Objective:To explore the correlation among cardiac troponin I (cTnI),cardiac troponin T (cTnT),crea-tine kinase isoenzyme (CK-MB)levels and range of myocardial infarction in aged patients with acute myocardial in-farction (AMI).Methods:Clinical data of 80 aged AMI patients hospitalized in our internal medicine department from Sep 2012 to Sep 2013 were retrospectively analyzed.Correlation among levels of cTnI,cTnT,CK-MB and range of myocardial infarction were analyzed before and one week after treatment.Results:Compared with before treatment,there were significant reductions in levels of cTnI [(4.63±0.21)μg/L vs.(0.15±0.03)μg/L],cTnT [(0.71±0.05)μg/L vs.(0.17±0.01)μg/L],CK-MB [(40.21±2.13)U/L vs.(23.32±2.11)U/L]and myo-cardial infarction area [(35.25±4.65)mm2 vs.(23.17±3.76)mm2 ]after treatment,P <0.01 all;Pearson cor-relation analysis indicated that cTnI,cTnT and CK-MB were all positively correlated with myocardial infarction area (r =0.99,0.98,0.95,P <0.01 all).Conclusion:Cardiac troponin I,T and creatine kinase isoenzyme are closely related to myocardial infarction range.Combination of these three indexes can be used as important basis for judging myocardial infarction range in patients with myocardial infarction.

OBJECTIVE:To observe the clinical efficacy and safety of different doses of atorvastatin in the treatment of chron-ic subdural hematoma(CSDH). METHODS:One hundred and tweaty-eighie CSDH patients selected from our hospital during Jun. 2013-May 2015 were divided into observation group(n=62)and control group(n=66)in accordance with random number table. Both groups were given conventional treatment of brain cell nutrition. Control group received Atorvastatin tablet 20 mg,po,qd;observation group received Atorvastatin tablet 40 mg,po,qd. Both groups were treated for 6 months. Clinical efficacy,CSS and ADL score,hematoma volume,the levels of serum inflammatory factors (hs-CRP,MMP-9,IL-6,TNF-α) were observed in 2 groups. ADR was recorded during treatment and recurrence rate was also recorded. RESULTS:2 patients withdrew from observa-tion group and 6 from control group. Finally,120 patients met the criteria were included,with 60 cases in each group. Total re-sponse rate of observation group(88.3%)was significantly better than that of control group(73.3%),with statistical significance (P<0.05). After 1,3,6 months of treatment,CSS score,hematoma volume,the serum levels of hs-CRP,MMP-9,IL-6 and TNF-α in 2 groups were significantly decreased,while ADL score was increased significantly;the improvement of above indexes in observation group was significantly better than in control group,with statistical significance(P<0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). The recurrence rate of control group(13.3%)was significantly higher than that of observation group(3.3%),with statistical significance(P<0.05). CONCLUSIONS:Daily dose of shows ator-vastatin 40 mg better therapeutic efficacy and lower recurrence rate in the treatment of CSDH with good safety.

Objective: To explore the correlation among cardiac troponin I (cTnI), cardiac troponin T (cTnT), creatine kinase isoenzyme (CK-MB) levels and range of myocardial infarction in aged patients with acute myocardial infarction (AMI). Methods: Clinical data of 80 aged AMI patients hospitalized in our internal medicine department from Sep 2012 to Sep 2013 were retrospectively analyzed. Correlation among levels of cTnI, cTnT, CK-MB and range of myocardial infarction were analyzed before and one week after treatment. Results: Compared with before treatment, there were significant reductions in levels of cTnI [(4.63±0.21) μg/L vs. (0.15±0.03) μg/L], cTnT[(0.71±0.05) μg/L vs. (0.17±0.01) μg/L], CK-MB [(40.21±2.13) U/L vs. (23.32±2.11) U/L] and myocardial infarction area [(35.25±4.65) mm2 vs. (23.17±3.76)mm2] after treatment, P<0.01 all; Pearson correlation analysis indicated that cTnI, cTnT and CK-MB were all positively correlated with myocardial infarction area (r=0.99, 0.98, 0.95, P<0.01 all). Conclusions: Cardiac troponin I, T and creatine kinase isoenzyme are closely related to myocardial infarction range. Combination of these three indexes can be used as important basis for judging myocardial infarction range in patients with myocardial infarction.

Objective To quantitatively assess the left ventricular systolic dyssynchrony in patients with varied degrees of chronic congestive heart failure after old myocardial infarction(OMI) by real-time three-dimensional echocardiography(RT-3DE) and investigate the clinical value of the systolic dyssynchrony index(SDI). Methods Forty patients with congestive heart failure after OMI (infarction group) were divided into the severe dysfunction group (LVEF ≤35 %) and the mild dysfunction group (35 % ＜ LVEF＜50%) ,and 30 normal subjects served as the control. RT-3DE was performed on all subjects to obtain the 17-segmental time-volumetric curves and global systolic function. SDI changes in above groups and the correlation between SDI and LVEF were analyzed. Results The SDI of the infarction group was significantly higher than that of the normal control group ( P ＜0. 01 ). The SDI of the severe dysfunction group was significantly higher than that of the mild group (P＜0.01). SDI and LVEF were negatively correlated ( r = -0.84, P ＜0. 01 ). The dyssynchrony rate in the infarction group was 85 %,in the severe dysfunction group was 100%, in the mild group was 75%. Conclusions Left ventricular systolic dyssynchrony is prevalent in patients with OMI, and it is negatively correlated with the LVEF. SDI is a sensitive indicator in assessing left ventricular systolic dyssynchrony. RT-3DE has a unique advantage in the evaluation of the left ventricular systolic dyssynchrony,especially in the patients with myocardial infarction.

Objective To assess the left ventricular function of patients with acute myocardial infarction (AMI) treated by percutaneous coronary intervention (PCI) by speckle tracking imaging (STI).Methods 75 AMI patients who had AMI for the first time and have been treated by primary PCI were enrolled.Dynamic images were acquired before PCI,at 6 months after PCI and analyzed by STI.Dynamic images were analyzed for longitudinal peak systolic strain (LPSS),radial peak systolic strain (RPSS) and circumferential peak systolic strain (CPSS) values by STI.According to the comparison of left ventricular ejection fraction (LVEF) before PCI and 6 months after PCI,patients were divided into left ventricular function improved group (△LVEF≥5％) and not-improved group.Results Compared to non-improved group,LPSS (P ＜0.001),RPSS (P ＜0.05,P ＜0.001) and CPSS (P ＜0.001) of improved group were all higher before and 6 months after PCI.LPSS (r =-0.578,P ＜0.001) and CPSS (r =-0.817,P ＜0.001) before PCI were both closely related to △LVEF.In single parameter mode of ROC curve analysis,the area under the ROC curve (AUC) (0.867),sensitivity (94.7％) and specificity (74.4％) of CPSS are relatively higher than other STI parameters.In multiple parameters united mode of ROC curve analysis,AUC (0.897),sensitivity (94.7％) and specificity (74.4％) of LPSS,RPSS and CPSS united were the highest among all the combinations of all STI parameters.Conclusions Left ventricular function improvement of patients with AMI 6 months after PCI is accurately assessed and predicted by STI.CPSS is a strong predictor for left ventricular function improvement 6 months after PCI of AMI patients among all the STI parameters and is an effective indicator for the assessment of left ventricular function improvement of AMI patients.

Objective To assess left ventricular(LV) longitudinal strain in patients with coronary heart disease by two-dimensional speckle tracking imaging (2DSTI),and to explore the clinical value of 2D longitudinal strain in detecting myocardial ischemia. Methods Forty-four patients with coronary heart disease (CHD group) and 28 age-matched subjects (control group) were enrolled into this study. The two-dimensional data were obtained in apical 4-chamble, 2-chamber and long axis view. And the longitudinal strains of every segments, the average longitudinal strain of LV 18 segments (SL18), the average longitudinal strain of 12 segments (SL12,excluded the 6 apical segments) were analyzed. Results In the patients with CHD, the longitudinal strain of ischemia segments and the global LV longitudinal strain were significantly decreased than that of the control subjects. Both in patients with CHD and in control subjects,the longitudinal strains in apical segments were higher than that of middle and basal segments. There was significant difference between SL18 and SL12 ( P=0.027 in CHD group and P =0.003 in control group).Receiver operating curve (ROC) analysis demonstrated that the cutoff point of SL18 to detect myocardial ischemia was - 18.8％ (sensitivity 80.2％ and specificity 74.1％ ) ,and the cutoff point of SL12 to detect myocardial ischemia was - 17.8％ ( sensitivity 81.7％ and specificity 85.6％ ). Conclusions 2D longitudinal strain was sensitive to detect myocardial ischemia, SL12 was better than SL18 in detecting myocardial ischemia. 2DSTI might be useful for identifying patients with severe CHD.

ObjectiveTo assess the clinical values of the longitudinal strain delay index(LSDI) and the delay of time in peak anterospetal wall to posterior wall strain(TAS-POST),which are analyzed by speckle tracking imaging,was discussed in the article.Methods The study included 39 patients with acute myocardial infarction,37 patients with coronary heart disease but not acute myocardial infarction which was confirmed by selective coronary angiography and 30 age-gender-related volunteers.Two-dimensional echocardiography was performed to collect dynamic images of left ventricular apical long axis view,two-chamber view,four-chamber view and parasternal short axis mitral view,papillary view and apical view.The time to minimal systolic longitudinal,radial,circumferential strain (Tssl,Tssr and Tssc) were measured from the start point of QRS wave of electrocardiogram.The left ventricular segmental standard deviation (Tssl-SD,Tssr-SD,Tssc-SD) and maximal difference (Tssl-Dif,Tssr-Dif,Tssc-Dif) were calculated.The left ventricular dyssynchrony was defined as TAS-POST≥130 ms and LSDI≥25％.ResultsThe dyssynchrony parameters in the acute myocardial infarction group were significantly increased compared to the control group ( P ＜0.001 or P ＜0.05 ).The parameters in the myocardial ischemia group were also higher than those in the control group ( P ＜0.05).Linear regression showed that LSDI was positive correlated with TAS-POST( r =0.676,P ＜0.05).In acute myocardial infarction group,LSDI was more sensitive in the detection of left ventricular dyssynchrony than TAS-POST ( P ＜ 0.05 ).Conclusions Left ventricular dyssynchrony can be evaluate accurately by speckle tracking imaging.LSDI and TAS-POST are quantitative parameters for the evaluation of left ventricular dyssynchrony in coronary heart disease.

Objective To evaluate the usefulness of speckle tracking imaging(STI) for assessment of left ventricular(LV) and right ventricular (RV) functions in patients with isolated disease of right coronary artery.Methods 45 cases were diagnosed as single right coronary lesions given echocardiography,30 cases had chest pain but coronary angiography had not seen the obvious narrow as a comparison.The twodimensional loop-cinec were obtained in apical 4-chamber view,apical 2-chamber view and long axis of LV view.Eighteen segments of LV longitudinal peak systolic strain,global peak systolic strain of each view and three segments of RV free wall were measured by two-dimensional strain software.Results In the patients who had right coronary lesions but did not happen myocardial infarction,the strain(S) values in the base,mid and apex segmental of LV post wall,the base and mid segmental of LV inferior wall and the base and mid segmental of LV septum were significantly lower( P ＜0.05).The S values in the mid segment of RV free wall was lower( P ＜0.05).In the patients who had right coronary lesions and myocardial infarction,the S values in the base,mid segmental of LV antsept,the apex segmental of LV anterior wall,the base,mid and apex segmental of LV post wall,the base and mid segmental of LV inferior wall and the base and mid segmental of LV septum were significantly lower( P ＜0.05).The S values in the mid and apex segments of RV free wall were lower ( P ＜0.05).And the LV global longitudinal strains were lower in the two groups (P ＜0.05).Conclusions STI is a new and useful technology for assessment ventricular functions in patients with isolated disease of right coronary artery,and there are multiple segments impaired.

Objective To explore the clinical significance of sinus heart rate turbulence (HRT)and heart rate variability (HRV) in patients with chronic obstructive pulmonary disease(COPD).Methods The 59 moderate to severe COPD patients and 30 healthy subjects were enrolled in this study. The 24-hour holter monitor was used to screen the HRT onset (TO), turbulence slope (TS)and HRV. Pulmonary function tests and echocardiographic examination were performed for measuring left ventricular ejection fraction (LVEF), right atrial dimension (RAD), right ventricular dimension (RVD), right ventricular wall thickness (RVWT). Then all the parameters were compared between NC group and COPD group, and the relationship between HRT and HRV was investigated. Results Compared with control group, TO was significantly increased [(-0.2±1.1) % vs.(-3.8±2.8) %, t=6. 830,P＜0.01] and TS was decreased [(7.0±3.6) ms/RR vs. (11.7±6.1) ms/RR, t =3. 866, P＜0.01] in COPD group. In time domain HRV parameters, normal RR intervallerinin standart deviation(SDNN), standard deviation of normal-to-normal beats index (SDNNi), standard deviation of the averages of normal sinus to normal sinus (SDANN), mean squared differences of the successive RR intervals (rMSDD), fraction of consecutive normal sinus intervals that differ by more than 50 ms (PNN50) were significantly lower in COPD group than in control group(P＜0. 05). TO was negatively correlated with SDANN and rMSDD (r=-0. 369, P＜0. 05; r=-0.472, P＜0.01).TS was positively correlated with SDNN, SDANN and PNN50 (all P＜0.05), but had no correlation with rMSDD (P＞0. 05). Conclusions HRT and HRV are dramatically blunted in COPD patients.Combination of HRV and prognosis. and HRT may be simple and elegant ways for evaluating cardiac autonomic functions.

Objective To assess the left ventricular dyssynchrony in coronary artery disease(CAD) without visual segmental wall motion abnormalities using strain delay index (SDI).Methods A total of 135 patients under suspicion of CAD were recruited in this study.Two-dimensional cchocardiography was performed to collect dynamic images of left ventricular apical long axis views,tow-chamber views,four chamber views and parasternal short axis mitral views,papillary views and apical views.The time to minimal systolic longitudinal,radial,circumferential strain (Tssl,Tssr and Tssc) were measured from the start point of QRS wave in electrocardiogram.The left ventricular segmental standard deviation (Tssl-SD,Tssr-SD,Tssc-SD),maximal difference (Tssl-Dif,Tssr-Dif,Tssc-Dif) and longitudinal,radial,circumferential SDI (LSDI,RSDI,CSDI) of 18 left ventricular segments were calculated.Results According to coronary angiography results,patients were divided into three groups:severe stenosis group,mild stenosis group and control group.Compared with the other two groups,SDI and Tssl-SD,Tssl-Dif were decreased in severe stenosis group (P ＜0.001 or P ＜0.05).However,there were not significant differences between the mild stenosis group and the control group except Tssr-SD.The receiver operating characteristic (ROC) curves analysis demonstrated that LSDI had the highest accuracy and Tssl-SD had the lowest accuracy for detecting severe CAD (areas under the curve were 0.891,0.797,0.666,0.580 and 0.556 respectively).High sensitivity and specificity (80.6％ and 86.7％,respectively) were shown when using-12.67％ as a cutoff point of LSDI to diagnose severe CAD.Conclusions SDI can be helpful for assessing the left ventricular dyssynchrony in patients without visual segmental wall motion abnormalities,and LSDI is the most effective parameter to detecting severe CAD.