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 left atrial (LA) function by real-time three-dimensional echocardiography (RT-3D) and speckle tracking imaging (STI) after circumferential ablation of pulmonay vein ostia for atrial fibrillation guided by carto mapping system. Methods Thirty patients who had ablation procedure for paroxysmal atrial fibillation were accepted echocardiography to estimate the LA function at pre-operation,3 days and 3 months of post-operation. The LA maximal, minimal and pre-systolic volume (LAVmax, LAVmin and LAVp), LA passive ejection fraction (LAPEF), LA active ejection fraction (LAAEF) were measured by RT-3DE respectively. The strain rate curve was acquired in each LA segment (anterior, posterior, lateral, inferior and septal) by STI. Systolic strain rate (SRs), early diastolic strain (SRe) and late diastolic strain rate(SRa) of each left atrial segments were measured. Results Comparing with preoperative,3 days post-ablation SRs,SRe and SRa decreased significantly in each wall of LA. After 3 months,SRa and SRe in anterior, inferior and septal were significantly improved, however, SRs showed no significant difference. LAVmax and LAVpre were significantly decreased. LAPEF and LAAEF were significantly improved. Conclusions The patients with circumferential pulmonary vein ablation were in a deterioration after three days. The pump function and conduit functions of left atrial were increased after 3 months.

Objective To measure the parameters of mitral valve leaflets and mitral annulus in patientswithmildmitralregurgitation( MR )byreal timethree-dimensionaltransesophagealechocardiography (RT-3D-TEE),and explored the mechanism of MR.MethodsFifty-seven MR subjects were selected and twenty-eight subjects without mitral regurgitation were served as control group,all subjects were examined by RT-3D-TEE and acquired image,mitral valve quantification (MVQ) software was used for post-processing.Mitral annulus parameters (H/DAIPm,E2D,θAv-Mv,mitral annulus θnpa) and mitral valve leaflets parameters(A3DE,L2DAIPm,VA1-3tentVp1-3tentVtentHtentθnpa ) at the end of systolic were measured.The results of two groups were compared,and the most affected parameters to mild mitralregurgitation were selected.Results Compared with control group,VA3tent was decreased,mitral annulus θnpa and L2DAIPm increased,and the mitral valve leaflets θnpa was independently correlation factor of mild mitral regurgitation.ConclusionsThe mitral annulus geometry to flat in subjects with mild MR,the mitral valve local area is increased in subjects with mild MR,the mitral valve leaflets θnpa is independently correlation factor of mild mitral regurgitation.

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 left ventricular (LV) remodeling and function after acute myocardial infarction (MI) in rats using speckle tracking imaging (STI). Methods The left anterior descending coronary was ligated to induce MI in twenty normal rats. One day after creation of MI, fifty survivals based on the diagnostic criteria of MI were divided into 4 groups as follows:pre-infarction, 1 day,4weeks,and 8 weeks after MI. Echocardiography was performed to evaluate the changes of left ventricularfunction in rats. M-mode and two-dimensional cross-sectional echocardiography data were acquired at the papillary muscle level and digitally stored for further analysis. Circumferential strain rate(SRcir) and radial strain rate(SRrad) indexes were measured by STI software for each animal. Results One day after MI,indexes of SRcir and SRrad in anterior and lateral segments were significantly decreased (P ＜0.01, for both). Four weeks after MI,compared with baseline,SRrad and SRcir were decreased in all segments ( P ＜0.01). Eight weeks after MI, however, SRrad and SRcir showed no significant difference compared with 4weeks group. Conclusions STI can correctly identify LV dysfunction in rats and can be used for serial assessment of cardiac remodeling in rats models.

ObjectiveTo evaluate the clinical effects of surgery using scar flap in situ combined with radiotherapy in 24 hours in the restorative treatment of keloids on the auricula and the preventive effects of the therapy in the recurrence of the keloids.MethodsThe scar flap in situ was designed,its size was large enough for covering the wound of the keloid on the auricula.The keloids along the designed lines were excised using local anesthesia,the flap was clipped into the one with even thickness and suitable size which covered the wound tensionlessly to ensure that the scar flap in situ survived well,and then the wound was bandaged with pressure and drained when necessary.18-24 hours after the surgery the wound was perpendicularly irradiated by the 5 MeV high energy electron beam (beta particle) of the Siemens Primus linear accelerator.After the dressing change was performed and the drain was removed; the wound was exposed to the irradiation,3-4 Gy segmentation dose per time,and the wound was then bandaged with pressure.The radiation was performed every two days and four times altogether with a total irradiation dose of 12-16 Gy.Stitches were removed 8-10 days after the surgery.ResultsThere were no avascular necrosis in the 25 scar flaps in situ and the wounds were all primary healing with normal color and fine appearance.All the patients were satisfied with the surgery.There was no recurrence of the 23 patients during the 8 to 42 months' follow-up,but there was a tendency to recur in 2 patients after 4-6 months,and the recurrence was controlled after the beta methasone was locally injected for 2-4 times.ConclusionsIt is not necessary to harvest the flaps on the other sites applying the sear flap in situ in the restorative treatment of keloids on the auricula,and therefore it prevents the formation of the keloids on the donor sites.Furthermore,the surgery is simple and the appearance of the auricula is fine,and it presents satisfactory clinical effects to irradiate the wound in 24 hours after the surgery.

BACKGROUND:Due to the different transplantation time after myocardial infarction, the homing ability of bone marrow mesenchymal stem cels to damaged tissues as wel as the repairing role wil be very different. OBJECTIVE:To explore the optimal window time for the homing of bone marrow mesenchymal stem cels to the myocardial tissue after myocardial infarction. METHODS: Eighteen Chinese miniature pigs were modeled by the ligation of left anterior descending coronary artery. BrdU-labeled bone marrow mesenchymal stem cels were injectedvia the coronary artery at 1 day, 3 days, 1 week, 2 weeks, 3 weeks, 4 weeks after modeling, respectively. Then, the animals were kiled at 3 days after cel transplantation to detect the home of bone marrow mesenchymal stem cels in the infarct zone. RESULTS AND CONCLUSION:BrdU-labeled positive cels with brown nuclei were visible at 1 day, 3 days, 1 week, 2 weeks, 3 weeks, and 4 weeks after myocardial infarction, especialy at 1 week after myocardial infarction (P < 0.05). It indicates that the best homing window for bone marrow mesenchymal stem cels was at week after myocardial infarction, when the stem cel transplantation is given to be able to promote myocardial repair.

BACKGROUND:Occluder closure of atrial septal defect exhibits clear function, safety and efficiency advantages ＜br> OBJECTIVE:Using real-time three-dimensional echocardiography (RT-3DE) technique to evaluate the effect of atrial septal defect occlusion using different occluders on left ventricular structure and motion of the mitral annulus. ＜br> METHODS:Thirty-seven cases diagnosed as atrial septal defect underwent atrial septal defect occlusion, including 20 males and 17 females, aged 20-60 years. The occluder was chosen individual y according to defect size and edge hardness. Conventional and RT-3DE examinations were performed at 1 day prior to occlusion, 1 and 3 months after occlusion. ＜br> RESULTS AND CONCLUSION:Four of 37 patients were withdrawn from the study because of poor RT-3DE results. The other 33 patients harvested good occlusion results. At 1 and 3 months after occlusion, left ventricular end diastolic volume, left ventricular end systolic volume, left atrial end diastolic volume, left atrial end systolic volume were significantly increased (P＜0.05). Moreover, the more increase in these parameters occurred at 3 months after occlusion (P＜0.05). There were no significant changes in left ventricular ejection fraction and mitral annular displacement at three different time points. Left ventricular volume change rate and left atrial volume change rate were positively correlated to the type of occluders, while there was no correlation between endocardial cushion stump and mitral annular displacement. These findings suggest that atrial septal defect occlusion can increase the volume of the left ventricle and left atrium, but exhibit no effect on the motion of the mitral annulus.

BACKGROUND:Stromal cel-derived factor-1 (SDF-1) is one of the most powerful chemokines in myocardial infarction region and plays a particularly pivotal role in the homing of stem cels to an injured myocardium and promoting angiogenesis. On the other hand the microbubble and acoustics active substances carrying targetable ligands can be prepared into targeted ultrasound contrast agents that can be combined with living cels used for molecular imaging. The key of ultrasonic molecular imaging is to find imaging targets, and to successfuly prepare targeted ultrasound contrast agent which can be combined with the imaging target specificaly and efficiently. OBJECTIVE:To prepare and evaluate targeted microbubble contrast agents with SDF-1 monoclonal antibody. METHODS:Targeted microbubble contrast agent with SDF-1 monoclonal antibody was prepared using the biotin-streptavidin method. The physiochemical properties of targeted microbubble contrast agent were evaluated by appearance, pH, particle diameter, optical and fluorescence microscope and flow cytometry test. Four minipigs underwent ligation of the left anterior descending coronary artery to complete the establishment of acute myocardial infarction model, and another two minipigs were subject to thoracotomy but no ligation of the coronary artery. Then, al animals were injected with microbubble contrast agents. The stability of microbubbles was assessed by immunofluorescence testin vivo. RESULTS AND CONCLUSION:SDF-1 and microbubbles were combined by biotin-streptavidin method.In vitro appearance of the contrast agent was translucent yelow or green, and stratified after standing. pH vaule was 7.02±0.12 for non-targeted contrast agent and 6.10±0.19 for targeted microbubble contrast agent. Under the fluorescence microscope, the distribution and size of targeted microbubbles were uniform, and the microbubbles were surrounded by bright and ring shaped green fluorescence that had no changes after highly shaking. The diameter of microbubbles was (2 422.62±238.82) nm after carrying the SDF-1 antibody. Flow cytometry results showed that the carrying rate of targeted contrast agents was stable in different periods.In vivo test showed that targeted microbubbles gathered in vascular endothelial cel surface after acute myocardial infarction. These findings indicate that the targeted microbubble contrast agent carrying SDF-1 monoclonal antibody prepared by biotin-streptavidin method can be combined with vascular endothelial cels, and the binding rate is high and stablein vitro.

Objective To investigate the relationship between the content of stromal cell-derived factor-1 (SDF-1) in myocardium in different period of myocardial infarction and left ventricular function.Methods Twenty three Chinese miniature pigs were randomly divided into the experimental group and the control group.The swines in experimental group were prepared as acute myocardial infarction model by ligating anterior descending coronary artery and were randomly divided into 6 subgroups according to the different time points after infarction.The left ventricular end-diastolic diameter (LVDd),left ventricular ejection fraction (LVEF) and left ventricular fraction shortening (LVFS) were measured respectively.Global circumferential strain (GCS) and global radial strain (GRS) of left ventricle were measured.The content of SDF-1 were also measured by real-time quantitative PCR.Results Compared with the control group,SDF-1 levels were significantly elevated,and LVEF,LVFS,GCS and GRS were reduced.However,LVDd were significantly increased.The content of SDF-1 and GCS has a negative correlation (r =-0.580,P =0.000).Conclusions The content of SDF-1 in myocardial tissue have a certain relationship with GCS of left ventricular myocardium.