < 0 .05) ,while there was no significant difference about TLSmid( P > 0 .05) . Moreover ,compared with the control group ,GLSendo ,GLSmid ,GLSepi of single‐vessel stenosis group and multi‐vessel stenosis group decreased significantly( P < 0 .05) . Compared with the single‐vessel stenosis group ,GLSendo ,GLSmid ,GLSepi of multi‐vessel stenosis group decreased significantly( P < 0 .05) . For predicting corresponding blood‐supply vessel stenosis ≥75% ,the sensitivity and specificity were 55 .6% , 72 .6% and 57 .8% ,76 .4% ,when the cut‐off of TLSendo and TLSepi were 20 .5% and 15 .5% respectively . For predicting multi‐vessel stenosis ,the sensitivity and specificity were 54 .5% ,71 .4% ;50 .0% ,87 .5% and 63 .6% ,87 .5% ;when the cut‐off of GLSendo , GLSmid , GLSepi were 21 .5% , 17 .5% and 16 .5%respectively . Conclusions Systolic dysfunction of LV happened through all layers in CHD patients . The longitudinal strain of layer‐specific by 2D‐STI can accurately evaluate the regional and global systolic function of LV in patients with CHD ,which can also be used to predict the degree or range of coronary artery stenosis .

Objective To evaluate intra-and interatrial synchronization in patients with paroxysmal atrial fibrillation (PAF) by dual gate Doppler and discuss the predictive value of atrial asynchrony for detecting PAF.Methods Twenty-nine patients with PAF as AF group and 24 healthy volunteers as control group underwent echocardiography.The time interval of the onset of a'wave between mitral annular septal and lateral site was T1 by dual gate Doppler,which was used to evaluate left atrial synchronization.The time intervals from the onset of a'wave at tricuspid annular right ventricular free wall site to a'wave at tricuspid annular septal site and mitral annular lateral site were T2 and T3,which were respectively used to evaluate right atrial and interatrial synchronization.The greater time interval predicted the worse synchronization.Compared these indexes between two groups,the most valuable index was obtained and combined with left atrial volume index (LAVI) to predict PAF,its optimal values were found out by ROC curve.Results ①There were no significant differences in many other basic indexes between two groups (P ＞0.05).However,compared with control group,the ratio of early diastolic transmitral flow velocity (E) and mitral annular velocity of septal site (e'),the diameters and volume indexes of atria were significantly increased in AF group.②T1,T2 and T3 (standardized before and after) increased significantly in AF group (P ＜0.01).Standardized T1 had the largest area under curve (AUC) for detecting PAF.The AUC of standardized T1 and LAVI were 76.6％ and 84.1％.Standardized T1 ≥29.55 ms and LAVI≥ 21.60 ml/m2 were combined for detecting PAF (sensitivity 82.8 ％,specificity 79.2％,AUC 87.1％).③ Standardized T1 was positively correlated with age,left atrial systolic diameter,LAVI,RAVI and E/e'(P＜ 0.05).Conclusions Patients with PAF have worse intra-and interatrial synchronization and left atrial asynchrony can provide predictive value for detecting PAF.Dual gate Doppler is expected to be a new technique for evaluating intra-and interatrial synchronization accurately and detecting the risk of AF.