Objective To evaluate the ventricular systolic and diastolic synchronicity in elderly patients with the complete right bundle branch block (CRBBB) by Doppler tissue velocity imaging (TVI) technology. Methods The 35 elderly CRBBB patients were selected as CRBBB group, while 31 healthy people were chosen as control group to evaluate myocardial function. The time to peak velocity at systolic and early diastolic phase (Ts and Te) in the base and interlude 14 segments of left and right ventricles was measured. The average time of Ts in right ventricular 2 segments(Ts-2-RV), Ts and Te in left ventricular 12 segments (Ts-12-LV and Te-12-LV), and the standard deviation in left ventricular 12 segments (Ts-12 SD and Te-12-SD), the maximum Ts and Te difference (Ts-diff and To-dill) were calculated. The left ventricular end-systolic and end-diastolic diameter (LVEDs and LVEDd) and volume (LVEVs and LVEVd) were measured. Results (1)The time to peak velocity at systolic phase in 14 segments of left and right ventricles was longer in CRBBB group than that in control group(P<0.05 or P<0.01). Compared with the control group, the Ts-12-LV,Ts-12-SD and Ts-diff showed significant prolongation (P<0.01). The Ts-2-RV was longer than Ts-12-LV in CRBBB group[(226.3±37.4 ) ms vs. (195.5±69.5) ms, P < 0.05]. (2) There was no significant difference in the time to peak velocity at early diastolic phase in 14 segments between CRBBB group and control group(P>0.05), but the Te-12-SD and Te-diff was longer in CRBBB group than that in control group (P< 0.01). (3) The LVEDs and LVEDd were obviously increased in CRBBB group compared with controls (P<0.05 and P<0.01), but no significant difference was showed in LVEVs and LVEVd(P>0.05). Conclusions Compared with normal people, the Ts at systolic phase is longer, especially in the right ventricle, the LVEDs and LVEDd are significantly increased, and the ventricular systolic and diastolic synchronicity is not well in CRBBB patients.

Objective To observation the changes of left atrium and pulmonary veins(PV)in patients with atrial fibrillation(AF) by transthoracic two-and three-dimensional echocardiography. Methods Transthoracic echocardiography were applied in 126 patients,which were divided into sinus rhythm(SR) group(64 cases)and AF group(62 cases),AF group were further divided into two subgroups:the paroxysmal AF and non-paroxysmal AF group.Left atrial area(LAA),left atrial volume(LAV),left atrial diameter(LAD)were measured by 2-dimensional echocardiography imaging.PV diameters were measured by three-dimensional echocardiography. Results Compared with SR group,PV diameters were significantly increased in AF group(P＜0.05).In patients with AF,PV diameters in non-paroxysmal AF group were larger than paroxysmal AF group.The four PV diameters in SR,paroxysmal AF and non-paroxysmal AF group did not show statisticant difference(P＞0.05).Compared with SR group,LAD,LAA,LAV were increased in AF group.LAD,LAA,LAV were larger in non-paroxysmal AF group than SR group and paroxysmal AF group(P＜0.05).Conclusions Left atrium and PV dilate significantly in patients with AF,transthoracic echocardiography could be a non-invasive method to observe left atrium and PV.

Objective:To evaluate the changes of the left atrial systolic function in patients with acute myocardial infarction(AMI)using quantitative tissue velocity imaging(QTVI).Methods:The systolic velocities of the middle of left atrial lateral wall,anterior wall,inferior wall and atrial septum were measured with QTV1 in 45 patients with AMI.The left atrial volume and active atrial emptying fraction(AA-EF)were measured using single-plane Simpson method.Results:(1)Compared with the control group(30 normal subjects),the diameter and volume of the left atrium,as well as AA-EF,increased obviously in patients with AMI(P ＜ 0.01).(2)Compared with the control group,the systolic velocities of the middle of left atrial lateral wall,anterior wall,inferior wall and atrial septum,as well as the average value,increased significantly in patients with AMI (P ＜ 0.05 or P ＜ 0.01).In addition,the average value of left atrial systolic velocity was closely correlated with AA-EF(r=-0.906,tr=14.001,P ＜ 0.01).Conclusion:QTVI could be used to evaluate the left atrial systolic function accurately in patients with AMI.

Objective To assess the prognostic value of tissue Doppler imaging(TDI) parameters in aeute myocardial infarction(AMI) patients. Methods After one week of AMI,102 patients underwent twodimensional/Doppler echocardiography and TDI examination.Early and late transmitral flow velocity E,A,deceleration time(DT)were measured. The average velocity of mitral valve at septal and lateral weremeasured including the systolic velocity(Sm),early diastolic velocity(Em)and late diastolic velocity(Am),Em/Am,E/Em were calculated.After 1 year follow up,the patients were divided into two groups according to whether hospitalizated due to heart failure(HF)or not. Stepwise multivariate COX regression analysis was used to identify the predictors of the cardiac event. Results In patients with H F,Sm,Em were lower than those of no HF group(P＜0.05),E,E/Em were higher than those of no HF group(P＜0.05 and0.01 respectively). Stepwise multivariate COX analysis identified that the E/Em was the only independent predictors of HF.E/Em≥12 was a useful HF predictors with a sensitivity of 84.2%,specificity of 77.1%.Conclusions E/Em ratio may assist in the risk stratification in AMI,and is a powerful predictor of HF.

Objective To investigate the endothelial function and atherosclerosis in patients with coronary artery disease (CAD).Methods Two-dimensional echocardiography (2-DE) was used tomeasure changes in brachial artery inner diameter as parameter of endothelium-dependant and endothelium-nondependant vascular diastolic function and pathologic characters of carotid atherosclerosis in 90 elderly CAD patients and 30 controls.Results Endothelium-dependant vascular diastolic function and endothelium-non dependant diastolic function were significantly decreased in CAD group as compared with control group [(9.08±2.28)% and (6.14±2.21)% vs.(15.58±2.20)%, P<0.01].The carotid intima-media thickness and plaque score were significantly increased in CAD group as compared with control group.Conclusions There are correlations of endothelium dysfunction and carotid atherosclerosis are relatied to with coronary atherosclerosis.