Objective To construct the uItrasound microbubbIes co-carrying recombinant adenovirus containing stromal cell derived factor 1 (SDF-1α) and bone morphogenetic protein 2 (BMP2),and to study the maximum efficiency of carrying adenovirus and the optimum proportion of double gene combined with ultrasound contrast agents.Methods Microbubbles were combined separately with recombinant adenovirus co-expression of enhanced green fluorescent protein and SDF-1α(pAd-EGFP/SDF-1α) as well as red fluorescence protein and BMP2 (pAd-RFP/BMP2) via biotin-streptavidin method,and the maximum efficiency of carrying DNA in microbubbles was detected.Three microbubbles with binary vectors were prepared by blending the two above-mentioned pAd at different ratio (1 ∶1,1 ∶ 2,2 ∶ 1) into the microbubbles.The microbubbles with binary vectors were evaluated though physiochemical properties,fluorescence microscope and flow cytometry to test the carrying rate of DNA in microbubbles.Results There was no significant difference in PH,average diameter and concentrations between targeted microbubbles and control group (P ＞0.05).The carrying efficiency of DNA increased with virus loads in microbubbles,but lowered if further increasing virus amount after reaching saturation.When the proportion of binary vectors and microbubbles was 1 ∶ 1,its efficiency of carrying SDF-1α gene and BMP-2 was approximately equal,and flow cytometry demonstrated that the positive rate of microbubbles labeled by both fluorescein isothiocyanate(FITC) and rhodamine was (65.6 ± 0.5)％.However,it was (59.0 ± 2.3)％ when their proportion was the 2 ∶ 1,which was significantly lower than those when other two proportions (1 ∶ 1 and 1 ∶ 2).Under the fluorescence microscope,the targeted microbubbles were equally surrounded by bright green or red fluorescence.Conclusions Ultrasound microbubbles of double genes carrying EGFP/SDF-1a and RFP/BMP2 is made successfully via biotin-streptavidin method.The optimal proportion of combining microbubbles with double gene is 1 ∶1,which can reveal the optimum load rate and stable combination.

Objective To evaluate the applied values of echocadiography in closing membranous ventricular septal defects (VSD) with the Amplatzer devices. Methods The VSD were closed by transcatheter Amplatzer closure devices in nine patients. The patients′ age ranged between 15-45 years old,mean (26?10) years old. The VSD diameter was measured from 3 to 15 mm. Seven patients were guided by transthoracic echocardiography and 2 patients by transesophageal echocardiography. Results All VSD were successfully closed by the Amplatzer devices, without complications. The device size ranged from 6 to 18 mm. No residual shunt and complication were detected by the echocadiography in intraoperation and 3 or 4 days after operation. Conclusions Echocardiography plays an important role in closing VSD with Amplatzer device, not only in intraoperative guidance and monitor, but also in post-operative follow up study.

Objective To evaluate the systolic and diastolic function in hypertrophic segments by myocardial strain rate imaging in the patients with hypertrophic cardiomyopathy (HCM).Methods Ten patients with HCM in the mid segment of the ventricular septum and 20 age-matched healthy controls were included.The myocardial strain rate (SR) curves in bas,mid and apical segments were respectively acquired on the left ventricular septum longitudinal axis position for all the participants,and the SR curves of endocardial,mid-myocardial,epicardial layers in mid segment were also acquired.The SR values including the peak systolic SR,the peak early-diastolic SR,the peak late-diastolic SR were respectively measured,the left ventricular eject fraction (EF) and the Doppler transmitral filling velocities (E and A values) were also measured.Results SR values measured from the hypertrophic segments were significantly lower than those from the corresponding segments of the septum in control group (P

Objective To evaluate the difference of myocardium strain between myocadial infarction and ventricular aneurysm (VA) by two-dimensional speckle-tracking imaging in rabbits.Methods 26 healthy New Zealand white rabbits were enrolled in this study,6 were put into the control group and 20 in the experimental group.models of myocardial infarction concomitant with VA were prepared by the ligation of the middle segment of left anterior descending artery and left circumflex artery.At 4 weeks after the procedure,according to the pathological inspect and echocardiography for whether VA formed,the experimental animals were divided into the VA group and the myocadial infarction group.Echocardiography was performed to measure the LV cavity size and cardiac function.Radial strain rate (SrR) and circumferential strain rate(SrC) indexes were measured by 2D-STI software for each animal at the level of apex in left ventricular short-axis view,and then calculated the strain rate decrease percentage in each segment.Results 1)Compared with the control group,SrR-S,SrR-E,SrR A,SrC-S,SrC-E,SrC-A in all segments were reduced significantly in the VA group and the myocadial infarction group (P ＜ 0.05),the VA group was the most significant.2)Compared with the myocadial infarction group,the strain rate decrease percentage of SrR-S,SrR-E,SrR-A,SrC-S,SrC-E,SrC-A in all segment had significant in the VA group.Comparison between the each section,the strain rate decrease percentage of SrR-Santerior wall,SrR-Sateral wall,SrC-Santerior wall,SrC-Slateral wall were the most significant.3)There were the tighter relationship between the strain rate decrease percentage of SrR-Santerior wall,SrC-Santerior wall,SrR-Slateral wall,SrC-Slateral wall and left ventricular ejection fraction (r =0.82,0.72,0.75,0.71,repectively,all P ＜ 0.05).4) The ROC curve analysis showed that when the strain rate decrease percentage was 60％ as the critical point,the strain rate decrease percentage of SrC-Santerior wall,SrC-Slateral wall,SrR-Santerior wall,SrR-Slateral wall had a sensitivity of 83.30 ％,84.40％,83.30％,67.70％％ and a specificity was 73.60％,78.20％％,69.70％,83.30％ for prognosis ventricular aneurysm,repectively.Conclusions After ventricular aneurysm formation,anterior and lateral wall myocardial strain were give priority to the myocardial mechanics reconstruction,thus systolic myocardial strain rate decrease percentage can be important indicator of infarction myocardial developing into ventricular aneurysm.

Objective To assess the value of the myocardial segment number of color change in the bull's eyes of three-dimensional speckle tracking echocardiography (3D-STE)in the detection of multi-vessel coronary stenosis at the resting state.Methods A total of 125 consecutive patients were enrolled and divided into the following three groups according to the coronary angiography(CAG):multi-vessel coronary stenosis group (n=48),single-vessel stenosis group(n =34)and control group (n =43).All patients underwent two-dimensional (2D)and three-dimensional echocardiography (3D)and three-dimensional speckle tracking echocardiography (STE).The bull's eyes of left ventricular 17 myocardial segments including longitudinal strain(LS),circumferential strain (CS),area strain(AS)and radial strain(RS)were acquired by 3D-STE.The homogeneous colors were regarded as normal wall motion myocardial segment (LS,CS,AS is a uniform red,RS for uniform blue ),the colors were uneven or shallower,or changes were regarded as abnormal wall motion myocardial segment.The myocardial segment number of color change in the bull's eyes can be calculated.Receiver operating characteristic (ROC ) curves were computed to determine optimal strain cutoff values to predict multi-vessel coronary stenosis.Results The myocardial segments of abnormal wall motion in the bull's eyes (LS,CS,AS,and RS)were significantly increased compared with the control group(P <0.001).In particular,the multi-vessel coronary stenosis group were dramatically increased than the single-vessel coronary stenosis group.Meanwhile,these parameters were higher in patients with multi-vessel coronary stenosis than in those with single-vessel coronary stenosis (P <0.05).ROC analysis demonstrated areas under the curve of 0.84 for 3D GLS,0.89 for 3D GCS,0.95 for 3D GAS,and 0.89 for 3D GRS.An optimal cutoff value of magnitude,sensitivity and specificity were LS,12,89.6%,76.7%;CS,11,89.6%,74.4%;AS,12,91.7%,88.4%;RS,13,81.2%,86.0%,respectively. Conclusions The myocardial segment number of color change in the bull's eyes by 3D-STE is useful to detect multi-vessel coronary stenosis,where in GAS are more valuable indicators with higher sensitivity and specificity.

Objective To study the best titer of recombinant adeno-associated virus serotype 2 (rAAV2) delivered to myocardium by targeted ultrasound microbubbles. Methods Twenty one adult SD rats were divided into seven groups. SonoVue attached with different titer [1.5 × 109~ 3.0 × 1011 vg/ml (virus genome/ml)] of rAAV2-EGFP was infused into the tail vein of rats, following ultrasound mediated microbubbles destruction,as experiment groups. Normal saline was infused into the tail vein of rats as the control group (without rAAV2). Rats were killed after 14 days and hearts were harvested. GFP protein expression which showed rAAV2 transfer was observed under fluorescence microscope in frozen section and integrate optical density(IOD) was measured by Image Pro Plus software. Results When the titer of rAAV2 was 1.5 × 1011 vg/ml infused into the tail vein of rats there was much more GFP expression in myocardium than lower titers (P <0.01). Conclusions The best titer of rAAV2 delivered to myocardium by targeted ultrasound microbubbles is 1.5 × 1011 vg/ml in the tail vein infusion of rats.

Objective To evaluate the early changes of left ventricular (LV) diastolic function in patients with diabetes mellitus (DM) by two-dimensional speckle tracking echocardiography. Methods Thirty-six patients with DM and forty-five normal subjects (NOR) were studied. The peak early (E') diastole,peak late (A') diastole of longitudinal strain rate(SrL) in 18 myocardial segments and the average peak E' and A' of SrL on base segments, mid segments, apical segments were measured on apical long-axis views respectively. The global peak E'and A' of circumferential strain rate (SrC), radial strain rate (SrR) and rotation rate (RotR) at three levers were measured on short-axis views respectively. The ratio of E' and A', untwisting rate and untwisting half-time were calculated. At the same time, LV conventional ultrasound parameters were measured. Results Compared with NOR group in SrL,E' of 15/18 segments and E'/A' of 16/18 segments were decreased in DM group,A' of 14/18 segments were increased. The E' of global SrL and SrC, E'/A' of global SrL, SrC and SrR were decreased in DM group. The A' of global SrL, SrC and SrR, E' and E'/A' of global RotR were increased. There was no significant difference in LV conventional ultrasound parameters, untwisting rate and untwisting half-time between DM and NOR groups. Conclusions The decrease of SrL and SrC, increase of RotR and disappearance of myocardial regular movement in SrL and SrR are the early changes of diastolic dysfunction in patients with DM.

Objective To study the changes of left ventricular structure and function after transcatheter closure of atrial septal defect(ASD)by strain rate(SR)imaging.Methods Twenty-eight patients with secundum type ASD were undergone transcatheter closure.Left and right ventricular end-diastolic diameter(LVED and RVED),left ventricular ejection fraction(LVEF),the Doppler transmitral filling velocities(E values and A values)and tricuspid regurgitation pressure were measured respectively at pre-operation,3 days,1 month and 3 months of post-operation.According to tricuspid regurgitation pressure,systolic pulmonary artery pressure(SPAP)was estimated.SR curves in all segments of left ventricular walls were acquired for all patients.The SR values including the peak of systolic SR,early-diastolic SR,late-diastolic SR were measured respectively.ResultsAfter operation,LVED,LVEF,E values and A values increased significantly while RVED and SPAP decreased.Almost all left ventricular walls' SR increased at post-operation except that SR of interventricular septeum(IVS)and left ventricular post wall(LVPW)decreased at 3 days,1 month of post-operation.Conclusions LV systolic and diastolic function are improved after operation,but SR characteristic changes of IVS and LVPW is the one of the most unique characters.

Objective To evaluate the value of peak time(PT) and corrected peak time(PTc) in the assessment of left ventricular long axis systolic function in patients with dilated cardiomyopathy(DCM).Methods Thirty-one DCM cases and thirty-six healthy cases were investigated using echocardiography.To obtain image of apical four-chamber view and apical two-chamber view, PT was measured by the technique of tissue motion annular displacement.The value of PTc was corrected by R-R interval.The critical value of PT and PTc was obtained by ROC curves.Results Compared with the PT of control group, the PT of DCM group at the site of septal and lateral were significantly increased ( P ＜0.05), but the PT at the site of anterior and inferior were no significantly increased ( P ＞0.05).The PTc at the four sites were significantly increased compared with control group ( P ＜0.05).The areas of under the ROC curve of PTc was 0.849 (95 % CI 0.699～0.929, P = 0.000), sensitivity and specificity of diagnosis cardiac dysfunction were 80.6 % and 66.7% respectively.Conclusions The PTc was significantly increased in patients with DCM.PTc was useful to evaluate left ventricular dysfunction in DCM patients.