Objective To evaluate the echocardiographic features of apical hypertrophic cardiomyopathy( ApHCM). Methods Twenty-seven patients with ApHCM including 21 men and 6 women, average age (42.7 ± 5. 1 ) years old were followed up from 1995 to 2008 to investigate the clinical, electroeardiographic and echocardiographic features. Results The major features of ECG were increased R amplitude( V_4 > V_5 > V_3)and inverteted T wave(especially in V_(3-5) leads and the voltage of the inverteted T waves may be up to ≥10 mm). The major feature of echocardiography was the thickening of left ventricular apical wall to 15 - 37 ( 18. 0± 3. 3 ) mm. The final follow up showed that the mean thickness of the apical wall was ( 19. 7 ±3. 7) mm. The ratio of the thickness of left ventricular apical wall to posterior wall before and after the follow up was 1. 7 ±0. 3 and 1. 9 ±0. 9 respectively, with significant statistical difference ( P < 0. 05). There was no difference in the left ventricular end-diastolic dimension and left ventricular ejection fraction. The main cardiovascular events were atrial fibrillation ( 16 cases) , heart failure of NYHA ID-IV class (3 cases) , anterior wall myocardial infarction ( 1 case) and sudden death ( 1 case). Conclusions The final diagnosis of ApHCM depends on the characteristic inverteted T wave in ECG and apical hypertrophy in echocardiography. The prognosis of ApHCM is rather good for its progression is relatively slow.

Objective To evaluate left ventricular(LV) twist and untwist using velocity vector imaging(VVI) in patients with apical hypertrophic cardiomyopathy (ApHCM). Methods Twenty-three patients diagnosed with ApHCM were consecutively enrolled and compared with normal controls. After a standard echocardiographic examination, parasternal basal and apical short-axis planes were scanned to quantify LV rotations,twist and LV untwist using VVI. Results Compared with the normal controls, the rotation and rotaional velocity of apical subendocardial myocardium were markedly decreased in ApHCM patients during the period of systole ( P＜0.05) ,but the decreases in basal planes were not significant. As a consequence,LV twist was significantly lower in ApHCM patients (P＜ 0.05). Compared to normal controls,the velocity of LV untwisting was also significantly decreased in ApHCM patients ( P＜0.05).Conclusions The twist and untwist of LV subendocardial myocardium were decreased in ApHCM patients.VVI is a useful method to assess the characteristics of LV twist and untwist in ApHCM patients.

Objective:To explore the effect of self-made dynamic cardiovascular three-dimensional model combined with CBL (case-based learning) teaching method in the clerkship of valvular heart disease for medical students.Methods:Sixty five-year clinical medical undergraduates from Nanjing Medical University (Batch 2016) were randomly divided into experimental group and control group. The experimental group received dynamic cardiovascular 3D model combined with CBL teaching method, while the control group received traditional model combined with CBL teaching method. After the course, the teaching effect was evaluated by examination and questionnaire. SPSS 19.0 was used for independent sample t test and chi-square test. Results:Compared with the control group, the students in experimental group had higher scores of basic theoretical knowledge [(43.10±3.51) vs. (40.87±3.19)] and clinical thinking ability [(42.20±3.15) vs. (40.20±3.81)], with significant differences ( P<0.05). Furthermore, they showed higher evaluation and satisfaction to learning initiative and enthusiasm, mastery of theoretical knowledge, clinical thinking ability, classroom learning interest, classroom activity and clarity of knowledge teaching, with significant differences ( P<0.05). Conclusion:In the teaching of valvular heart disease clerkship, the application of self-made dynamic cardiovascular three-dimensional model combined with CBL teaching method, can cultivate students' clinical diagnostic thinking ability and improve teaching quality.