Objective To assess the value of left ventricular (LV) twist and rotation in left-to-right shunt congenital heart diseases(CHD) by two-dimensional speckle tracking imaging(2D-STI).Methods 16 patent ductus arteriosus(PDA),20 ventricular septal defect(VSD) and 36 age,sex matched normal subjects were included.LV end-diastolic volume (LVEDV) and LV end-systolic volume (LVESV) were measured by Biplane Simpson method,then LV ejection fraction (LVEF) was calculated.Two-dimensional images in LV basal and apical short-axis views in three complete cardiac cycles were required.Using speckle tracking imaging,the rotation of 6 segments in basal and apical short-axis levels were measured in CHD patients and control subjects,respectively.Basal and apical rotation versus time profiles and LV twist versus time profiles were drawn.Correlation analysis of LVEDV,LVESV and LV peak twist and rotation were made respectively.Results Compared to the control group,LV peak twist and the apical rotation were increased in CDH patients,which was statistically significant (P ＜0.05).LV peak twist had significant correlation with LVEDV and LVESV.Conclusions LV volume overload which was caused by left-to-right shunt CHD significantly impacted LV twist and apical rotation,but has no significant effect in basal rotation.LV peak twist correlated with LVEDV and LVESV.

Objective To study the correlation between serum lipids and thyroid function after withdrawn of thyroid hormone in the patients with differentiated thyroid cancer .Methods One hundred and thirty cases of differentiated thyroid carcinoma treated by operative therapy in our hospital form August 2014 to August 2015 were selected .Serum FT4 ,TSH ,FT3 ,triglyceride ,total cho-lesterol ,LDL-C ,HDL-C indexes were detected before discontinuation of levothyroxine sodium (L-T4) ,before operation and 3 weeks after drug withdrawn .Thus the correlation between blood lipid levels and thyroid function was analyzed .Results The HDL-C and the TSH level was positively related before operation (P<0 .05) ,other indexes had no obvious correlation with thyroid function (P>0 .05);the blood lipid levels after medication withdrawn had no obvious correlation with thyroid function (P>0 .05);the total cholesterol levels after medication discontinuation had negative correlation with FT 3 and FT4 levels(P<0 .05);HDL-C was nega-tively correlated with FT3 and FT4 levels(P<0 .05) ,and positively correlated with TSH level (P<0 .05);LDL-C was negatively correlated with FT4 (P<0 .05) .Conclusion When the application treatment of thyroid hormone is suspended ,with the TSH level increase ,the HDL-C level has somewhat elevation ;total cholesterol ,HDL-C and LDL-C levels are negatively correlated with FT 3 and FT4 ,after discontinuation of medication withdrawn ,the blood lipids metabolism abnormality is closely related with thyroid function decline .

Objective To evaluate global left ventricular(LV) strain of patients with chronic renal failure(CRF) by three-dimensional speckle tracking imaging(3D-STI) and discuss the possible association between global peak strain and ejection fraction of LV.Methods The study includes 22 patients in the renal failure period,25 patients with uremia (pre-dialysis),and 20 healthy controls.Global peak longitudinal strain (GPSL),global peak area strain(GPSA) and global peak radial strain(GPSR) were measured by 3D-STI.Then possible association between GPSL,GPSA,GPSR and LVEF were discussed by the Pearson correlation analysis.Results The GPSL,GPSA,GPSR were statistically different in the control group,patients in the renal failure period and patients with uremia.There were significant differences between groups(F =13.28,4.65,4.68,P ＜ 0.01) as following,all of GPSL,GPSA,GPSR were lower in uremia group compared with control group [q =7.48(GPSL),4.19(GPSA),4.72(GPSR),P ＜0.01],GPSL was lower in renal failure group compared with control group [q =4.9 (GPSL),P ＜0.01].The Pearson correlation analysis revealed GPSL,GPSA,GPSR were strongly associated with LVEF(r =-0.679,-0.781,0.719,P ＜0.01).Conclusions In patients with CRF,the global peak strain can reveal the systolic function of left ventricle and the global peak longitudinal strain can recognize systolic dysfunction more sensitively.

Objective:To investigate the relationship between VitD 3 concentration and glucose and insulin levels of OGTT in patients with CKD 3-5 stages.Methods: We included the patients with CKD 3 and 4 and 5 stages who fulfill the including standard.All patients were recorded the concentrations of [1,25 (OH):D3]concentration of glucose and insulin at fasting ,postprandial 1 h,2 h during OGTT and concentration of glycosylated hemoglobin level ,C peptide concentration.We performed the correlation analysis about [1,25 (OH):D3],glucose and insulin.Results: We totally included 91 patients with 3-5 stages CKD into our study.The D3 concentration of stage 3 were 160.9-261.3 mmol/L[(218.38±8.67)mmol/L] of stage 3,75.2-166.3 mmol/L[(117.01±4.72) mmol/L] of stage 4 and 11.8-96.5 mmol/L[(41.91±12.83)mmol/L] of stage 5 (P<0.05).The average concentrations of serum glucose at fasting,1 h after the meal and 2 h after the meal was(4.74±0.21)mmol/L,(8.31±0.43)mmol/L and(7.36±0.32)mmol/L in 3 stage and (4.92±0.25) mmol/L,(9.14±0.15) mmol/L and (9.14±0.39)mmol/L at 4 stage and (4.81±0.13)mmol/L, (10.72±0.41)mmol/L and (10.72±0.49)mmol/L at 5 stage (P<0.05).The average concentrations of insulin during OGTT at fasting,1 h after the meal and 2 h after the meal was (6.58±0.32) μU/L,(57.78±5.63)U/L and (42.77±8.45)U/L in 3 stage (6.03±0.53)U/L,(55.69±7.35)U/L and (62.52±5.39)U/L in 4 stage and (6.12±0.65)U/L,(62.82±9.73)U/L and (77.34± 8.62)U/L in 5 stage (P<0.05).Correlation analysis shows that the concentration of 1,25 (OH):D3 of different stages of patients with CKD and vitamin D 3 concentration and glucose tolerance test was found to be inversely associated with the insulin levels ( P<0.05 ) . Conclusion:There are obvious differences of concentration of vitamin D 3 between patients with 3-5 stages of chronic kidney disease (CKD).There also showed a negative correlation relationships between glucose and insulin levels ,and vitamin D3 concentration and glucose and insulin levels at OGTT of patients with 3-5 stages CKD.

Objective To assess the left ventricular longitudinal shrinkage function in liver cirrhosis patients with two-dimensional speckle tracking imaging (2D-STI). Methods Echocardiography and Doppler echocardiography were performed in 34 patients with liver cirrhosis and 35 healthy subjects of corresponding ages. High frame rate two-dimensional images were recorded from apical long-axis view, four-chamber view and two-chamber view of left ventricle; then the left ventricular diameter, left atrium diameter, the peak filling velocity of E wave and A wave, E/A ratio, EF and FS were measured. The peak systolic strain of left ventricular segment was measured with two-dimensional strain software. Results Compared with healthy subjects, left ventricular diameter, left atrium diameter, EF and FS of liver cirrhosis patients were not statistically different (P>0.05), but the E/A ratio was lower (P<0.05). The peak systolic strain of most left ventricular segment in liver cirrhosis reduced significantly (P<0.05), except that of base segment of posterior wall, anterior wall, inferior wall, anterior and posterior interventricular septum, as well as middle segment of posterior interventricular septum. Conclusion The heart shape, systolic and diastole function of liver cirrhosis are abnormal. 2D-STI can early and accurately evaluate the systolic function of liver cirrhosis.

ObjectiveTo analyze the characteristics of left ventricular (LV) twist and discuss the relationship between LV ejection fraction (LVEF) and LV twist in patients with chronic kidney disease (CKD) by two-dimensional speckle tracking imaging (2D-STI).MethodsForty-six patients with CKD and 30 healthy controls were enrolled in this study. After conventional echocardiography, LV end-diastolic volume (LVEDV) and LV end-systolic volume (LVESV) were measured by Biplane Simpson method and the LVEF was calculated. And relevant parameters of LV rotation and twist were measured by speckle tracking imaging. Correlation analysis of LVEDV, LVESV and LV peak rotation and twist were analyzed respectively. ResultsCompared with the control group, LV peak twist and the apical rotation were decreased in CKD patients, which was statistically significant (t=0.002 and 0.020, bothP<0.05). The inferior wall and posterior intermediate septum of basal segment were significantly decreased (t=0.044 and 0.041, both P<0.05). Pearson correlation analysis revealed LV apical peak rotation had a relationship with LVEDV and LVESV (r= 0.355 and 0.409, bothP<0.01).Conclusion2D-STI is an practical noninvasive method which can analyze LV twist accurately and recognize LV systolic dysfunction of CKD patients sensitively.

To assess right ventricular free wall longitudinal myocardium deformation and examine the changes with normal age by speckle tracking imaging (STI), myocardial systolic peak strain (epsilon), systolic peak strain rate (SRs), early diastolic peak strain rate (SRe), late diastolic peak strain rate (SRa), the ratio of SRe/SRa were measured in the basal, middle and apical segments of right ventricular free wall in 75 healthy volunteers (age range: 21-71 y) by STI from the apical 4-chamber view. RV longitudinal strain and strain rate were highest in the basal segment of the free wall. Older subjects had lower early diastolic strain rate (SRe) than younger subjects, but they had higher late diastolic strain rate (SRa). A negative correlation between age and the ratio of SRe/SRa was found in all RV free wall segments (r=-0.466 - -0.614, P<0.01). It is concluded that RV diastolic strain rate changes with age and STI can be used for the study of RV myocardial deformation.
Age Factors ; Diagnostic Imaging/*methods ; Echocardiography/methods ; Heart/physiology ; Models, Statistical ; Myocardial Contraction ; Myocardium/*pathology ; Reproducibility of Results ; Stress, Mechanical ; Ventricular Dysfunction, Right ; Ventricular Function, Right

Objective To investigate the effect of right ventricular(RV)volume and RV pressure overload on left ventricular(LV)rotation and twist in patients with atrial septal defecl(ASD).Methods Using speckle tracking imaging(STI),the peak rotation of 6 segments in basal and apical short-axises was measured respectively in 35 patients with ASD(18 of which with pulmonary hypertension)and 21 healthy subjects as controls.The average peak rotation and duration time of the 6 segments in basal and apical short-axises in negative direction during early systolic phase were also measured respectively.LV twist versus time profile was drawn and the peak twist and time to peak twist were calculated.LV ejection fraction(EF)was measured by biplane Simpson method.Results Compared to ASD patients without pulmonary hypertension and healthy subjects,the peak rotation of posterior wall,inferior wall and postsept wall in basal was lower(P＜0.05).And at the basal level,the averagepeak rotation of 6 segments in negative direction during early systolic phase was higher(P＜0.05),and the average duration time was delayed(P＜0.05).LV peak twist was also lower(P＜0.05),and had a significant negative correlation with pulmonary arterial systolic pressure(r=-0.57,P=0.001).There were no significant differences in LVEF among 3 groups.Conclusions Although RV volume overload due to ASD has no significant effects on LV rotation and twist,LV peak twist is lower in ASD patients with pulmonary hypertension.Thus LV twist may be a new index which predicting whether ASD patients also has pulmonary hypertension or not.

Objective To access the left ventricular sysytolic function in children at acute stage of Kawasaki disease using speckle-tracing imaging. Methods Two-dimensional echocardiograghic images of 27 patients and 19 normals were collected in apical long-axis view, two-champer view, four-champer view, short-axis views at the levels of mitral annulus, papillary muscle and apex. The systolic peak values of longitudinal strain, radial strain and circumferential strain were measured by speckle-tracking imaging. Results Compared with controls the values of longitudinal strain and radial strain are lower in most segments in patients(P < 0.05). There were no significant differences between the patients and controls in circumferential strain(P>0.05). Longitudinal strain and radial strain measured were lower in 8 patients with coronary ectasia(including 7 cass with coronary artery aneurysms in vessels) than other 19 patients,but the two groups have no significant differences(P>0.05). Conclusions Long-axis and short-axis function of the heart decreased regardless of coronary artery ectasia.

0.05). Conclusion The sensors can eliminate the interference of Ac effectively and lay a basis for the development of practical blood sugar detector.