1.Atherosclerotic reference segments influence assessment of coronary remodeling by intravascular ultrasound in patients with acute coronary syndrome
Chinese Journal of Ultrasonography 2011;20(4):282-285
Objective To investigate the influence of atherosclerotic reference segments on coronary remodeling by intravascular ultrasound(IVUS) in patients with acute coronary syndrome(ACS). Methods One hundred and three consecutively enrolled patients [male 68 cases,female 35 cases,average age (60 ±11) years] with ACS were undergone by coronary artery angiography and IVUS with time selecting operation. The remodeling index(RI) was defined as lesion external elastic membrane cross section aere (EEM CSA) divided by the mean reference EEM CSA at the culprit vessel. Positive remodeling was RI≥ (67 cases), negative remodeling was RI <1(36 cases). The parameters of plaque were analysed between two remodeling groups, as well as compared between distal and proximal references. Results Only one patients do not have plaque at reference sites. In the analysis of 103 lesions and 102 reference sites, there were not significant different in plaque burden,plaque CSA,lumen CSA and lesion EEM CSA between two groups. Distal plaque burden[(39. 76 ±12. 54)% vs (32.38 ± 13.97)%, P <0.001] and plaque CSA [(6.14 ± 3.20)mm2 vs (4. 75 ± 3. 07) mm2, P = 0. 001] were larger than those at proximal reference. EEM CSA at distal reference was smaller than proximal one[(14. 99 ± 4. 12)mm2 vs (28. 37 ± 4. 48)mm2 , P <0. 001]. Plaque burden, plaque CSA and lumen CSA persented positive corelation between distal and proximal reference sites. Conclusions The reference segments lay a severe diffuse atherosclerosis in the group of ACS, which may influence assessment of coronary remodeling. Coronary remodeling as a process, a accurate evaluation could be result from the combination of static and serial approach by IVUS.
2.Quantitative Evaluation of the Left Ventricle Diastolic Function in Chronic Mitral Regurgitation by Pulsed Wave Doppler Echocardiography
Weiguo SHI ; Weiqiang KANG ; Tongliang HAN
Chinese Journal of Ultrasonography 1996;5(3):110-112
Pulsed wave Doppler echocardiograpdy was performed in eighteen cases with chronic mitral regurgitation(CMR)and 21 normal individuals td detect the quantitative changes of the mitral diastolic flow spectrum.The results showed that the pseudonormalization of mitral flow spectrum in CMR was actually caused by impaired left ventricle(LV)active relaxation and decreased LV compliance:It thus masked the LV diastolic dysfunction in CMR.E-wave pressure gradiant(E-PG),A-wave pressure gradiant(A-PG),isovolumic relaxation time(IVRT),E deceleration time(E-DT)and LV filling time(LVFT)in CMR group were significantly different in from those in normal group(P<0.01).Therefore it is essential to integrate these parameters as the indexes to evaluate the LV diastolic dysfunction in CMR.
3.Study on the character and risk factors of coronary artery changes in patients with coronary heart disease and impaired glucose tolerance
Shengfang TIAN ; Weiqiang KANG ; Chenghao GUO
Chinese Journal of Diabetes 1994;0(02):-
Objective To investigate the character and risk factors of coronary artery disease in prediabetes. Methods The 193 patients with coronary artery disease were divided into 3 groups according to the American diabetes associations (ADA) standard of diabetic diagnoses. (1) Normal glucose tolerance group(NGT group,122 cases). (2) Impaired glucose tolerance group (IGT group,39 cases). (3) Diabetes mellitus group (DM group,32 cases). All patients were checked by the coronary angiographic semiquantitative (CAG) and the 75g oral glucose tolerance test. Blood glucose, insulin, TG, TC, HDL C, blood pressure, BUN and Cr were determined. The coronary artery changes were analysed by CAG, and the severity of coronary artery stenosis were evaluated by AHA standards. The risk factors in coronary artery disease were analysed by pluralized straight line statistics. Results The coronary multivessel changes and the severity of coronary artery stenosis and calcification were more frequent in IGT group than in NGT group (66 5% vs 35 1%,8 9?3 6 vs 6 5?3 9,6 6?6 1 vs 3 9?4 1,P
4.Correlation of left ventricular geometry with left atrial structure and function in essential hypertension
Weiguo SHI ; Weiqiang KANG ; Xiaowen MU
Chinese Journal of Ultrasonography 1997;0(06):-
Objective To investigate the effects of the left ventricular geometry on left atrial structure and function in essential hypertension (EH).Methods One hundred and thirty-eight patients with EH and 86 normal controls were studied with echocardiography.According to left ventricular mass index (LVMI) and relative wall thickness (RWT),a total of 138 patients with EH were divided into normal geometry group (58 cases),concentric remodeling group (22 cases),concentric hypertrophy group (21 cases) and eccentric hypertrophy group (37 cases).Correlation between left atrial diameter index (LADI),left atrial ejection force (LAEF) and all parameters was respectively obtained using linear regression analysis,and the stepwise regression analysis was used to assess the independent effect of each parameter.Results Compared with control group,LADI and LAEF were higher ( P
5.Value of color Doppler flow imaging and Doppler power imaging in diagnosis of choroidal detachment
Guojun LIU ; Weiqiang KANG ; Yijie QIU
Chinese Journal of Ultrasonography 2003;0(08):-
Objective To investigate value of color Doppler flow imaging(CDFI) and Doppler power imaging(CDPI) in the diagnosis of choroidal detachment(CD). Methods Color Doppler ultrasound was performed in 30 cases with choroidal detachment. At the base of eyeball shape, lens, vitreous and retina examined by ultrasound, intraocular band-shaped echo was examined by CDFI and CDPI, to understand its blood flow. The observation was compared with that of surgical results. Results Of 30 cases with choroidal detachment, the diagnostic positive correspondonce of ultrasound was 80.0%, while ultrasound combined with CDFI and CDPI, the correspondence increased up to 96.7%. The sonographic features of CDFI and CDPI in choroidal detachment patients were abundant blood flow in band-shape or short stick-like. In 3 cases out of 4 cases with retinal detachment, blood flow was not abundant,their blood flow showed a sparked pattern. In addition, 14 cases combined with vitreous hemorrhage, 8 cases had vitreous opacity and 4 cases vitreous proliferation. Ultrasound diagnosis corresponded with that of clinical surgery in 27 choroidal detachment cases. Conclusions Ultrasound combined with CDFI and CDPI provide valuable references for diagnosis and treatment of choroidal detachment.
6.Study on left ventricular function after off-pump coronary artery bypass with transesophageal echocardiography
Weiqiang KANG ; Lin ZHAO ; Enkui HAO
Chinese Journal of Ultrasonography 2003;0(10):-
Objective To evaluate the impact of the off -pump coronary artery bypass (OPCAB) on left ventricular(LV) function with transesophageal echocardiography(TEE). Methods Blood flow velocities of pulmonary vein (PV) and mitral valve (MV) were performed in 21 patients with coronary heart disease and myocardial infarction two weeks pre-OPCAB, and the left ventricular SV, CO and LVEF were measured by biplane Simpson′s method, the data were compared with the results observed one month post-OPCAB. Results The peak flow velocities of PV had significant difference between pre- and post-OPCAB(P
7.Tei index evaluation of left ventricular function after off-pump coronary artery bypass
Haicun WANG ; Lin ZHAO ; Weiqiang KANG
Chinese Journal of Ultrasonography 2003;0(10):-
Objective To assess the changes of left ventricular function after off-pump coronary artery bypass (OPCAB) using Tei index. Methods Fourty-six patients of coronary artery disease, who had accepted OPCAB, were enrolled. Left ventricular ejection fraction(LVEF), E/A ratio at mitrial orifice(E/A), E deceleration time(EDT), isovolumic relaxation time(IVRT), ratio of systolic wave to diastolic wave of pulmonary vein flow(S/D) and Tei index were measured by transthoracic echocardiography before, immediate, 1 week, 1 month, 3 months and 6 months after OPCAB. Results Tei index decreased gradually as time went on after OPCAB and the differences were significant between different times(P
9.The study of correlation between the plaque burden and remodeling in patients with
Hongsh-uai, SHEN ; Dalin, SONG ; Meilian, WEI ; Weiqiang, KANG
Chinese Journal of Medical Ultrasound (Electronic Edition) 2015;(6):446-452
ObjectiveTo discuss the potential relationship of plaque burden (PB) and coronary remodeling in acute coronary syndrome (ACS) patients.MethodsNinety-one patients with ACS in Qingdao Municipal Hospital during January 2011 to June 2014 underwent the conventional coronary angiography and intravascular ultrasonography (IVUS). The remodeling of 60 cases were positive (remodeling index [RI]>1) and those of 31 cases were negative (RI<1). All 91 patients were included in this study, including 9 cases (PB<60%), 19 cases (60%≤PB<70%), 48 cases (70%≤PB<80%) and 15 cases (PB>80%). The difference of plaque cross-sectional area (P-CSA), lumen cross-sectional area (L-CSA), external elastic membrane cross-sectional area (EEM-CSA), average EEM-CSA, PB between positive remodeling andnegative remodeling were compared by independent-samplest test. ANOVA was used to compare P-CSA, L-CSA, EEM-CSA and RI among patients with different PB. The relevance of PB, P-CSA, EEM-CSA, L-CSA and RI were analyzed by Pearson correlation analysis.ResultsThere were no signifi cant differences in P-CSA, L-CSA, EEM-CSA and PB between patients with positive remodeling and negative remodeling. Average EEM-CSA of patients with negative remodeling were signifi cantly greater than that of patients with positive remodeling ([13.24±1.98] mm2vs [17.30±3.16] mm2,t=2.46,P<0.05). P-CSA, EEM-CSA and L-CSA had signifi cant differences (F=24.56, 28.97 and 7.14,P<0.001) while RI had not statistical signifi cant difference among patients with different PB. With the increase of PB, P-CSA and EEM-CSA increased (P-CSA: [6.01±1.68], [9.12±2.00], [11.42±2.05] and [14.05±4.00] mm2, EEM-CSA: [11.43±1.90], [13.64±2.93], [15.14±2.64] and [16.64±4.08] mm2), L-CSA reduced ([5.44±0.89], [4.52±0.99], [3.72±0.74] and [2.60±0.63] mm2). PB was positively correlated with P-CSA and EEM CSA (r=0.76, 0.50,P<0.001), but was negatively correlated with L-CSA (r=-0.74, P<0.001). RI had no relationship with PB, P-CSA, L-CSA and EEM-CSA.ConclusionsCoronary artery remodeling is a very complicated dynamic process. Except the PB, other factors probably affect the direction of remodeling. RI is not suitable as the index for the assessment of vascular remodeling.
10.Relationships between vascular factors and plaque morphology in patients with acute coronary syndrome
Weiqiang KANG ; Dalin SONG ; Guoren REN ; Jilong TENG
Journal of Geriatric Cardiology 2009;6(2):75-78
Objective To investigate the relationships between vascular factors and plaque morphology in the patients with acute coronary syndrome(ACS). Methods lntravascular ultrasound(IVUS) was performed on 56 consecutively enrolled patients with ACS. Cytometric bead array for seven vascular factors(sPE,t-PA, MCP-I, IL-8,IL-6,sVCAM-1, and sCD40L) was measured by cytometry. The others biomarkers were tested by ELISA or biochemistry. Differences in bio-factors were compared between vulnerable plaque and non- vulnerable plaque groups, accte myocardial infarction (AMI) and ustable angina (UA) patients, and occurring plaque rupture. The relationship between the parameters of morphology and vascular factors was analyzed. Results There were positive correlations between sVCAM-1sPE, sVCAM-1-sCD40L, sCD40L-sPE, IL-6-IL8,IL8-MCP4, and MCPI-sVCAM-1; CRP (18.868±4.907mg/L vs 5.806±3.553 mg/L)and IL-6 (19.5 pg/ml [9.2±44.6 pg/ml]vs 5.3 pg/ml [2.3~ 13.4 pg/ml])were elevated in the vulnerable plaque group(P <0.05). sCD40L(473.82±126.11 vs 237.94±34.78 pg/mi),sPE (107.214±39.90 vs 49.06±5.61 μg/L) and MCP-1(132.42±17.85 vs 127.174±13.27 pg/ml) were increased in the plaque rupture group(P < 0.05);There was correlation between tPA and plaque morphology(P < 0.05). Increases in sCD40L, MCP-1, sPE, and TC were independent factors for plaque rupture. Conclusions IL-6 and CRP may be biomarkers for vulnerable plaque and for diagnosis ofAMI, sCD40L, MCP-1 and sPE are potential markers when for plaque rupture patient present with severe ACS.